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History of Medicine |

Corpulence and Correspondence: President William H. Taft and the Medical Management of Obesity

Deborah I. Levine, PhD
[+] Article and Author Information

From Providence College, Providence, Rhode Island.

Acknowledgment: The author thanks A. Licia Carlson, Scott H. Podolsky, David S. Jones, and Jeremy A. Greene for insightful comments during the preparation of this manuscript and Allan M. Brandt, Charles E. Rosenberg, Nancy F. Cott, Alisha M. Rankin, Conevery B. Valencius, and Elly R. Truitt for helpful comments during the overall research and preparation of this material.

Grant Support: By Harvard University Graduate School of Arts and Sciences, Charles Warren Center for Studies in American History, and Andrew W. Mellon Postdoctoral Program “Modeling Interdisciplinary Inquiry” at Washington University in St. Louis.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0682.

Requests for Single Reprints: Deborah I. Levine, PhD, Providence College, 1 Cunningham Square Providence, RI 02918; e-mail, dlevine2@providence.edu.

Author Contributions: Conception and design: D.I. Levine.

Analysis and interpretation of the data: D.I. Levine.

Drafting of the article: D.I. Levine.

Critical revision of the article for important intellectual content: D.I. Levine.

Final approval of the article: D.I. Levine.

Provision of study materials or patients: D.I. Levine.

Statistical expertise: D.I. Levine.

Obtaining of funding: D.I. Levine.

Administrative, technical, or logistic support: D.I. Levine.

Collection and assembly of data: D.I. Levine.


Ann Intern Med. 2013;159(8): 565-570. doi:10.7326/0003-4819-159-8-201310150-00012
Text Size: A A A

This article analyzes the letters exchanged as part of the clinical weight management of President William H. Taft, one of the first public figures in U.S. history to be defined popularly in terms of his pathologic obesity. In 1905, Taft hired Dr. Nathaniel E. Yorke-Davies, an English diet expert, to supervise a weight-loss plan. Taft corresponded extensively with Yorke-Davies over the next 10 years, receiving and responding to courses of treatment via post. This correspondence is one of the few archival collections documenting physician and patient perspectives on the treatment of obesity, and it took place at the precise moment when obesity began to be framed as both a serious and medically manageable condition. This intimate clinical history of the 27th president and 10th chief justice of the Supreme Court offers a unique opportunity to examine in detail the history of the obesity experience in the United States, and it sheds light on the almost-timeless challenges of creating and maintaining long-term treatment courses for conditions like obesity.

Figures

Grahic Jump Location
Figure 1.

Taft on horseback, 1905.

Source: Library of Congress, LC-USZ62-88514.

Grahic Jump Location
Grahic Jump Location
Figure 2.

Handwritten record of William Howard Taft's weight loss from 2 December 1905 to 24 December 1905.

Source: Library of Congress, Presidential Papers of President William Howard Taft, MSS42234.

Grahic Jump Location
Grahic Jump Location
Figure 3.

Correspondence from 14 February 1906.

The letter reads, “Dear. Mr. Taft, Your letter and table of weights has come duly to hand, and I see that the total loss since you begun the dieting has reached 40 lbs, which is a nice drop and shows plainly enough that the dietary is effective and that a steady perseverance will bring you down to the desired standard. It is to be remarked, however, that during the last month, taking, say, the whole month of January the loss has not been up to average. It amounted to only about 9 lbs, whereas it ought to have been at least 14 lbs for that time. I mention this in case you may know of any way in which you have relaxed, as once you give way to any relaxation the process of reduction becomes tediously slow. I should like you to, if it is not troubling you too much, to have a list made for a complete week, showing everything you eat and drink, and stating how cooked, this would give me the opportunity to detect any errors. Believe me, Yours very truly, NE Yorke-Davies.” Source: Library of Congress, Presidential Papers of President William Howard Taft, MSS42234.

Grahic Jump Location
Grahic Jump Location
Figure 4.

Taft in the Philippines.

Source: Louisville Herald. Reprinted in Harpers’ Weekly. Vol. 49. No. 2599. 19 August 1905:1201.

Grahic Jump Location

Tables

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Letters

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Comments

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Comment
Posted on November 11, 2013
John G. Sotos, MD
University of North Carolina School of Medicine Chapel Hill, NC
Conflict of Interest: None Declared

The Oct. 15 article about the letters exchanged between President William Taft and weight loss specialist Dr. Nathaniel Yorke-Davies(1) makes several unreferenced statements at variance with my researches into Taft's obstructive sleep apnea(2). With more than 700,000 lightly indexed documents comprising Taft's papers, it is easy for key documents to go unfound, so I am hoping for clarification of 5 points.

First, was Taft really 6 feet 2 inches tall? He self-reports his height as 5 feet, 11 1/2 inches in an insurance application filed in 1900(3).

Second, the article reports Taft weighed 354 lbs in 1909 and 280 lbs at death. I uncovered no primary documentation for a weight above "335 to 340 pounds"(4), and the definitive Taft biography(5) says he weighed 244 lbs 12 months before dying -- his lowest weight since age 27.

