Clinical Use of a Protein-Sparing Modified Fast

    November 1978 in “ JAMA ”
    Bruce R. Bistrian
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    TLDR The Protein-Sparing Modified Fast is effective for rapid weight loss and maintaining it, but requires medical supervision and can have side effects.
    The document from 1978 discusses the Protein-Sparing Modified Fast (PSMF) as a treatment for obesity, emphasizing its effectiveness in achieving rapid weight loss while preserving muscle mass and improving physiological functions. It reports weight loss of over 18 kg in the majority of patients in large outpatient studies, with more than half of 36 patients maintaining a weight loss greater than 9 kg for up to 4.5 years. The PSMF is distinguished from dangerous liquid protein diets by its inclusion of high-quality protein and essential nutrients. It induces biochemical changes and can lead to side effects such as postural hypotension and temporary hair loss. The PSMF is recommended for individuals at least 30% over desirable body weight and requires careful medical management, including monitoring and supplementation to prevent complications. It is contraindicated in certain conditions and should be considered investigational, with informed consent advised. The document stresses the importance of a comprehensive obesity treatment program for optimal results.
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