How extreme was Dr. Kempner’s rice diet compared to traditional surgical approaches? Is there a safer alternative?
Can Morbid Obesity Be Reversed Through Diet?
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. Extremely low-sodium, low-fat, no animal fat, no cholesterol, 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.
He published this analysis of 106 patients who lost at least 100 pounds—not because there were only 106. He was just picking the last 100 people who lost over 100 pounds, and by the time he finished looking through their charts, six 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. Here’s a weight chart of someone who lost, in a year, nearly 300 pounds: from 430 pounds down to 130 pounds.
One 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, the rice diet is pretty drastic. Definitely don’t try this at home. 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 #1 advocate for the rice diet—Dr. Kempner himself.
The best safe approximation of the diet, so, low in sodium, and also no animal fat, protein, and cholesterol, would be a vitamin B12-fortified diet centered around whole, unprocessed plant foods. But even a medically-supervised rice diet could be considered un-drastic compared to, like, getting one’s internal organs stapled or rearranged, wiring someone’s jaws shut, or even brain surgery.
Attempts have been made to destroy the parts of the brain associated with the sensation of hunger, by irradiation, or by 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 brain lesions in very obese patients.
The surgeons defended these procedures, 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. To which a critic replied, “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 [of experimental surgery] and steam-rolling the patient’s approval.” To which 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.” But 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: this “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. Here are the current procedures, including various reconfigurations of the digestive tract. Complications of surgery occur in almost about 20% of patients, nearly one in ten of which may be death. In one of the largest studies, 1.9% 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 [diet and exercise] seems a societal travesty.”
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.
Please consider volunteering to help out on the site.
- F Quaade. Letter: Stereotaxy for obesity. Lancet. 1974 Feb 16;1(7851):267.
- [No authors listed] Editorial: Infant and adult obesity. Lancet. 1974 Jan 5;1(7845):17-8.
- J S Skyler. Walter Kempner. A biographical note. Arch Intern Med. 1974 May;133(5):752-5.
- W Kempner, B C Newborg, R L Peschel, J S Skyler. Treatment of massive obesity with rice/reduction diet program. An analysis of 106 patients with at least a 45-kg weight loss. Arch Intern Med. 1975 Dec;135(12):1575-84.
- P Klemmer, C E Grim, F C Luft. Who and what drove Walter Kempner? The rice diet revisited. Hypertension. 2014 Oct;64(4):684-8.
- W Kempner. Radical dietary treatment of hypertensive and arteriosclerotic vascular disease, heart and kidney disease, and vascular retinopathy. GP. 1954 Mar;9(3):71-92.
- M A Maggard, L R Shugarman, M Suttorp, M Maglione, H J Sugerman, E H Livingston, N T Nguyen, Z Li, W A Mojica, L Hilton, S Rhodes, S C Morton, P G Shekelle. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005 Apr 5;142(7):547-59.
- Reference Committee D, D W Martin, Chair. American Medical Association House of Delegates. Recognition of Obesity as a Disease. Resolution 420 (A-13).
- D L Katz. Perspective: Obesity is not a disease. Nature. 2014 Apr 17;508(7496):S57.
- B M Cheung, T T Cheung, N R Samaranayake. Safety of antiobesity drugs. Ther Adv Drug Saf. 2013 Aug;4(4):171-81.
- G Di Dalmazi, V Vicennati, R Pasquali, U Pagotto. The unrelenting fall of the pharmacological treatment of obesity. Endocrine. 2013 Dec;44(3):598-609.
- W Kempner. Treatment of heart and kidney disease and of hypertensive and arteriosclerotic vascular disease with the rice diet. Ann Intern Med. 1949 Nov;31(5):821-56, illust.
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. Extremely low-sodium, low-fat, no animal fat, no cholesterol, 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.
He published this analysis of 106 patients who lost at least 100 pounds—not because there were only 106. He was just picking the last 100 people who lost over 100 pounds, and by the time he finished looking through their charts, six 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. Here’s a weight chart of someone who lost, in a year, nearly 300 pounds: from 430 pounds down to 130 pounds.
One 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, the rice diet is pretty drastic. Definitely don’t try this at home. 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 #1 advocate for the rice diet—Dr. Kempner himself.
The best safe approximation of the diet, so, low in sodium, and also no animal fat, protein, and cholesterol, would be a vitamin B12-fortified diet centered around whole, unprocessed plant foods. But even a medically-supervised rice diet could be considered un-drastic compared to, like, getting one’s internal organs stapled or rearranged, wiring someone’s jaws shut, or even brain surgery.