Third, did I miss a letter trove reflecting an "extensive" correspondence lasting 10 years? From autumn 1906 through 1914, Taft and Yorke-Davies wrote to each other only 7 times (plus hints of 2 lost letters from York-Davies), with Taft writing a total of 9 sentences, the last of which declined further services from Yorke-Davies fils.

Fourth, did I miss the letters in which Yorke-Davies tried to "join [Taft's] inner circle"? Except for a congratulatory letter written upon Taft's election as President, Yorke-Davies's other 13 surviving letters focus exclusively on reducing Taft's weight. The Taft Papers' index lists no letters from Yorke-Davies to Taft's colleagues or family.

Fifth, and most importantly, I find no instance in which Taft's 7 typewritten weight reports to Yorke-Davies -- containing a total of 117 data points -- misrepresent any of his matching raw handwritten records. All match exactly. Although sometimes noncompliant, Taft's technique for recording and transmitting his weight data was meticulous. He weighed himself, always when stripped, to a precision of one ounce, and always at 8:30 to 9:00 am (he recorded the time).

Taft was scrupulously honest in all matters, public and private. Plus, as Secretary of War managing the Herculean task of building the Panama Canal, he had better things to do than tell his assistant to fudge reports to an unseen physician thousands of miles distant. He should not be used as an example of an untruthful patient.

Finally, I would submit that the article's conclusion -- about public attitudes toward obese national leaders -- is not supported by analyzing private correspondence between two individuals.

John G. Sotos, MD
University of North Carolina School of Medicine
Chapel Hill, NC
taft2013@sotos.com

(1) Corpulence and correspondence: President William H. Taft and the medical management of obesity. Ann Int Med. 2013; 159: 565-570.

(2) Sotos JG. Taft and Pickwick: sleep apnea in the White House. Chest. 2003; 124:1133-1142.

(3) Available from: William Howard Taft National Historic Site, US National Park Service, Cincinnati, OH. Accessed Nov. 1, 2001 (sic).

(4) Letter from William H. Taft to Dr. George Blumer, May 18, 1913. In: William Howard Taft Papers, Library of Congress, series 8, v.3, microfilm reel #518, page 403.

(5) Pringle HF. The Life and Times of William H. Taft. New York: Farrar & Rinehart, 1939. Page 1072.

Author's Response
Posted on February 21, 2014
Deborah I. Levine, PhD
Providence College
Conflict of Interest: None Declared
I am grateful to Dr. Sotos for his careful engagement with my recent article on William Howard Taft’s correspondence with his physician. I am familiar with Sotos’ work on the history of sleep apnea and cite it both in the brief article in Annals as well as in my in-process book manuscript on the history of obesity.

Sotos’ questions about my article bring to light several of the most important and exciting challenges that historians face in attempting to illuminate the patient experience of any illness across the decades. First, due to both a lack of exact machinery and to common fluctuations in reporting, competing measurements of height and weight abound, especially for well-known public figures. Historians must choose which sources they deem most reliable. For my work on President Taft, I chose to use sources that did not rely on self-reporting, such as notoriously inaccurate early life insurance data (1) but rather on corroborated reports of his contemporaries and early biographers (2). Either approach may well be off the mark by a few inches or pounds, which is why exact biometric knowledge of historical figures may be impossible, and it is the job of the historian to determine which sources are closest to the mark for scholarly use.

But fortunately we do not need to know the exact height or weight of a historical figure in order to find meaning in weight loss patterns, shifting communication techniques between doctor and patient, or disease-oriented approaches to obesity. This is the true gift of the historical letters exchanged between President Taft and his physician. Sotos is right to point out that the Library of Congress collection of Taft’s paper is immense and only loosely organized, but the index to that collection has 40 entries for correspondence items sent from Yorke-Davies to Taft or high ranking members of his White House during the period 1905-1914. (3) Many other items in the collection reference Taft’s treatment with Yorke-Davies and weight loss, such as Taft’s own letters to his family members and friends. Not all of these entries are individual personal letters, some are dietary regimens, receipts, or short notes, but all are important evidence of the most extensive correspondence I have been able to find in years of research searching for communication between doctor and patient for treatment of obesity during this period. Taft’s records were saved for posterity precisely because of his elite political status, and the correspondence itself existed chiefly because he chose to pursue treatment with a physician living abroad, making this a unique collection indeed.

Finally, one of the most important responsibilities of historians of medicine is to evaluate available archival materials in light of the many other sources detailing the relevant context of these sources. In this short piece in Annals, I had space only to recount a few of the political and social responses to Taft’s weight and weight loss efforts. In my forthcoming book, I am able to explore these aspects of Taft as a modern obesity patient and public figure in far more detail, as well as give a detailed analysis of the meanings behind points of departure between written and typed weight records. Still, the evidence I present in this short piece, designed to be particularly of use to a clinician audience, presents printed evidence as well as an editorial cartoon demonstrating that Taft’s weights and his attempts at weight loss were of a continuing and evolving interest to both the press and the reading public.


(1) Murphy S. Investing in Life: Insurance in Antebellum America. Baltimore: Johns Hopkins University Press, 2010.

(2) See for example, Sullivan M. Our Times: The United States, 1900-1920. New York: Scribner, 1926.

(3) Index to the Taft Manuscript Collection, Library of Congress. Page 2474.


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