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Catapres (Clonidine)

For many physicians the answer to those who claim they cannot lose weight is – ‘Come into hospital for two weeks, and I’ll show you that you can.’ Under hospital supervision a reducing diet providing 400-600 Calories has yet to fail. It is very important for the patient with apparently resistant obesity to know that he or she can succeed in losing weight.
On a reducing diet, people shed weight at different rates. This is because they differ in the rate at which they expend energy. Textbooks have told us that an average man needs 2,500 to 3,000 Calories per day. But there are not many average men; and for some of us this may well be an overestimate. Some people require only 1,400 to 1,600 Calories per day. For them, 1,500 Calories of food is not a reducing diet, but a normal one. On the other hand, some very active men may need 3,000 to 4,000 Calories or more per day.
This is one of the mysteries which requires careful study. Why do a few individuals need so little food energy? Some are extremely sedentary. Possibly others have an unusually thrifty metabolism. Some strains of mice are prone to very severe inherited obesity. Dr W. P. T. James in Cambridge has found that they lack the ability shown by normal animals (and by human babies) to produce extra heat when, for example, stressed or exposed to cold. Affected mice tend to store food in the form of fat instead of using it to produce heat. Perhaps, Dr James suggests, some obese people have a similar problem. This would make weight reduction difficult. However they would still lose surplus weight if their Calorie intake were sufficiently low.
During a prolonged reducing diet some people lose the ability to convert their thyroid hormone into its active form. This tends to retard weight loss.
On a reducing diet the average person will lose I kg of weight for a shortfall of 7,000 Calories, or 1 lb for a deficit of 3,200 Calories. Suppose your diet gives you 500 Calories a day less than you are used to; and suppose you add 250 Calories of exercise to each day (an hour’s walk, 20 minutes’ running, 40 minutes of golf or dancing, half an hour of swimming or tennis). Your daily shortfall will be 750 Calories. On average you will lose at least l 1/2 (2/3 kg) a week. In three months this is 20 lb. Isn’t that fast enough?

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