Attempts have been made to destroy the parts of the brain associated with the sensation of hunger, by irradiation, or by 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 brain lesions in very obese patients.
The surgeons defended these procedures, 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. To which a critic replied, “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 [of experimental surgery] and steam-rolling the patient’s approval.” To which 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.” But 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: this “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. Here are the current procedures, including various reconfigurations of the digestive tract. Complications of surgery occur in almost about 20% of patients, nearly one in ten of which may be death. In one of the largest studies, 1.9% 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 [diet and exercise] seems a societal travesty.”
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.
Please consider volunteering to help out on the site.
- F Quaade. Letter: Stereotaxy for obesity. Lancet. 1974 Feb 16;1(7851):267.
- [No authors listed] Editorial: Infant and adult obesity. Lancet. 1974 Jan 5;1(7845):17-8.
- J S Skyler. Walter Kempner. A biographical note. Arch Intern Med. 1974 May;133(5):752-5.
- W Kempner, B C Newborg, R L Peschel, J S Skyler. Treatment of massive obesity with rice/reduction diet program. An analysis of 106 patients with at least a 45-kg weight loss. Arch Intern Med. 1975 Dec;135(12):1575-84.
- P Klemmer, C E Grim, F C Luft. Who and what drove Walter Kempner? The rice diet revisited. Hypertension. 2014 Oct;64(4):684-8.
- W Kempner. Radical dietary treatment of hypertensive and arteriosclerotic vascular disease, heart and kidney disease, and vascular retinopathy. GP. 1954 Mar;9(3):71-92.
- M A Maggard, L R Shugarman, M Suttorp, M Maglione, H J Sugerman, E H Livingston, N T Nguyen, Z Li, W A Mojica, L Hilton, S Rhodes, S C Morton, P G Shekelle. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005 Apr 5;142(7):547-59.
- Reference Committee D, D W Martin, Chair. American Medical Association House of Delegates. Recognition of Obesity as a Disease. Resolution 420 (A-13).
- D L Katz. Perspective: Obesity is not a disease. Nature. 2014 Apr 17;508(7496):S57.
- B M Cheung, T T Cheung, N R Samaranayake. Safety of antiobesity drugs. Ther Adv Drug Saf. 2013 Aug;4(4):171-81.
- G Di Dalmazi, V Vicennati, R Pasquali, U Pagotto. The unrelenting fall of the pharmacological treatment of obesity. Endocrine. 2013 Dec;44(3):598-609.
- W Kempner. Treatment of heart and kidney disease and of hypertensive and arteriosclerotic vascular disease with the rice diet. Ann Intern Med. 1949 Nov;31(5):821-56, illust.
Republishing "Can Morbid Obesity Be Reversed Through Diet?"
You may republish this material online or in print under our Creative Commons licence. You must attribute the article to NutritionFacts.org with a link back to our website in your republication.
If any changes are made to the original text or video, you must indicate, reasonably, what has changed about the article or video.
You may not use our material for commercial purposes.
You may not apply legal terms or technological measures that restrict others from doing anything permitted here.
If you have any questions, please Contact Us
Can Morbid Obesity Be Reversed Through Diet?
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
For more on Kempner and his rice diet, see:
- Kempner Rice Diet: Whipping Us Into Shape
- Drugs and the Demise of the Rice Diet
- Can Diabetic Retinopathy Be Reversed?
More on the surgical approach can be found in Reversing Diabetes with Surgery and Stomach Stapling Kids.
And, for more on weight, see:
- Waist Circumference Less Than Half Your Height
- Nuts and Obesity: The Weight of Evidence
- How Much Exercise to Sustain Weight Loss?
- Nutrient-Dense Approach to Weight Management
- What Diet Should Physicians Recommend?
- How to Prevent Prediabetes in Children
- Are There Foods with Negative Calories?
- Eating More to Weigh Less
- Diabetes Reversal: Is It the Calories or the Food?
- Does Apple Cider Vinegar Help with Weight Loss?
If you’re curious about weight loss pills, I did two videos on them in 2019: Are Weight Loss Pills Safe? and Are Weight Loss Pills Effective?
Stay up to date with all of my newest weight loss videos on the topic page. I also have a bunch of fasting videos coming out in 2019 and 2020.
If you haven't yet, you can subscribe to our free newsletter. With your subscription, you'll also get notifications for just-released blogs and videos. Check out our information page about our translated resources.