A Milk Diet Cure For Obesity

An interesting lesson may be learned from a record published by Professor Debroc of Paris, who treated a man, fifty-five years of age, who weighed on admission to hospital 234 lbs., and after a year's treatment weighed only 180 lbs., the remedy employed being a severely restricted milk diet. The patient had been growing fat from the age of twenty-five. He was of sedentary habits, and given to alcoholic indulgence. Active exercise could not be prescribed, as, on account of gravel and gout, the patient could not leave his bed. Debroc therefore adopted the only method he thought practicable, viz., by giving the patient an insufficient amount of nourishment, and obliging him to consume his own fat.

He was put on an exclusive milk diet, the amount being restricted. For the first month 2 quarts a day were given, during the second month 1 1/2 quarts, and during the third month 1 quart only. He lost 27 lbs. the first two months, and 4 lbs. the third month. During the four following months the patient took less than a quart of milk a day, and his weight finally fell to 180 lbs. When reported on, the patient was in perfect health. As Burney Yeo points out in commenting on this case, it is a remarkable and most instructive instance of the small amount of food upon which existence can be maintained, and excess of weight thereby reduced without injury to health, provided the patient be kept at rest in bed. Weir Mitchell has also strongly recommended a restricted milk diet for the treatment of obesity. An admirable illustrative case is as follows: -

A lady, set. 45, 5 feet 4 1/2 ins. in height, weight 190 lbs., anaemic, feeble, and breathless. She was kept in bed for five weeks. Massage was used at first once daily, and after a fortnight twice a day, while milk was given, and in a week made the exclusive diet. Her average loss for thirty days was a pound a day, and the diet was varied by the addition of butter after the third week, so as to keep the reduction within safe limits. On the fourth week the diet was added to, and Swedish movements were added to massage, which was applied but once a day, and during the fifth week she began to sit up and move about. Her weight at the seventh week had fallen to 145 lbs., and her appearance had decidedly improved. After two years she was a well and vigorous woman.

Fluids In Obesity

Considerable difference of opinion exists as to the advisability of restricting markedly the amount of fluid taken in obesity. This much is certain. Where any highly nitrogenous dietary is in use, there should be no restriction whatever in the amount of fluid; on the contrary, at least 3 pints of fluid in the form of hot or cold water, or occasionally weak clear soup, should be taken daily, this being taken on an empty stomach between meals. Apart from this, there is no doubt that the amount of fluid taken with meals should always be restricted, and to this end soups are, as a rule, contra-indicated. When there is a special weakness of the heart and circulation, a dry diet is advisable for the sake of the heart, apart altogether from the obesity.

Plain water and the various mineral and table waters may be taken, but all sweetened beverages should be avoided. Weak tea and coffee are permissible, and should be taken without sugar and milk. All sweet wines and malt liquors should be excluded from the dietary. Alcohol in all its forms should, if possible, be avoided; but if specially indicated, should be taken in the form of mature whisky or dry, natural wine.

General Summary Of Dietetic Treatment

Every case of obesity must be treated on its merits, remembering always that there are certain broad principles to be followed. The following may be taken as a practical guide to the dietetic treatment of the average ease.

The total amount of food must be reduced, farinaceous foods in particular being very greatly restricted.

Sugar should be cut off from the dietary, saccharin being employed in its place. Dried fruits should be forbidden because of their richness in sugar, but fresh fruits may be allowed in moderation, and, when desired, may be stewed, and sweetened with saccharin. The meats should, as a rule, be selected from the leaner varieties, such articles as pork, mackerel, eel, and salmon being excluded from the list. Skimmed milk may with advantage take the place of ordinary milk, and no milk puddings should be allowed. Bread and bread foods should be given in the greatest moderation, and are often advantageously cut off altogether for a time. Green vegetables should be freely used, as they have comparatively little nutritive value, and by their bulk give a feeling of fullness. The amount of fluid taken with meals should be much reduced, and alcohol in all its forms should be avoided. Suitable exercises, either in the form of open-air exercise, Swedish movements, or massage, according to the condition of the patient, constitute a very important part of the treatment.