Fasting helps you lose weight

The importance of fasting in the treatment of obesity

Dr. med. Francoise Wilhelmi de Toledo, Ueberlingen

Fasting can be Lose weight help. It trains eating habits and helps to find a healthy lifestyle. In less than 50 years, the fat-making triad has prevailed in industrialized countries:

  • Oversupply of enjoyable food, especially fat and high in calories, also easily available
  • Insufficient muscle work and high exposure to stress
  • Heated houses

In addition to these environmental influences, there are also genetic causes. Studies with adopted children and twins have led to the estimate that the genetic makeup is responsible for 30-40% of the development of obesity (7). For example, people who have inherited a genetic disposition for it develop overweight in the "sedentary" paradise of industrialized nations , with the greatest frequency after the age of 30 and 40 (5).

In response to this development, a wide range of models of food restriction has emerged over the past few decades. The result of this collective diet marathon did not appear to have reduced the incidence of obesity in the population of the industrialized nations. Today there is no magic program that can show more than partial success, mostly only short to medium-term. Nevertheless, guidelines for serious obesity therapy have been worked out. The German Obesity Society (DAG) published its therapy guidelines in 1996 (19). The definition of obesity, normal values, guidelines for the risk evaluation of obesity and finally therapeutic measures are described: "The therapy of obesity includes dietary measures as well as exercise and behavioral therapy, which are to be used in parallel. In this way, the way of life and the quality of life can be improved." Medicines and surgical interventions currently play a subordinate role in quantitative terms.

The main feature of a modern and serious obesity therapy is the multidisciplinarity, which corresponds to the multicausality in the development of obesity.

As dietary measures, the DAG recommends low-energy mixed food and diets with extremely low energy content (VLCD) (20) with the appropriate macronutrient ratio and micronutrient substitution, again combined with a multidisciplinary program. Fasting is not spoken of in plain language, and I would like to try with my lecture to fill this void.

The importance of fasting in the treatment of obesity

Fasting is basically not a diet, and certainly not a zero diet. Fasting is also not a powder that can be bought in a supermarket, it is not to be equated with an anorexic flare-up or with chronic hunger against one's will. Fasting is a physiological ability of humans and animals (12), which can have physical-emotional, social and also a multitude of therapeutic effects.

Some definitions and some history are essential at this point:

Traditional fasting

Traditional fasting, as offered by the major world religions, did not aim to lose fat. The actual renunciation of solid food is only one aspect of fasting, which experience has shown to cleanse and regenerate the body. Two other dimensions are just as indispensable to fasting:
  • the social and human dimension: fasting connects people. Fasting periods are limited in time in all cultures, mostly recurring annually and ritualized. An entire population or community conducts a Lent and ends it together, usually with a festival. The entire social climate has a special character: solidarity, mercy ("giving alms"), reconciliation, hospitality are the main themes.
  • a spiritual dimension: It contains the idea of ​​purification, but also of repentance, the search for new orientations for one's own life. Let's hear what Niklaus Brantschen SJ (3) says on this topic: "Fasting is a whole with a health, a religious and a human-social dimension. It is an exercise that challenges the whole person with body and soul and with Fasting is a wakeful, active human event in which body and soul adjust to accepting the food, without despising it and without starving, for a certain time not from the outside, but from the inside to obtain your own depot. It is an exercise that affects all the senses and brings them to the inside! " On the occasion of a fast, Mahatma Gandhi said in November 1925: "Fasting is part of my being. I cannot do without it any more than I can do without my eyes. What the eyes are for the outer world, fasting is for the inner one!"

Therapeutic fasting

By the turn of the century, fasting had almost disappeared in the Christian tradition and was replaced by partial renunciation exercises. Naturopathic doctors like Otto Buchinger (4) or F. X. Mayr (23) updated fasting as a therapy and preventive measure in German-speaking countries. Otto Buchinger coined the word "therapeutic fasting" in 1920. By "salvation" he understood both physical health and physical and mental balance (11). He developed a method of stationary fasting, where in addition to tea, water and vegetable broth, juices and honey were also given. Rest and distance from everyday life are essential prerequisites, but also the balance between sufficient exercise and rest and the promotion of elimination processes. Complementary procedures are included for each individual indication, in groups or as individual therapy (6). This is how today's stationary fasting according to the Buchinger method came about, a multidisciplinary concept, also known as "therapeutic fasting".

