The Cause of Obesity

About a generation ago, a movement that had for its objective the demonstration that obesity was often attendant on internal disease began to be generally felt. It was pointed out that many of the most obese persons were apparently not large eaters and that when they were observed in the clinic they did not lose the expected amount of weight, even though the physician believed that he was underfeeding these patients. About this time, von Noorden¹demonstrated that the heat production per kilogram of body weight was definitely lower in obese than in noramal persons. He took this fact to mean that the adiposity was caused by some serious abnormality of the metabolism. However, in so doing, he completely ignored the law of surface area, discovered by Rubner,²who, with his pupils, showed that the basal metabolism for all mammals is proportional to the area of the surface