The doctor's advice to the fat and to the lean, has long been a target for the humorous paragrapher. It is just possible, too, that they draw a picture too often true, when they describe the doctor as advising the fat patient to leave off starch, sugar and fat, and the lean one to eat them. Leanness cannot be cured by any rule of arithmetic, but only by scientific dieting. People may be lean because they eat too much fat and starch, as well as not enough. It is a matter of digestion rather than ingestion. Leanness is undoubtedly hereditary; but Nature never intended one to be too lean for vigor and endurance. Capacity for work and general health is the real standard for condition. When people fall below their average weight, with a tendency toward weakness, there is cause for apprehension.

Causes Of Leanness

Besides hereditary tendencies, mental worry, over-exertion, mental or physical, loss of sleep, inability to digest starchy food, insufficient, or too much food. Those who are too thin, or lack strength, but are otherwise well, should reckon just how much food they consume each day, and if the quantity eaten does not produce at least 3,000 calories of heat (see dietaries) for moderate work and average size, the diet is deficient. Food in great excess causes indigestion, which may prevent the formation of fat. Such persons will likely have sour stomachs and heartburn, with gaseous eructation (see gastritis and dilated stomach). Those who have excessive acid secretions will not have a sour stomach from fermentation, until the stomach becomes dilated. Persons of this tendency are nearly always hungry, and are sometimes charged with "eating so much that it makes them poor to carry it."

Diet

The first requisite is freedom from worry or mental strain. Then regular habits and plenty of sleep. Ten hours' sleep is a great aid toward the accumulation of fat. There must be no excesses of any character, and two or three moderately cold baths (in a warm room), should be taken every week. After each bath crash towels or flesh brushes must be used for at least ten minutes, until the skin glows. People who are "run down," should not usually be put on large quantities of starch and fat. The system must be toned up by moderate quantities of food that are easily digested. Malted wheat gluten and beaten eggs, with well-cookcd wheat foods, containing fine bran, will secure activity of the bowels and put the system in condition. Cream, nut butter, and malted nuts will fatten the quickest of all foods. It is a common notion that both milk and water are fattening. The ingestion of large quantities of water may cause more fat to be stored in the system, but it could not, of itself, make fat; and milk is not ordinarily more than three or four per cent. fat. Starch digestion will greatly be increased by using dry food. Tea and coffee should be dropped in favor of hot water and milk, or cereal coffee. The quantity should not exceed four or five ounces at a meal.

Particular care should be taken to dress warmly. If the leanness be due to diarrhoea or female diseases, or, in fact, any disease, they must be treated accordingly. Tobacco users should quit the habit, or at least use the least possible.