Zero Diet - VLCD - Modified Fasting

The greatest confusion of definitions arose in the medical world in the 1970s, when the stationary zero diet (up to 249 days!) (18) was practiced to combat obesity - at that time without exercise, training or behavioral therapy. It was given up because of high relapse rates and a few incidents, and the outpatient, protein-modified formula fasting was developed. Because of an apparently wrong composition, the Liquid Protein Diet (8) called for death from acute cardiac arrhythmia in 17-58 obese people who had carried out this outpatient formula fasting on their own for more than three months. Since then, fasting has been with the zero diet and with the Confused with Liquid Protein Diet.

If someone stops eating solid food without care, in everyday stress, in isolation, without exercise, intestinal hygiene and psychotherapeutic care, if this person does not go through a phase of food restoration, then he has actually done a crash diet and no fasting, and crash diets are obsolete in the therapy of obesity.

Fasting for obesity therapy must therefore have the following characteristics:

  • It has to be multidisciplinary (nutritionists, exercise therapists, psychotherapists).
  • It must be professionally supervised by doctors who can remain in the background in the event of preventive fasting.
  • It has to be limited in time.
  • It must be modified appropriately.
  • Fasting must be followed by a phase of food restoration and weight maintenance.

These characteristics are currently fulfilled by the fasting clinics, which are based on the naturopathic model. They often also offer an intensive training program.

Results of fasting therapy for the treatment of medically relevant obesity

1. "Results from the 2-year rehabilitation study in Baden" (13)
321 patients were examined who had fasted for 14-21 days in a clinic using the Buchinger-Lützner method and a multidisciplinary concept. The group was then divided into a follow-up group, which was hospitalized for 2 weeks again after 1 year, and a control group. 269 ​​patients could be examined again after 2 years. 72% of the follow-up group and 60% of the control group were still below the starting weight. Lützner attributes the success primarily to the "fasting" experience with the well-known increase in wellbeing, the rapid improvement in cardiopulmonary capacity and the training and motivational work.

2. "Repeated fasting" (22)
In a fasting clinic that had existed for 40 years, the files of 372 patients who had fasted more than ten times in their lives were retrospectively analyzed (mean BMI 28, mean fasting duration 2 weeks). After fasting ten times over a period of 16 years, a third of this group was found to have a lower weight than at the beginning of the first fast. One third showed no change in weight and the last third saw weight gain, albeit less than that of the average population over the same period. The rate at which the subjects lost weight was the same for the first and all other periods of fasting. The feared yo-yo effect did not occur. None of the incidents mentioned in the zero diet could be detected (acute heart failure with ventricular fibulation, eating behavior disorders, gallstones or acidotic decompensation). The small adaptation difficulties, such as hypotonic dysregulation, listlessness, headaches can easily be remedied by naturopathic measures.

3. "Fasting and Diet for the Treatment of Polyarthritis" (9, 10)
Kjeldsen-Kragh et al. studied 53 patients with documented rheumatoid arthritis who were divided into two groups. The diet group (27 subjects) fasted for 7-10 days and was then fed vegan for 3.5 months and lacto-vegetarian for 8 months. Not only significant improvements in the main parameters for assessing polyarthritis were found, but also a normal nutritional status. This study also demonstrated the immunomodulatory effects of fasting.

4. "1 year follow-up for safety control"
A group of 182 people of normal weight who carried out a 13-day "retreat" with fasting according to the Buchinger method in a meeting center of the Catholic Church was examined. They had meditation, retreat programs, and physical exercise daily. There were no complications either during or after the fast. In the three follow-up letters there was no difference to the control group in the development of banal infections, heart disorders or eating behavior disorders. The development of the weight showed a tendency to return to the starting weight after one year.

From these studies - of which there are unfortunately too few - the following findings emerge:

  • Inpatient fasting for a period of 2-4 weeks under medical supervision with a multidisciplinary concept shows positive results in both massive and moderate obesity. Religious fasting, medically supervised, is also a safe procedure, which in our study did not result in any loss of weight or eating behavior. The fasters did not suffer, on the contrary, well-being, lightening of mood and calming down are the recognizable trends. This was documented in a study (15, 16, 17).

Who Practices Fasting Today?

In addition to the already mentioned fasting clinics, there is now a broad movement of fasting groups (21):
  • Fasting groups for healthy people with expert but non-medical guidance, usually for a week, away from everyday life.
  • Fasting walks, fasting with a religious orientation in parishes or in religious centers.

This movement has serious, traditional and naturopathic roots. It is not primarily used to treat obesity, but it has potential: Fasting as a positive experience and not as self-mortification could, in the long term, antagonize the tendency to become overweight. However, medical supervision and documentation of results in terms of safety and quality control are required.

If we assume that fasting with the multidisciplinary concept and professionally supervised deserves its place in the serious weight reduction methods, one could try to work out certain features of this method, which have an original position in the fight against obesity.

