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Stugil (Cinnarizine, Domperidone)

Start with a small glass of unsweetened orange juice or grapefruit juice (120 ml, 4 fl. oz). Follow with a cereal such as corn, wheat or oat flakes; measure this out as f cup (180 ml, 6 fl. oz), and add the same amount of skimmed milk (sugar is not permitted). Twice a week, have a boiled or poached egg instead of the cereal. A small piece of white fish (steamed or grilled) is another alternative.
Have one thin slice of whole-wheat bread or toast (an option is one small roll, two pieces of crisp-bread or a piece of matzo). As a spread use a polyunsaturated margarine (5 g, 1 teaspoon), or peanut butter (2 teaspoons), or cottage cheese (5 teaspoons) or a yeast extract, such as Marmite.
End with tea or coffee, with skimmed milk (60 ml, 2 fl. oz) and with saccharin if required. Or have a cup of yeast extract or a meat extract such as Bovril.
Tea or coffee, black or with skimmed milk (30 ml, 1 fl. oz).
Start with clear soup (without noodles) or a half grapefruit. For a main dish choose chicken, turkey, veal or other lean meat, or a white fish, or (for a treat) lobster, crab or oysters; the helpings should be 120 g (4 oz) raw weight or 90 g (3 oz) when cooked. Have a generous helping of vegetables; the choice includes asparagus, broccoli, cabbage or red cabbage, carrots, cauliflower, celery, courgette, French beans, runner beans, marrow, mushrooms, peppers, spinach, sprouts or tomatoes. Have a very small baked or boiled potato if you choose. (Vegetables must not be cooked in or garnished with butter or other fat.)
Finish with fruit: one small apple, apricot, orange, peach, plum or tangerine, or a half-grapefruit or small banana, or eight to ten grapes or strawberries (no sugar).
If you depend on a packed lunch, try two crisp-breads, a helping of cold meat as described, with lettuce, tomatoes, celery or radishes, and end with a plain yoghurt or a piece of fruit.
Tea or coffee with or without 30 ml (1 fl. oz) of skimmed milk.
Begin with a half grapefruit, fresh or baked. Choose a main course from those suggested for lunch; or have a generous helping of cottage cheese (180 g, 6 oz, 3/4 cup). This may be accompanied by a variety of salads; use lemon juice, vinegar. Tabasco sauce and a little salt as a dressing. Then a helping of fruit as at lunch, and coffee with or without 30 ml (1 fl. oz) of skimmed milk.
Late evening
If you feel like it, have one piece of bread or toast or two of crisp-bread, with one teaspoon of polyunsaturated margarine. Have a cup of tea with 1 fl. oz skimmed milk.
If your weight loss is too slow, reduce your food intake by the following:
Breakfast: omit either the cereal or the bread.
Lunch: do without the potato.
Late evening: leave out the snack, and have one of the ultra-low-energy items listed above.
Some suggested treatments are unproven, ill-advised or even dangerous. Thyroid hormone in large doses causes loss of weight even in people with normal thyroid glands, but at the risk of abnormal heart rhythm, thinning of bones, and rebound obesity at the end of the treatment. Diuretic drugs reduce weight by causing loss of water and salt, not of fat; there is little point in becoming a dehydrated fat person, and there are risks of causing diabetes and gout, and of deficiency of potassium which can harm the heart. The hormone chorionic gonadotrophin seems relatively safe, but some trials have shown it to be no better at causing weight loss than a far cheaper injection of water! The group of drugs called anorectics does decrease appetite for the first few weeks of their use, and are occasionally helpful: all of these have one or other side effect, even the most recent which can cause dizziness and diarrhea. Unusual diets have been proposed by the score: low in carbohydrate, rich in eggs and the like. None is supported by sound scientific evidence. There is no need to have the double difficulty of following an abnormal diet as well as a restricted one.
A few words are needed about really severe obesity, about the unfortunate person who became obese early in life, is now 50 to 100 per cent overweight, and has had repeated cycles of weight reduction and relapse. Some people like this, if really motivated to lose weight, can be greatly helped by operations which have the effect of decreasing appetite and of limiting the absorption of food.
Lastly, remember Samuel Johnson: ‘It is plain that if a man is too fat, he has eaten more than he should have done.’ Unsympathetic but true.

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