Metabolic Study in Human Obesity
with Isocaloric Diets High in Fat, Protein or Carbohydrate

By A. KENWICK AND G. L. S. PAWAN

IN THE dietary treatment of obesity, attention is chiefly directed to reduction of caloric intake below the theoretical caloric expenditure of the individual, energy requirement of the subjects being based on their basal metabolic rate or being assumed to be in the neighborhood of 2000 to 3000 calories a day.

Thus, if intake is reduced below these figures, it is assumed that the body must provide the energy deficit on a caloric basis and an equivalent amount of tissue must be lost. Attention is, however, entered only on the intake side of this equation, while energy outflow is assumed to be constant and little changed by external factors.

Experience has shown that many obese patients do not lose weight in the theoretically predicted manner on same calorically deficient diets and, although this failure can be comfortably attributed either to water retention or lack of cooperation on the part of the patient in adhering to the diet, it is difficult to accept these explanations in all cases.