Case Report: 382 Day Therapeutic Fast

Features of a successful therapeutic fast of 382 days’ duration

A 27-year-old man weighing 456 pounds fasted for 382 days under clinical supervision. He lost 276 pounds (final weight 180 pounds) for an average weight loss of 0.76 pounds per day. The man was followed-up 5 years later, and he had maintained his weight at 196 lbs. This case report was published in 1973.

The authors describe case studies of other obese patients who died from fasting therapy:

“There have been reports of five fatalities coinciding with the treatment of obesity by total starvation (Cubberley, Polster & Schulman, 1965; Spencer, 1968; Garnett et al., 1969; Runcie & Thomson, 1970). One was attributed to lactic acidosis during the refeeding period following a 3 week fast (Cubberley et al., 1965). Two were considered to be due to ventricular failure, occurring during the fast, at 3 and 8 weeks respectively in patients who had shown evidence of heart failure before beginning the fast (Spencer, 1968). One patient (Runcie & Thomson, 1970) died on the thirteenth day of his fast from small bowel obstruction. Only one of the five ‘fasting’ deaths has been associated with a fast of more than 200 days’ duration. It occurred during the refeeding period after a fast of 210 days in an apparently well young woman (Garnett et al., 1969). Following this particular report doubt has been cast on the safety of the treatment of obesity by total fasting (Garnett et al., 1969; Rooth & Carlstrom, 1970). However, the allopurinol which had been given may have had unfavourable effects on nucleotide metabolism (Stewart & Fleming, 1969).”

The authors conclude:

“Short-term fasts, although demonstrating to the obese patient his ability to lose weight, have a poor long-term outlook with respect to subsequent weight gain (MacCuish et al., 1968). We have found, like Munro and colleagues (1970), that prolonged supervised therapeutic starvation of the obese patient can be a safe therapy, which is also effective if the ideal weight is reached. There is, however, likely to be occasionally a risk in some individuals, attributable to failures in different aspects of the adaptative response to fasting. Until the characteristics of these variations in response are identified, and shown to be capable of detection in their prodromal stages, extended starvation therapy must be used cautiously…Starvation therapy can be completely successful, as in the present instance.”



NCBI: Features of a successful therapeutic fast of 382 days’ duration

PDF: Features of a successful therapeutic fast of 382 days’ duration

Online Population-Based Cohort Study

An Internet Survey in a Population-Based Cohort Study

Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort is a web-based survey looking at the association of cancer risk and consuming ultra-processed foods in people in France who responded to a survey. Population-based cohort studies were previously done by calling people’s landlines, asking them to fill out surveys, and requesting that they drive to the clinic for a health examination.

Perhaps further epidemiological studies will be done primarily using online surveys, as the authors did in this paper. It would make epidemiological studies much less expensive and more readily available. But the validity of the results have not yet been verified.

Using the internet selects for younger people responding to the survey. This may not be representative of the larger population. But as these generations age, using the internet for data collection may be a useful tool.

The internet is an anonymous place, and it is difficult to understand the population that is being studied when using the World Wide Web as the only data collection vehicle. This may be a worth-while sacrifice for the convenience of bypassing what has historically been the most arduous part of studying the public’s health.


NCBI: Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort

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The Palate is a peer-reviewed online publication for medical students at the intersection of nutrition and public health.

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