The conference had been organized by Alan Howard and his colleague Ian McLean Baird. Howard was a biochemist and pathologist at the University of Cambridge who would later become the founding editor, with George Bray, of the International Journal of Obesity. Howard had become interested in carbohydrate restriction because he had been twenty pounds overweight, had unsuccessfully dieted for years, then finally lost the weight and kept it off by avoiding flour, starches, and sweets. At the London conference, Howard reviewed the literature on carbohydrate restriction dating back to Banting and concluded that this was the only effective method to induce and maintain weight loss. “A common feature of all who have written on the subject,” he said, is “that the patient’s hunger is satisfied whilst on a diet high in carbohydrate of the same caloric value, patients complain of hunger.”

After the London meeting, obesity conferences evolved from local to international affairs. The first was in Paris in 1971, hosted by European nutrition and dietetics associations. Here the sole presentation on the dietary treatment of obesity was by a collaboration from the French National Institute on Health and Medical Research (INSERM), which is the local counterpart of the NIH in the United States and the Medical Research Council in the United Kingdom. These INSERM investigators had prescribed diets of twelve to eighteen hundred calories to over a hundred obese patients, in either three or seven meals a day, and with varying amounts of carbohydrates. Weight loss increased, they reported, when the subjects divided their calories among seven meals, which served to moderate the insulin response. Moreover, “lowering the carbohydrate content of the diet increased the weight loss at both meal frequencies.”

The next conference was hosted by the NIH in Bethesda, Maryland, in October 1973. Six of the presentations at this meeting discussed the treatment of obesity by methods other than drugs or surgery. Two were on physical activity, and neither reported any significant effect of exercise on body weight. Two addressed the benefits of behavioral modification on weight loss, and neither reported any significant benefit. Of the two remaining presentations, one was by Ernst Drenick of UCLA on prolonged fasting to treat obesity—“our experiences are disappointing,” said Drenick—and the other was by Charlotte Young of Cornell on dietary treatments.