THE REVIEW:

The Disease That Caused Weight Loss In

King David the Great

Liubov (Louba) Ben-Noun

Ben-Gurion University of the Negev, Israel

Reviewed and Critiqued by:

Matthew David Carli
Buffalo State University
Doctor Jurgis Karuza
Adult Development PSY 327
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2 December, 2004

INTRODUCTION

Disease is for the “unfortunate” youth but is the inevitable for elders. Many

questions arise from this sad but overwhelmingly accepted irony; these questions are

what are paving the way for the field of geriatrics. Some can argue that it’s natures way

of population control but if babies can be conceived outside a mother’s womb, then can

the future of today’s or tomorrow’s older adults be that of peace and tranquility without

the fear of illness. Since the earliest of mans writings evidence of disease in later life has

been presence and fortunately so has the hope to improve the quality of life. In the past,

idea of a fountain of youth was the answer for such vague and broad questions, but today,

the questions have been narrowed down and progress is in the horizon. This article takes

us back to the time of the great King David, Israel’s second king, who ruled more than

3500 years ago. It provides a literary time machine that bridges the mysteries of

yesterday with the miracles of modern science.

SUMMARY

The article analyzed biblical passage to demonstrate King David; Israel’s second

king who suffered from weight loss in adulthood and the link to modern patients with the

same symptoms. The moral of the story would be that history repeats itself, even over

3500 years. In a deductive study, the author systematically looked at the causes of

weight loss in older adults, then from there correlated her findings to fit passages of the
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biblical passages (direct passages and not those of interpretations of various rabbis and

scholars). The main question that arose was, “what caused the weight loss of King David

and does this have modern implications?”

The attributed weight loss in older adults to three main sets of causes, first being

the social aspects, second being psychological, and the third and final one being the most

obvious: medical aspects. Her population was that of only one, King David and she

obtained all the information on his conditions from his writings.

King David’s writing described many different symptoms. A passage from Psalm

CII: 4 “…I forget to eat my bread” shows of his lack of food intake. This could also be

taken to indicate that the king suffered from anorexia. According to the article, anorexia

is defined as lack or loss of appetite (Hamerman D.) coming from Greek a + orexis

meaning literally no appetite. Then, in a later passage of Psalm CIX: 24, “My knees are

weak through fasting; and my flesh failed of fatness” gives substantial evidence at the

idea that the great King’s fasting was the direct cause of his weight loss. The true extent

of the problem was shown in a subsequent passage that states, “…my bones cleave to my

skin” (Psalm CII: 6). Since the condition reach this extreme state, it becomes compatible

with Cachexia (GK, Kakos for bad & hexis for state). Basically, Cachexia is a general

condition of ill health and malnutrition; a few of the symptoms are weakness and

emaciation both of which were explicitly mentioned in the writings of King David. This

common problem of unintentional weight loss is fairly common today in geriatric patients

(Rabinovitz M). The problem however is that this loss of weight increases the morbidity

rate in the elderly (Liu LJ, Bopp MM). Study after study supports these assumptions, for

example JF Potter, DF Schafer and RL Bohi did a retrospective study of 8,428 hospital
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patients and the results showed that being underweight and over age 60 is a strong

predictor of in hospital mortality. The Framingham study shows that the risk of death is

twice as high in those persons whose age is over 65 and who are in the lower extreme of

the body mass index (Harris T, Cook EF). So the case here is a strong, that the King’s

weight loss is one of the determining factors of his death.

Not all this weight loss might have been caused by disorders or diseases some

might be because of the King’s old age. According to C. Reife most men reach their

maximum weight in their forties, women in their fifties and then after these ages their

decline in lean body mass normally accounts for the majority of one’s weight loss. There

is also a shift from muscle mass in the extremities to fat stored in the trunk (Reife C).

Other factors that might have influenced the kings eating habits are due to the research

done by J. Morley that states, older adults eat less due to their altered metabolism and the

trend that they decrease physical activity. Other factors that affect older adults that effect

their eating habits; include poor oral hygiene (Langan LJ) or altered perception of tastes,

smells, or they steer clear of certain foods because they no longer seem palatable (Reife

C). Yet still the author feels that these physiological diagnoses do not seem feasible.

Other passages peak into the life of the great king also such as in Psalms XXII: 7,

12, “…I am a worm, and not a man; a reproach of men, and despised of the people”…and

“…trouble is near; for there is none to help”. These passages indicate loneliness, social

isolation, and neglect by others, all examples of social problems that are directly

correlated to health problems in older adults. Psychological problems like the one above

seem to be prevalent in more of King David’s writings. Psalms LI: 19 & XXXVIII: 9

speak of depression “…a broken and depressed heart” and then later followed by “I am
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feeble and depressed...” According to LJ Fitten and associates, late life depression is

associated with anorexia and the weight loss of those older adults is more than that of

younger individuals. And one key factor that is described by JE Morley is that of

excessive life burden, which is also very probable for weight loss in older adults, of

course be related to stress. Because of these strong social influences of weight loss the

author places the linkage here, for she feels that the King’s depression and social burden

got the best of him and caused his weight loss that could have been attributed to his

death, and because there are no direct medical records the King’s writings are the best

source to diagnose the great King David.

Medical conditions that might have been present in the great king are of course all

are speculative, but some of the ones that seem to be most probable are hypothyroidism,

osteoporosis, or malignancy. Hypothyroidism is a case where a person metabolism works

much slower, so in turn, it might cause a loss of appetite, but it is very unlikely that this

would have caused the extreme case of anorexia suffered by the King. Osteoporosis

might have had some impact on the king simply because there are many passages that

refer to his weak bones. For example, “My strength failed… and my bones are

consumed” and “My bones are wasted away through my anguished roaring all day long”

(Psalm XXXI: 11, XXXII: 3). The third one is malignancy, which refers to cancerous

cells that typically have the ability to spread, invade, and destroy tissue.

