We propose at this time to discuss, not the pathologically obese, but simply to suggest rational dietary changes for those individuals who show a tendency to accumulate an amount of adipose tissue greater than is required for the best physical efficiency and for the best physical proportions.

It may be said in passing that it is futile to try to cure the tendency to collect adipose tissue by taking anti-fat drugs. In a vast majority of cases this tendency to accumulate fat is not a disease, but simply a personal peculiarity. The fat is deposited from the excess of food over and above the needs of the body. The correction of this must evidently be the result of two things working together - first, increased activity or muscular exercise; second, decreased food. The increased activity will have to be measured somewhat by the conditions. One can simply take all the vigorous exercise out of doors that he has time to afford. If he doesn't live more than three miles from his business he ought to walk that distance at least once each day. Not less than one hour of vigorous physical exercise should be taken each day.

As to the reduction of food, no definite rule can be laid down because of the great variation of the assimilative powers of different individuals. Each individual must determine for himself how great a reduction is necessary in order to bring about a beginning of reduction of weight. When the food has been so far reduced in quantity that the individual begins to lose weight, at the rate of, say, a pound a week, the point has probably been reached where the menu may be maintained and the reduction in weight continued at the rate of a pound a week until it has been reduced to the normal for that individual. After the weight has reached the normal then a very slight increase of the amount of food may be taken to maintain the weight stationary at this point.

Various programs have been adopted by people who are reducing their weight; some abstain from breakfast, some from lunch, some from both. As the person is usually a member of the family circle, and in the house during at least two meals of the day, it would seem best on the whole for the individual to appear at the table, take part in the conversation, go through the motions of eating, but actually partake of a very light diet. In the case of a business man the following menu will be suggestive:

Breakfast

Two slices buttered toast. Cafe noir. Fresh fruit.

Lunch

Two cups hot water, if convenient; if not, two glasses cold water.

Dinner

Clear soup, bouillon, or a vegetable soup.

Meat, any kind, a moderate portion.

Potatoes, none.

Vegetables, any kind.

Salad: Lettuce or celery.

Tea.

Dessert: Fruit, stewed or canned.

If, after three months, following so light a diet as the one suggested above, together with an hour's vigorous exercise a day, there has been no reduction in weight, then the individual is justified in assuming that his case is a pathological one, and that the accumulation of fat is in his case an actual disease. He should consult a specialist. The several modes of treatment from a dietetic standpoint will be discussed in a subsequent chapter.