Fatalities on the liquid-protein diet: an analysis of possible causes
Frank, A.; Graham, C.; Frank, S.
International Journal of Obesity 5(3): 243-248
1981
ISSN/ISBN: 0307-0565 PMID: 7275462 Document Number: 172333
Reports of deaths in patients using variants of the liquid-protein diet (LPD) have raised questions about the safety of that procedure for the management of obesity. Case reports involving 44 publicized deaths were reviewed. Possible causes of death including such factors as potassium or electrolyte deficiencies or both, inadequate or poor-quality protein, imperfect selection or compliance of patients and associated medications or disease were examined. Findings in 8 patients are insufficient for analysis or show that the patients were not using a LPD. Of the other 36 patients 32 were inappropriately managed as judged by conservative standards; 4 patients who may have been properly managed all had known pre-existing cardiac disease. The analysis does not identify any single factor responsible for the deaths. It shows that the procedure was widely misused and suggests that this contributed in multiple ways to the fatalities. No properly managed patient died as a direct result of the LPD and the cardiac deaths could not be ascribed to the LPD. As the LPD, when properly supervised, has shown great promise in the management of obesity, it is suggested that caution be exercised in dismissing the LPD because of adverse publicity.