In 1968, the death of a morbidity obese patient while fasting sparked a debate over the safety of therapeutic fasting for obesity. However, the patient’s heart was already failing when the fast began. Older people with long term obesity tend to have cardiovascular problems due to strain of carrying so much weight for so long. It seems incongruous that a single death associated with fasting was so alarming in light of the high mortality rate that currently exists for gastric bypass surgery.

While science is discovering that gastric bypass carries significant risks, surgeons continue to routinely perform the surgery. An evaluation of therapeutic fasting and bariatric surgery for obesity determined, "Bariatric surgery is associated with disproportionately high mortality rates in both the perioperative and postoperative periods."

According to research, people who have gastric bypass surgery spend on average twice as much time in the hospital during the three years following surgery than during the three years prior to surgery, with most rehospitalizations being procedure related. Still, obese people are flocking to gastric bypass, probably because it seems easier than diet and exercise, or the abstinence required by a medically supervised fast.

Historically and scientifically, fasting has been a safer and more practical alternative. From the late 1950s to present, hundreds of doctors and researchers have safely and successfully used fasting for weight loss among the obese. Fasting can be difficult and is not practical for everyone. In addition to medical supervision, candidates should be cleared psychologically.

Fasting is inappropriate for those with certain condition, such as someone with a history of anorexia nervosa. Other psychological disorders related to histamine imbalances, such as schizophrenia, should be evaluated by a mental health professional prior to fasting. Because obesity is closely associated with eating disorders, psychotherapy is imperative for obese people considering fasting.

Research has indicated that psychotherapy can improve outcomes for those fasting for weight reduction. In 1984, four University of California Los Angeles (UCLA) professors evaluated the effects of individual and group crisis-oriented psychotherapy as an adjunct to medically supervised fasting in 72 obese patients. Individual crisis-oriented psychotherapy related significantly to successful completion of the program, to a higher percentage of excess weight lost, and to a higher percentage of patients approaching their ideal weight.

Although fasting can be a successful way to drop a substantial amount of weight, the results don’t last if the person doesn’t modify their diet and receive counseling to prevent transfer of addiction. In his book, Fasting and Eating for Health: A Medical Doctor's Program for Conquering Disease Joel Fuhrman puts it best when he says, "Fasting to lose weight without changing your diet is pointless."

References
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