  • Lent represents an interruption of all behavior patterns. Adapted behavior therapy is well received. Fasting allows a new body sensitivity for feeling hunger and satiety during this time, but also on the occasion of the restoration of food. The difference to food cravings can easily be perceived.
  • Fasting brings the deep experience of a physiological function that one reappropriates. In this sense there is a parallel to breastfeeding, which we now know that for healthy women, physiologically and psychologically, it surpasses milk formulas.
  • The fast-specific vegetative switchover brings people to rest, silence and internalization. It offers the chance to expand one's spectrum of enjoyment to non-material areas and not to get one's need for positive emotional valences mainly from eating and drinking. It brings ethical aspects into consideration of the problem of obesity, for example solidarity with hunger, as well as fairness in the distribution of food. For people who are looking for a spiritual path and as long as fasting is seriously accompanied, the asceticism can give a new meaning. Fasting, which is mostly done in a group, uses group dynamics and the human dimension as a powerful motivation and adjuvant to weight loss.
  • In the emotional area, the forces of repression are reduced during fasting, so that cathartic experiences are promoted. This enables emotional imbalances to be processed through appropriate psychotherapeutic support. It helps people to uncover basic needs and to take stock of their own life, which in turn can have an unspecific effect on combating obesity.
  • During fasting, you usually do not feel hungry, which is less the case with other reduction diets.

After fasting

The deep physical and physical-emotional renewal that fasting can result in gives a strong impetus to change consumer behavior (14).

Fasting, which is not primarily a weight loss method, can generally help antagonize the weight gain tendency in developed countries. If it is carried out medically correctly, according to naturopathic doctors and supplemented by national and international obesity societies, fasting is not very risky. However, this should be documented by quality control. If the human and spiritual dimension is added to the medical dimension, this can contribute to a revival of body-friendly asceticism.

The Association for Independent Health Advice trains competent fasting leaders and has developed a special concept for fasting courses.
You will find training and further education for fasting leaders here

Do you want to fast yourself? You can find qualified fasting leaders in the Healthy Eating Network.

LITERATURE:
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BLOOM W. L .: Fastings as an introduction to the treatment of obesity. In: Metabolism 8, pp. 214-220, 1959
BRANTSCHEN, N .: Experience fasting in a new way. 2nd edition, 1993
BUCHINGER, O .: The therapeutic fasting and its auxiliary methods, 20th edn., Stuttgart, Hippokrates-Verlag, 1935
DGE (Ed.): Nutrition Report 1992. Frankfurt am Main, 1992
FAHRNER, H .: Fasting as Therapy. 2nd edition, Hippokrates-Verlag, Stuttgart 1985
HAUNER, D. and Hauner, H .: Easier through life: Advice for overweight people, strategies for long-term weight loss. Trias-Thieme-Hippokrates-Emke, Stuttgart 1996
ITALLIE VAN B .; YANG, M. U .: Cardio dysfunction in obese dieters: a potentially lethal complication of rapid massive weight loss. In: Am. J Clin. Nutr. 39, pp. 695-702, 1984
KJELDSEN-KRAGH, J .: Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. In: Lancet 338, pp. 899-902, 1991
KNIES, J .: Rheumatism and nutrition, review article on nutritional therapy studies in rheumatoid arthritis. 1996
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LÜTZNER, H .: Experience-based impulses for changing consumer behavior in the dietary treatment of the metabolic syndrome: Results from the 2-year rehabilitation study in Baden. In: Current Nutritional Medicine 4, 20th year, Aug. 1995
LÜTZNER, H .: Active dietetics: Hippokrates Verlag, Stuttgart 1993
PEPER, E. et al .: Stationary therapeutic fasting - effectiveness on physical and emotional well-being as well as quality of life. In: Journal of General Practice (in press)
PEPER, E. et al .: Inpatient therapeutic fasting - pre / post questionnaire on physical and emotional well-being as well as changes experienced. In: Prevention and Rehabilitation (in press)
PEPER, E.et al .: Stationary therapeutic fasting - current and catamnestic effects on physical and emotional well-being, changes experienced and quality of life. In: Journal of General Practice (in press)
THOMSON, T.J .: Treatment of obesity by total fasting for up to 249 days. In: Lancet 2, pp. 992-996, 1966
WECHSLER, J.G. et al .: Therapy of Obesity. In: Deutsches Ärzteblatt 36, 1993
Review in: The Use of Very Low Calorie Diets in Obesity: Report on Health an Social Subjects 31, Her Majesty's Stationery Office, London 1987
WILHELMI DE TOLEDO, F .: Fasting is more than eating nothing. In: UGB-Forum 2, 1996
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