More or less total starvation has been used in a hospital setting to treat seriously obese patients, especially those who are to undergo elective surgery. Vitamins and minerals have to be supplied (see Chapter 11), as well as fluid, but apart from this an obese person can lose weight at about the predicted rate of 2.3 kg/week if starved completely. There are two major problems with total starvation as a means of rapid weight loss:

  • The problem of enforcement. It is very difficult to deprive someone of food and to prevent them finding more or less devious means of acquiring it — by begging or stealing from other patients, visitors and hospital volunteers, or even by walking down to the hospital shop or out-patients cafeteria.
  • As much as half the weight lost in total starvation may be protein from muscle and other tissues, in order to provide a source of amino acids for gluconeogenesis to maintain blood glucose (section 5.5.7) This is not desirable; the stress of surgery causes a considerable loss of protein (section, and it would be highly undesirable to start this loss before surgery.
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