OBESITY
Categories:
Constitutional Diseases
An excessive development of fat; it may be hereditary. It occurs
most frequently in women of middle age and in children. Its chief cause is
excessive eating and drinking, especially of the starch and sugar foods
and malt liquors, and lack of exercise. The increase of fat is in all the
normal situations and the heart and liver are often large and fatty. The
condition in general may be good or there may be inactivity of the mind
and body. Disturbances of digestion and symptoms of a fatty heart. There
is less power to resist disease. Death may occur from fatty infiltration
of the heart, resulting in dilatation or rupture.
Treatment. Must be in regulating the diet. The person must avoid all
excess in food and drink, and avoid especially foods that contain starch
and sugar. There must be regular and systematic exercise, hot baths and
massages are helps. Medicines made from the poke berry are much used and
are successful in some cases.
Diet. The food of a fleshy person should be cut down gradually. Its bulk
can be great, but its nourishing properties should be small. The diet for
reduction of obesity should consist chiefly of bulky vegetables, but not
too much of any one article or set of articles. The following list is
recommended by Dr. Hare of Philadelphia:
For Breakfast. One or two cups of coffee or tea, without milk or sugar,
but sweetened with a fraction of a grain of saccharin. Three ounces of
toasted or ordinary white bread or six ounces of brown bread; enough
butter may be used to make the bread palatable, not more than one ounce.
Sliced raw tomatoes with vinegar, or cooked tomatoes without any sugar or
fats. This diet may be varied by the use of salted or fresh fish, either
at breakfast or dinner. This fish must not be rich like salmon or
sword-fish, but rather like perch or other small fish.
Noon Meal--Dinner. One soup plate of bouillon, consomme julienne, or
other thin soup, or Mosqueras beef-jelly, followed by one piece of the
white meat of any form of fowl or a small bird. Sometimes a small piece,
the size of one's hand, of rare beef, or mutton but no fat, may be
allowed, and this should be accompanied by string beans, celery (stewed or
raw), spinach, kale, cabbage, beans, asparagus, beets and young onions.
Following this, lettuce with vinegar and a little olive oil (to make a
French dressing), a cup of black coffee or one of tea, and a little acid
fruit, such as sour grapes, tamarinds and sour oranges, or lemons may be
taken, and followed by a cigar, if the patient has such a habit.
Supper. This should consist of one or two soft boiled eggs, which may be
poached, but not fried, a few ounces of brown bread, some salad and fruit
and perhaps a glass or two of light, dry (not sweet) wine, if the patient
is accustomed to its use.
Before Going to Bed. To avoid discomfort from a sensation of hunger
during the night, the patient may take a meal of panada, or he may soak
graham or bran crackers or biscuits in water and flavor the mess with salt
and pepper. The reduction of the diet is generally best accomplished
slowly and should be accompanied by measures devoted to the utilization of
the fat present for the support of the body. Thus, the patient should not
be too heavily clad, either day or night, should resort to exercise, daily
becoming more severe, and should not drink freely of water, unless
sweating is established sufficiently to prevent the accumulation of liquid
in vessels and tissues. Baths of the proper kind, cold or Turkish, should
be used, if the patient stands them well. The bowels should be kept active
by laxative fruit or purges. Salts are useful if drinks are thrown off
rapidly. If proper exercise is impossible the rest cure with massage,
electricity, passive exertion and absolute skimmed milk diet may be
resorted to, particularly in those persons known as "fat anemics," who
have not enough red corpuscles in their blood to carry sufficient oxygen
to the tissues to complete oxidation.