approach of menopause in women, and diseases such as gout in which
there is a certain amount of disturbance in the blood and excretory
organs and in which the diet or the disease may be accountable for the
gain of surplus adipose tissue. Women approaching menopause may not
change their diet in the least and there may still be the noticeable
increase of fat.

~Obesity Cures.~--A great number of the "cures" are undertaken not
from a health standpoint but from the esthetic point entirely. It
makes no difference what reason is brought forward for instituting the
treatment, it is the results which count. Of the cures undertaken
which are in themselves good, but which are too strenuous for the
average "fat person" to stick to may be mentioned some of the early
cures instituted and recommended by Banting, Oertel, and Ebstein.
Obesity, then, may be said to be due to (1) heredity, (2) overeating
and drinking, (3) lack of exercise (sedentary life), (4) a combination
of the above causes. Whether the obesity is due to the lack of
exercise or the lack of exercise is due to the accumulation of fat
which causes a disinclination to move on the part of the individual,
can only be judged when a thorough examination into the life and
habits of the patient is made.

~Comparison of Food Intake and Energy Output.~--Many fat people who
claim to be small eaters in reality constantly consume more food than
their age, weight, or mode of living would necessitate. If such
patients could be prevailed upon to keep a correct chart of their
daily intake of food and the amount of exercise taken, they would be
astounded to find how much greater was the intake in comparison to the
output of energy, in other words, how much more food they ate than
they required to keep them in health. A glance at the first tables in
this text will show which foods are utilized by the body chiefly as a
source of energy.

~Uses of Food in Body.~--Physiological chemistry proves that when more
food is taken than is needed for the internal and external work of the
body, the surplus is stored for future use, first, in the liver and
muscles as glycogen for the general expenditures, and, second, as
adipose tissue for future use. Thus it is seen that when the intake is
constantly greater than the energy expenditure there must necessarily
be some way in which the body can store up the surplus fuel, and so
long as the digestion remains good and the amount of exercise limited
th