(http://www.healthscout.com/ency/article/002253.htm) The text states that it is possibly

the most common cause of weight loss, because the major indicators and symptoms can

be absent (Marton KI). But still these are just speculations and the King could have

suffered from any one, or a combination of any of these diseases.

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CRITIQUE

To link the weight loss and late life depression of King David to the modern

layman, I believe Erich Fromm theory does a great job. He spoke of the pressure laid

upon us by personal freedom, and how these pressures are the cause behind many

psychological problems. He talked of how a high amount of personal freedom can lead

to immense amounts of strain on ones mind, so in my personal opinion, this theory relates

very closely to the case of King David, because he was in a position to make all his own

choices, which in turn caused his depression. In a sense, giving irony to the saying, “It’s

good to be the king”. Although in ancient times, this might not be the case for the

common man, today the layman has this same responsibility, the responsibility of ones

own future. This tension exists in all ages, but because older adults can not always just

go out and get back into the labor force, they feel worried about the future. Of course

other theories may play in at this point, for example, some might reinforce the argument

above, but might contribute the depression to the feeling or illusion of lack of control.

Arguing that the older adults suffering comes from their own impression that they do not

have control over their life or future due to things such as social security, pension funds,

etc.

I do believe the author did a wonderful job of dissecting the passages written by

the King to reveal the possible causes of the king’s death. I can definitely see also where

the task put in front of her was a slow and time consuming study, but she made use of the

scientific method and produced a very interesting article. I did not see where there was
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any room for improvement, because she did the most she could, which was work

backwards in a sense, to establish a hypothesis for the cause of the king’s death. But in

doing so, this article gives a fantastic insight to the complex field of gerontology,

showing the readers how many facets contribute to the overall health of geriatric patients.

Overall, the message that should be gained through this article, is that late life depression

should be taken seriously and weight loss should be monitored and to us fortunate enough

to learn of this before our time has come, we should try our hardest to set up our lives for

the unpredictable future.

WHAT I LEARNED

This article gave me a complete introduction to the field of gerontology. It

showed how complex determining cause and effect can be in geriatric patients. But at the

same time, I enjoyed the process, because it is almost like a puzzle and you have to piece

every part together to see the whole picture. Especially for me, living in one of the

hottest retirement areas of the country, it has swayed my opinion on what has to be done

for me in the future. This article also forced me to enlighten myself on many diseases

that were mentioned, for I did not know what they were. It was a bit frightening at first

but because I enjoy different languages, and find it interesting to see where medical terms

come from. I recollected some of the terms before, but when they were broken down into

Greek, it showed me how simple large words can be once broken. The article also taught

me about the health of King David, which might not seem like much, but it does reinforce

many common sayings and teachings I have heard over my life. For example the saying,
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“It happens to the best of us”. With sayings like that I can feel more comfortable

knowing that I am never alone, which hopefully will always be a deterrent for depression.

Overall, the combination of the article and doing the research, taught me that knowledge

is exponential and the scientist and science in general, is an every growing realm of

society that’s collective efforts helps everyone.

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BIBLIOGRAPHY
The article being reviewed:

Ben-Noun, Liubov (Louba). Special Article: The disease that caused weight loss in King
David the great. Journal of Gerontology: Medical Sciences. 2004, Vol. 59A, No. 2: 143-
145

Additional Citations:

Friten LJ, Morley JE, Gross PL, Petry SD, Cole KD. Depression. J am Geriatr Soc.
1989;40:365-369
Hamerman D. Molecular-based therapeutic approaches of anorexia of aging cancer
cachexia. J Gerontology Sci. 2002;57A: M511-518

Harris T, Cook EF, Garrison R, Higgins M, Kannel W, Goldman L. Body mass index and
mortality among nonsmoking older persons: the Framingham Heart study. JAMA. 1988;
259:1520-1524

Langan MJ, Yaerick ES. The effect of improved oral hygiene on taste perception and
nutrition of the elderly. J Gerontol. 1976;31:413-418

Liu LJ, Bopp MM, Roberson PK, Sulivan DH. Under nutrition and risk of mortality in
elderly patients within 1 year of hospital discharge. J Geronto Med Sci. 2002;
57A:M741-746

Marton KI, Sox HC, Krupp JR, Alto P. Involuntary weight loss: diagnostic and
prognostic significance. Ann Inern Med. 1981;95: 568-574.

Mischel, Walter. Plomin, Robert. (1999). Erich Fromm, Introduction to personality (pp.
71-72, 85). Fort Worth: Harcourt College Publishers.

Morley J. Decreased food intake with aging. J Gerontol Med Sci. 2001; 56(special issue
2):81-88

Potter JF, Schafer DF, Bohi RL. In-hospital mortality as a function of body mass index:
An age dependent variable. J Gerontol. 1988; 43:M59-M63

Rabinovitz M, Pitlik SD, Leifer M, Garty M, Rosenfeld JB. Unintentional weight loss. A
retrospective analysis of 154 cases. Arch Inter Med. 1986; 146: 186-187

Reife C. Involuntary weight loss. Med Clin North America. 1995;79: 299-313

Roberts SB, Fuss P, Heyman MB, et al. Control of food intake in older men. JAMA.
1994; 272:1601-1606