Further experience with prolon- ged therapeutic starvation in gross refractory obesity

Twenty-five patients suffering from gross refractory obesity agreed to be starved in hospital until they weighed not more than 25% over their ideal weight. Two discharged themselves prematurely, four defaulted from follow-up, and seven who for various reasons were discharged before completing their treatment have since regained weight. After a mean follow-up period of nearly 18 months 8 of the remaining 12 remained near their weight on discharge. Some kind of initial psychological assessment might improve these results, but prolonged therapeutic starvation may be of value in young patients with gross refractory obesity who are psychologically suitable and socially able to undergo such treatment.