Part Four: Analysis of the Implementation Methods and Side Effects of Starvation Therapy

II. Starvation Therapy

For severe obesity that affects work, diet must be strictly controlled. Calorie intake should be limited to the minimum physiologically tolerable level, 1000-1200 kcal per day. If the obesity does not decrease after a period of treatment or is extremely severe, the following methods can be used.

1. Short-term starvation therapy

The fasting period is based on a one-week period, with a daily calorie intake of 100-200 kcal (some give 800 kcal/day) until weight loss occurs. Afterward, depending on the situation, a daily calorie intake of 1200, 1500, or 1600 kcal can be provided to maintain weight.

2. Intermittent fasting therapy

Fast for 1-2 days per week, and follow your usual dietary control for the remaining days.

The following foods can be used as a reference for a fasting therapy diet:

(1) Lean meat, can be cooked in various ways, without adding oil, and with little or no salt.

(2) Skinless chicken, without oil.

(3) Oil-free fish or seafood can be seasoned.

(4) Eggs are best boiled in water, not fried in oil, but other methods are also acceptable.

(5) Skim milk.

(6) Soy products: such as dried tofu, tofu slices, etc., but not products processed with cooking oil.

(7) A certain amount of water, about 6 to 7 cups, without adding sugar.

Fasting therapy should not be prolonged, and close monitoring is necessary during the fasting period, with hospitalization required. Fasting therapy has certain side effects and should not be used routinely. For example, due to significant protein loss, physical strength is noticeably weakened, and anemia, hypoproteinemia, hair cessation, and hair loss may occur. Significant loss of minerals such as potassium, sodium, calcium, and iron can lead to hypokalemia, causing muscle weakness, mental disorders, and electrocardiogram changes; hyponatremia can cause hypotension and muscle cramps; calcium deficiency can cause osteoporosis; and vitamin deficiencies can also occur.

Some obese individuals, even with calorie restriction, show initial effectiveness, but weight loss becomes less noticeable after weeks or months. Research suggests this is because the body loses more protein and water in the early stages of weight loss. Pure protein produces approximately 4 kilocalories per gram, but protein tissue contains a lot of water, resulting in an actual heat production of only 0.8 kilocalories per gram. Assuming a negative energy balance of 500 kilocalories, 625 grams of protein need to be consumed. Therefore, weight loss is rapid in the early stages due to high protein consumption. However, with continued calorie restriction, the proportion of energy generated from protein breakdown gradually decreases, and weight loss comes from adipose tissue. Fat produces 10 times more energy per gram than protein; assuming a negative energy balance of 500 kilocalories, only 65 grams of fat need to be consumed, thus slowing down weight loss. Therefore, dietary therapy sometimes fails to achieve ideal results and should be combined with exercise therapy.

It must be emphasized that the success of dietary therapy hinges on the obese individual's confidence, adherence to the regimen, and the swiftness of any changes in their eating habits. It is crucial to resolutely eliminate bad habits such as a fondness for sweets, snacking, and eating before bed. Food should be clean and low in salt. Obese individuals often have excess water retention; a low-salt diet can reduce water retention, making it particularly suitable for obese individuals with hypertension. Avoid strong tea and coffee, as both stimulate gastric acid secretion and increase appetite. Furthermore, the proportions of meals should be rationally distributed: breakfast should account for 30% of total calories, lunch for 45%–50%, and dinner for 20%–25%. This arrangement facilitates calorie expenditure during work and prevents excess calories from being stored as fat due to overeating at night. With confidence, perseverance, and some scientific guidance, one can achieve their ideal weight.