New York Times
POSTED: 01:30 a.m. HST, Oct 15, 2013
William Howard Taft, the only massively obese man ever to be president of the United States, struggled mightily to control his weight a century ago, worrying about his health and image, and endured humiliation from cartoonists who delighted in his corpulent figure. But new research has found that his weight-loss program was startlingly contemporary, and his difficulties keeping the pounds off would be familiar to many Americans today.
On the advice of his doctor, a famed weight-loss guru and author of popular diet books, he went on a low-fat, low-calorie diet. He avoided snacks. He kept a careful diary of what he ate and weighed himself daily. He hired a personal trainer and rode a horse for exercise. And he wrote his doctor, Nathaniel E. Yorke-Davies, with updates on his progress, often twice a week.
In a way, he was ahead of his time. Obesity became a medical issue by the middle of the 20th century, around the time the term "obesity" rather than "corpulence" came into vogue, said Abigail C. Saguy, a sociologist at the University of California, Los Angeles, who specializes in the study of obesity. Taft's story shows that "at least in some cases, corpulence was already treated as a medical problem early in the century," she added.
Like many dieters today, Taft, 6 feet 2 inches tall, lost weight and regained it, fluctuating from 350 to 255 pounds. He was 48 when he first contacted Yorke-Davies, and spent the remaining 25 years of his life corresponding with the doctor and consulting other physicians in a quest to control his weight.
Taft's struggles are recounted by Deborah Levine, a medical historian at Providence College in Rhode Island. She discovered the extensive correspondence between Taft and the diet doctor, including Taft's diet program, his food diary, and a log of his weight. Her findings were published Monday in The Annals of Internal Medicine.
His story, Levine said, "sheds a lot of light on what we are going through now."
Obesity — often said to be a product of our sedentary lifestyle and fast foods — has been a concern for over a century.
Obesity experts said Taft's experience highlights how very difficult it is for many fat people to lose substantial amounts of weight and keep it off, and how little progress has been made in finding a combination of foods that lead to permanent weight loss.
"Maybe we are looking for something that doesn't exist," said Dr. David B. Allison, the director of the Nutrition Obesity Research Center at the University of Alabama at Birmingham.
Doctors today would most likely offer Taft weight-loss surgery — which could have a big effect on weight — or drugs, which have a small effect at best. But the diet he was advised to follow would be largely unchanged, Allison said.
Levine became interested in Taft's story when she read old newspaper articles that mentioned he was working with Yorke-Davies to lose weight. She found their letters in the Library of Congress.
Yorke-Davies was known for creating strict personal diet plans for his patients. In a relationship sustained entirely by mail, he advised Taft to lose at least 60 to 80 pounds.
Meals were to be eaten at certain times and meats were to be weighed. Taft was to eat a small portion of lean meat or fish at every meal, cooked vegetables at lunch and dinner (no butter), a plain salad, and stewed or baked fruit (unsweetened). He got a single glass of "unsweetened" wine at lunch. The doctor also allowed his own diet product, gluten biscuits, that were produced to his specifications in London. Taft bought them and had them shipped to the U.S.
Taft tried to adhere to the program and also employed a personal trainer, known at the time as "a physical culture man."
By April 1905, six months after he first wrote to the doctor, Taft had lost 60 pounds. But even though people told him he looked good, he was "continuously hungry," he wrote the doctor.
Taft began to gain back the weight and stopped writing to the doctor, who asked Taft's friends and family what was going on. After learning Taft had regained 19 pounds, he told Taft he needed to return to his diet program or "in another three or four years you will be almost back to your original weight."
By the time Taft was inaugurated as president in 1909, he had indeed regained all he had lost, and more, weighing 354 pounds. He became the butt of jokes, with many relishing a story that he had gotten stuck in a White House bathtub.
But Taft never gave up. When he died in 1930, he weighed 280 pounds.
The tale is strikingly modern, obesity experts said. The self-monitoring — weighing himself daily, keeping a food diary — are "the fundamental tenets of changing behavior," said Dr. Kimberly Gudzune, an obesity researcher at Johns Hopkins. "Keep yourself accountable."
In some ways Taft got the sort of medical care doctors today wish they could provide. He was in constant touch with his doctor over a period of many years.
"That is really a model we try to strive for today," Gudzune said. She sees her patients once a month, a frequency that, for most primary care doctors, "is almost unheard-of."
She and others were also struck by Taft's persistent hunger pangs.
Dr. Jules Hirsch, an obesity researcher at Rockefeller University, said losing a substantial amount of weight and keeping it off amounts to telling the body it is starving. He saw this in his own pioneering studies decades ago. Fat people agreed to live in a hospital ward while they dieted to a normal weight. But they were ravenous and almost every one of them eventually succumbed to intense hunger and regained the weight that was so painfully lost.
"One of the most important drives we have is to prevent starvation," Hirsch said.