Reversing Massive Obesity with Diet

Image Credit: Kristina DeMuth. This image has been modified.

Dr. Walter Kempner introduced the first comprehensive dietary program to treat chronic kidney disease and, in doing so, also revolutionized the treatment of other disorders, including obesity. Kempner was Professor Emeritus of Medicine at Duke, where he came up with the so-called rice diet, which basically consisted of rice, sugar, fruit, and fruit juices, was extremely low in sodium and fat, and included no animal fat, no cholesterol, and no animal protein. The sugar was added as a source of calories so people wouldn’t lose too much weight. But some people need to lose weight, so he started treating obese patients with a lower calorie version of the diet, which I discuss in my Can Morbid Obesity Be Reversed Through Diet? video.

He published an analysis of 106 patients who each lost at least 100 pounds. Why 106? Kempner simply picked the last 100 people who lost more than 100 pounds, and, by the time he finished reviewing their charts, 6 more had joined the so-called century club. Average weight loss among them was 141 pounds. “This study demonstrates that massively obese persons can achieve marked weight reduction, even normalization of weight, without hospitalization, surgery, or pharmacologic intervention…[O]ne important fact to be gained from this study is that, despite the misconception to the contrary, massive obesity is not an uncorrectable malady. Weight loss can be achieved, massive obesity can be corrected, and it can be done without drastic intervention.”

Well, Kempner’s rice diet is pretty drastic, so definitely don’t try this at home. In fact, the rice diet is dangerous. It’s so restrictive that it may cause serious electrolyte imbalances, unless the patient is carefully medically supervised with frequent blood and urine lab testing. Dangerous? Says who? Said the world’s number-one advocate for the rice diet: Dr. Kempner himself.

The best, safe approximation of the diet, meaning low in sodium and without fat, protein, or cholesterol from animals, would be a vitamin B12-fortified diet centered around whole, unprocessed plant foods. However, even a medically supervised rice diet could be considered un-drastic compared to procedures like getting one’s internal organs stapled or rearranged, wiring someone’s jaws shut, or even undergoing brain surgery.

Attempts have been made to destroy the parts of the brain associated with the sensation of hunger, by irradiation or going in through the skull and burning them out. “It shows how ineffective most simpler forms of treatment are that anyone should think it reasonable to produce irreversible intracranial lesions in very obese patients.” The surgeons defended these procedures, however, explaining that their “justification in attempting the operation is, of course, the very poor results of conventional therapy in gross obesity, and the dark prognosis, mental and physical, of the uncorrected condition.” In reply, a critic countered, “Such strong feelings [about how dark the prognosis is] run the risk of being conveyed to the patient, to the effect of masking the operative dangers and steam-rolling the patient’s approval.” The surgeon replied, “If any ‘steamrolling’ is taking place, it comes rather from obese patients who sometimes threaten suicide unless they are accepted for experimental surgical treatment.”

As of 2013, the American Medical Association officially declared obesity a disease, by identifying the enormous humanitarian impact of obesity as requiring the medical care and attention of other diseases. Yet the way we treat diseases these days involves drugs and surgery. Anti-obesity drugs have been pulled from the market again and again after they started killing people—an unrelenting fall of the pharmacological treatment of obesity.

The same has happened with obesity surgeries. The procedure Kempner wrote about was discontinued because of the complication of causing irreversible cirrhosis of the liver. Current procedures include various reconfigurations of the digestive tract. Complications of surgery appear to occur in about 20 percent of patients, and nearly one in ten of which may be death. In one of the largest studies, 1.9 percent of patients died within a month of the surgery. “Even if surgery proves sustainably effective, the need to rely on the rearrangement of [our] anatomy as an alternative to better use of feet and forks [that is, diet and exercise] seems a societal travesty.”


For more on Kempner and his rice diet, see my videos:

Learn more on the surgical approach in Reversing Diabetes with Surgery and Stomach Stapling Kids.

And, for more on weight, see:

In health,
Michael Greger, M.D.

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