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Obesity. Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. . Remarkable Case of Enormous Obesity . Dangers of excessive eating . . A case published at the The Lancet Journal – Vol. XII - 1826 -7 – No.199 p.360

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    1. Obesity Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health.

    2. Remarkable Case ofEnormousObesity. Dangersofexcessiveeating.

    3. A case publishedatthe The Lancet Journal– Vol. XII - 1826 -7 – No.199 p.360 Editedby Thomas Wakley London, June 23rd, 1826 • Commentsandpersonalconclusions are typed in redthroughoutthispresentation.

    4. Commentsby: Vilemar Magalhães vilemar@ewi.com.br

    5. BMI – BODY MASS INDEX • A measure of body fat is calculated by dividing an adult’s weight (in kilograms) by the square of his or her height (in meters). If you are 1.70m and 65kg BMI = 65/ (1.70 x 1.70 = 2.89) = 22,49 BMI Categories: Underweight = <18.5 Normal weight > 18.5–24.9 Overweight = 25–29.9 Obesity = BMI of 30 or greater

    6. Revealingthe cause • Thispresentationintendsto show thatmeatisnotlikelytomakeonefat, but hormonal imbalancecanberesponsible for thequantityoffoodheneedstoeat in ordertobesatisfiedandtogainweight. • The case herewithdiscussedis no doubtanexampleofthehardships a personwithhypothyroidismorunderactivethyroidgoesthroughwhennottreated. • Oursubjectisprobably a man, identified as Kröckerfrom Berlin. The case wastreated as anacute case ofobesityduetoexcessive animal proteiningestion.

    7. Name: Kröcker • Age: 37 • Occupation: Butcher • Place: Berlin, Germany. • Kröcker was not fat until he was about 30 years old. • He started to eat excessively and to gain weight, drink too much beer and eat too much salt. His health condition improved after he was received for treatment. • Important: When he was administered iodine his appetite went back to normal and so his weight. He could have had less problems if the right diagnose were found at that time. It was not possible as scientists were able to identify hypothyroidism as a illness in 1850.

    8. Symptomsofhypothyroidism a) chronic daily headache b) epigastric pain c) chronic chest pain d) intense malaise e) lethargy f) mental confusion spells g) breathlessness at rest h) bloated i) painful and tender thyroid 

    9. Kröcker’s diet • He startedtoeatlotsofmeat. The more he ate, the more hewantedtoeat. Andmostofthe time hewaseatingorsleeping. • Kröcker probablyhadintense malaise and lethargy not for eating meat, but as a symptom for his hypothyroidism condition.

    10. diet • For a bethehasfrequentlydevouredtheboiledfleshofanentirecalf in a day, seasonedonlywithsalt, in thepresenceofmanypersons. He saidoncehewouldbeable for a second. • But when aldosterone level gets too low, which can be common in some patients with cortisol deficiency, the kidneys will excrete too much salt, and it leads to low blood pressure; low blood volume; a high pulse and/or palpitations, dizziness and or lightheadedness when you stand; fatigue; and a craving for salt. Symptoms of low aldosterone can also include frequent urination, sweating, a slightly higher body temperature, and a feeling of thirst, besides the craving of salt. Potassium can fall, as well.http://www.stopthethyroidmadness.com/aldosterone/

    11. KNOWING THE FACTS • He wouldnottrusthimself in thesausagemanufactory, as hewouldeatthemincedmeatbythepound, spreading it over breadwith as littleceremony as thepeople spread treacle • Howmuchbreadwouldn’theeat in orderto consume somuchmeat? The sugar ofthebreadhasimmediateabsortionandthesame does nothappentomeat in our diets. So, whatmighthaveaggravedthisobesityproblem, thebreadorthemeat?

    12. Diet • Animal foodwashisfavouriterepast • He woulddevourfrom 8 to 10 poundsoftripeat a mealorfrom 6 to 7 poundsofbeefandsausages. • Later hegotto 16 poundsofbeefdailytosatisfyhishunger • Bywayofbreakast, orsupper, hewouldeatfromtwotothreedozenofthepettitoesofpigs • His usual drink wasbeer, ofwhichhedailydrankfromtwotothree quarts. • Comments: Drinkingbeerinterferedwiththeironabsortion. Thereforehisthyroidproblemgotworse. Andhewasdehydrating.

    13. Symptoms • As hefedhimselfthatwayhewasgraduallyincreasing in bulk. • His breathingbecomingdaily more difficult. He wasafraidofbeingcompletelychoked. • His eyesappearingto start fromhishead. • Lips: dullviolet color. • His poweroflocomotiondailydiminishing • He wasobligedto confine himselftohislargechairandhisbed. • Everynowandthenhewas in greatdangerofsuffocation. Graefereportedthe case

    14. Symptomsofhypothyroidismandnotofof a meatrich diet. • The conjunctivalliningbeingof a brightred color • The entirecountenancewasof a darkcrimson. • The pulse wastremulous, irregular, andfrequentlyintermittent. • Complaintsofgreatpulpitationoftheheart. • Although, fromtheimmenseprojectionoftheabdomen, andthehugependulonsbreasts, it wasimpossibletobringthehanduponthepartofthechestcovering it. • He couldonlyspeakatintervals, andthatwithgreatdifficulty. • The abdomenprotruded, so as to cover theupperhalfofthethighs; andonseveralpartsof its imenselydistendedsurfacewere round redish spots, ofaboutthefourthofaninch in diameter, hard andpainfultothetouch, somewhatresemblingsmall lipoma orfattytumours.

