The documented failure of semi-starvation diets for the obese dates back at least half a century. It begins with Albert Stunkard’s analysis of the relevant research in the mid-1950s, motivated by his desire to resolve what he called the “paradox” between his own failure to reduce obese patients successfully by diet at New York Hospital and “the widespread assumption that such treatment was easy and effective.” Stunkard managed to locate eight reports in the literature that allowed for an accurate assessment of whether semi-starvation diets worked. In 1959, he reported that the existing evidence confirmed his own failures: semi-starvation diets were “remarkably ineffective” as a treatment for obesity. Only 25 percent of the subjects discussed in these articles had lost as much as twenty pounds on their semi-starvation diets, “a small weight loss for the grossly overweight persons who are the subjects of these reports.” Only 5 percent successfully lost forty pounds. As for Stunkard’s own experience with a hundred obese patients, all prescribed “balanced” diets of eight to fifteen hundred calories a day, “only 12% were able to lose 20 lb., and only 1 patient lost 40 lb….Two years after the end of treatment only two patients had maintained their weight loss.”*76

A decade later, when Stunkard was invited to discuss obesity at Richard Nixon’s White House Conference on Food, Nutrition, and Health, he had come to believe that the adverse effects caused by semi-starvation diets as a treatment for obesity often outweighed any benefits. “Attempts at weight reduction are often accompanied by anxiety and depression, at times severe enough to warrant discontinuation,” he said. “Many obese persons today might well be better off if they learned to live with their condition and stopped subjecting themselves over and over to painful and frustrating attempts to lose weight.”