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Abnormal glucose tolerance is known to occur in the obese (Butterfield, Hanley & Whichelow, 1965) and Karam, Grodsky & Forsham (1963) have demonstrated increased insulin levels to be a feature of the response to a glucose load in overweight subjects. There has been no previous published work on the effects of prolonged starvation (over 14 days) on the carbohydrate metabolism of obese patients and this paper reports our findings in the first 12 subjects studied.

Twelve obese subjects (11F, 1M; aged 16–55 yr., 125–245% standard weight) were admitted to hospital and treated by complete starvation for 2–18 weeks (mean 7). None were known to be diabetic. Before fasting an oral glucose tolerance test (50 g.) was performed and venous blood was removed for the determination of blood sugar, plasma insulin and free fatty acid (FFA) levels at 0, 30, 60, 90 and 120 min. The fast was terminated by administering