    15. STARTING HIS TREATMENT • Height: 5’4” high • The circumferenceofhisabdomen: 5’5” • The circumferenceofhisthigh: 2’4” • The circumferenceofthecalfofhislegs: 1’7” • The circumferenceofhisbreasts: 1’8” andwere 8” long. • WhenhestartedhistreatmentwithGraefe, hewasweighing 400 pounds.

    16. Chamber’ssmell • Althoughthechamber in whichhelaywaskeptvery clean, andhislinenfrequentlychanged, theodourexhaledwasexceedinglyoffensiveandresemblemuchthesmellof a dissectingroom, or a butcher’s shop, ontheeveningof a hot day. • Comments: Fat people do nothavetosmellbad. And it happenswhenthefatperson does notorcannot clean himselfwell. Some ofthemhavedifficultiescleaningtheirbodiesafterdefecating for notbeingabletoreachthepartstobecleaned.

    17. Kröcker • He wasbleedingcopiouslyandfrequentlyand for thathewasgivenlarge doses ofcalomel (commentsonnext slide), andthesubstituitionoffasting for hisenormousstuffing. "The appeal is that [fasting] is quick, but it is quick fluid loss, not substantial weight loss," says Madelyn Fernstrom, PhD, CNS, founder and director of the University of Pittsburgh Medical Center's Weight Loss Management Center.

    18. (Therapycomments: Calomel (Quicksilver) • A drug based on mercury • Indication: a) Variety of physical and mental ailments, b) Laxative and disinfectant, c) Treatment for syphilis. • It is highly toxic. Its toxicity is made worse because the mercury accumulates over time as a poison within the body. • It was believed to be an effective purgative and helped release the 'impurities' from the sick patient. • Side effects: the loss of hair and teeth permanently

    19. Medicine • Purgative medicines werefrequentlygiven. • Having purgative one can develop electrolyte imbalance and dehydration which can be serious. If blood potassium becomes deficient, one can have symptoms such as weakness, fating or rapid heartbeat and it can result in death.

    20. Diet • Strictlyvegetable diet andvegetableacids • 4 weeks later hewasreducedtoabout 316 pounds. When vegetables are taken too largely, and for too long, they are apt to produce irritation of the gastro - intestinal mucous membrane, to lessen the appetite and disturb digestion, and, partly through this effect, and partly, in all probability, through a direct depression of the circulatory function, to impair the organic processes generally, and thus occasion paleness, general weakness, and emaciation. Read more: http://chestofbooks.com/health/materia-medica-drugs/Treatise-Therapeutics-Pharmacology-Materia-Medica-Vol2/III-Vegetable-Acids.html#ixzz1yfddsGhe

    21. Iodine • During 4 monthshetooklarge doses ofiodinetoaccelerateabsorption, hewasreducedtoabout 267 pounds. • When thyroid hormone levels are too low, the body's cells can't get enough thyroid hormone and the body's processes start slowing down. As the body slows, one may notice that he feels colder, tires more easily, the skin gets drier, he becomes forgetful and depressed, and starts getting constipated. http://www.thyroid.org/patients/patient_brochures/iodine_deficiency.html

    22. August 10, 1826 • He wasactive, cheerful • Ableto resume hisformer business • He wasreducedto 209 pounds • Goodhealth • Appetitemoderate

    23. hypothyroidismchecklist(I) ____ I am gaining weight inappropriately____ I'm unable to lose weight with diet/exercise____ I am constipated, sometimes severely____ I have hypothermia/low body temperature (I feel cold when others feel hot, I need extra sweaters, etc.) ____ I feel fatigued, exhausted____ Feeling run down, sluggish, lethargic ____ My hair is coarse and dry, breaking, brittle, falling out ____ My skin is coarse, dry, scaly, and thick ____ I have a hoarse or gravely voice ____ I have puffiness and swelling around the eyes and face ____ I have pains, aches in joints, hands and feet ____ I have developed carpal-tunnel syndrome, or it's getting worse ____ I am having irregular menstrual cycles (longer, or heavier, or more frequent) ____ I am having trouble conceiving a baby ____ I feel depressed ____ I feel restless ____ My moods change easily ____ I have feelings of worthlessness ____ I have difficulty concentrating ____ I have more feelings of sadness ____ I seem to be losing interest in normal daily activities ____ I'm more forgetful lately http://thyroid.about.com/cs/basics_starthere/a/hypochecklist.htm

    24. hypothyroidismchecklist (II) ____ My hair is falling out____ I can't seem to remember things ____ I have no sex drive ____ I am getting more frequent infections, that last longer ____ I'm snoring more lately ____ I have/may have sleep apnea ____ I feel shortness of breath and tightness in the chest ____ I feel the need to yawn to get oxygen ____ My eyes feel gritty and dry ____ My eyes feel sensitive to light ____ My eyes get jumpy/tics in eyes, which makes me dizzy/vertigo and have headaches ____ I have strange feelings in neck or throat ____ I have tinnitus (ringing in ears) ____ I get recurrent sinus infections ____ I have vertigo ____ I feel some lightheadedness ____ I have severe menstrual cramps http://thyroid.about.com/cs/basics_starthere/a/hypochecklist.htm