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Medical Research Pays Off for All Americans

27th President of the United States, William Howard Taft (1857–1930)

Photo: Library of Congress

Upon reaching the White House in 1909 as 27th President of the United States, William Howard Taft (1857–1930), had already served as Solicitor General of the United States, a federal judge, first Governor-General of the Philippines, and Secretary of War. He would go on to serve as the 10th Chief Justice of the United States Supreme Court from 1921 until his death from heart failure on February 3, 1930—the only person ever to be President and Chief Justice.

Despite his unmatched public record, "Big Bill" Taft is best remembered today as the nation's heaviest chief executive, standing just under 6 feet tall and weighing in at 340 pounds. During his life, he suffered bouts of severe obesity and, especially during his Presidency, from obstructive sleep apnea—two conditions which afflict tens of millions of Americans of all ages.

William Howard Taft—Then & Now

Taft's Condition Treatment Then Treatment Today

Obesity—"Obesity" refers to excessive body fat. Men with more than 25 percent body fat and women with more than 30 percent are obese. More than 65 percent of U.S. adults are overweight or obese. The average male is 5'9.2" tall and weights 189.8 pounds; the average female, 5'3.8" and 162.9 pounds.

Serious medical conditions linked to obesity include type 2 diabetes, heart disease, high blood pressure, cancers of the colon, rectum, or prostate in men; cancer of the gallbladder, uterus, cervix, or ovaries in women. Emotional suffering may be one of its most painful results.

Strict dieting, which Pres. Taft managed successfully—for a time—and proudly described: "I have dropped potatoes entirely from my bill of fare, and also bread in all forms. Pork is also tabooed, as well as other meats in which there is a large percentage of fat. All the vegetables except potatoes are permitted, and of meats, that of all fowls is permitted. In the fish line I abstain from salmon and bluefish, which are the fat members of the fish family. I am also careful not to drink more than two glasses of water at each meal. I abstain from wines and liquors of all kinds, as well as tobacco in every form."

The method of treatment depends on the level of obesity, overall health condition, and readiness to lose weight. Treatment may include a combination of diet, exercise, behavior modification, and sometimes weight-loss drugs. In some cases of extreme obesity, bariatric surgery may be recommended.

For more on obesity and treatment, including bariatric surgery:

Sleep Apnea—Sleep apnea is a common, sometimes serious disorder. There are two types. Obstructive sleep apnea (OSA), which President Taft had, is caused by relaxation of soft tissue in the back of the throat that blocks passage of air. Central sleep apnea (CSA) is caused by irregularities in the brain's normal signals to breathe.

Most people will have a combination of both. Breathing stops or gets very shallow from 10 to 20 seconds or more and can occur 20 to 30 or more times per hour. It is more likely in men than women, and in the overweight or obese. People with sleep apnea often snore loudly. However, not all snorers have sleep apnea.

The disorder's hallmark is excessive daytime sleepiness. Additional symptoms include restless sleep, morning headache, trouble concentrating, irritability, forgetfulness, mood or behavior changes, anxiety, and depression.

People with even a few of these symptoms should visit their doctor for evaluation. Untreated, it can be life threatening. It also appears to be a risk for stroke and transient ischemic attacks (TIAs, also known as "ministrokes"), and for coronary heart disease, heart failure, irregular heartbeat, heart attack, and high blood pressure.

According to physician and Taft scholar Dr. John G. Sotos, M.D., writing in Chest, the Journal of the American College of Chest Physicians:

"It was years before Taft's aides realized his sleepiness was a sign of sickness. Taft refused their advice to see a physician.

"Taft weighed over 300 pounds his entire Presidency. He could sleep anywhere, anytime. He fell asleep during conversations with the Speaker of the House and with the Chief Justice of the Supreme Court. He publicly slept in church, at the theater, and at a funeral. He fell asleep while playing cards, while signing documents, and while eating. He became sleepy playing golf. He could sleep standing up."

"…He made so many political errors that he was called 'Taft the Blunderer' and 'Mr. Malaprop.'

"The election of 1912 took the Presidency from the 55-year-old Taft, but saved his life. Free from the strains of the White House, he dropped his weight from 340 pounds to 264 in a year. He stayed there, approximately, for the rest of his life. His decade-long sleepiness vanished. His blood pressure fell. In the last nine years of his life he was extremely effective and productive as Chief Justice on the Supreme Court…."

Although there is no cure for sleep apnea, there are a variety of treatments, depending on an individual's medical history and the severity of the disorder. Most treatment regimens begin with lifestyle changes, such as avoiding alcohol and medications that relax the central nervous system (for example, sedatives and muscle relaxants), losing weight, and quitting smoking.

Some people are helped by special pillows or devices that keep them from sleeping on their backs, or oral appliances to keep the airway open during sleep.

If these conservative methods are inadequate, doctors often recommend continuous positive airway pressure (CPAP), in which a face mask is attached to a tube and a machine that blows pressurized air into the mask and through the airway to keep it open. There are also surgical procedures that can be used to remove tissue and widen the airway. Some individuals may need a combination of therapies to successfully treat their sleep apnea.

Recent studies show that successful treatment can reduce the risk of heart and blood pressure problems.

For more on sleep apnea and its treatment:

Fall 2007 Issue: Volume 2 Number 4 Pages 24 - 25