Could Dr Atkins have the answer?
(Filed: 19/07/2005)

In the final extract from his new book, William Leith meets a diet guru and decides to give his low-carbohydrate regime a go

The large waiting room of the Atkins Centre in New York is about the size of two squash courts, and exudes the bright, hopeful air of the Seventies. High ceilings, low furniture, white walls. The paintings on the walls are the sort of thing a rock star might buy - huge canvases encrusted with jagged clumps of paint. Walking towards the reception desk I'm apprehensive, wondering if I look fat, wondering if people will think I've come to see Dr Atkins because I'm fat.


William Leith: Atkins-inspired
A woman arrives, introduces herself, and tells me that she will introduce me to Dr Atkins, and for a moment it doesn't occur to me that the unobtrusive, ghostly presence hovering just behind her might actually be the doctor, so I nod and back away, distracted.

''This is Dr Atkins,'' she says.

''Oh,'' I say.

We shake hands.

Atkins is a pleasant looking, 72-year-old man, the sort of old guy who would be the decent grandfather in a heart-warming movie. He is calm, benign, possibly a little frail. He does not look like a diet guru. He wears a black tie and a stiff dark tweed jacket with long, broad lapels and a single button at the waist, the style popular a dozen years ago. The jowls around his neck and chin are fairly minimal, signs of age rather than excess weight.

He points me towards the lift, and tells me we'll do the interview in his office upstairs. We walk across the Seventies-looking room, which reminds me that Dr Atkins was originally a phenomenon of the early Seventies, the era when people wanted to believe in hedonism without consequences - Atkins's original ''no hunger'' Diet Revolution was a counterpart to Timothy Leary's saying that LSD was good for us. What Atkins said was that, if you avoided carbohydrates, you could eat more or less what you wanted.

Since then, he's fallen into disrepute, and been reincarnated. Over the years, the Atkins diet has been radical, trendy, wildly popular, disapproved of, reviled, buried, resurrected, again radical, and again trendy. But on the day of our interview, in January 2003, it's wildly popular again.

How long will this mood last? Perhaps the backlash is already beginning. Some people are starting to say that Atkins is a fad - that it will come and go, to be replaced by something else, possibly the avoidance of another food group.

Naturally, Atkins himself does not think that Atkins is a fad. He thinks that low-fat diets - the diets that presided through the Eighties and Nineties - were the fad. His scientific reasoning is that low-fat diets don't work - it was during the low-fat decades that we got so very fat.

Like me, it turns out, Atkins hasn't had lunch, even though it's early afternoon. ''I sometimes just eat some macadamia nuts when I'm working,'' he tells me. ''That's just something to tide me over until dinner.'' Macadamias are highly calorific - a handful can contain 250 calories, as much as a handful of chocolate drops. But that's fine according to Atkins, because they're very low in carbs.

We sit down on either side of his desk. For breakfast, he tells me, he ate: ''Ham and eggs. And onions. Very dark fried onions.'' Sometimes, he has an omelette, sometimes bacon and eggs.

Atkins begins by telling me about his struggles over the decades. He has followed the Atkins diet since November 1963, more than 39 years. He sounds embattled, and a touch weary. But the tide, he points out, seems to be turning his way. ''Now,'' he says, ''the evidence confirms what I had noticed in studies that were done 50 years ago. Which is that there's a metabolic advantage to a low-carbohydrate diet." Listening to this elderly man, looking at his pleasant face with the crinkly smile, I can feel something nagging at me.

He tells me the story of his own weight loss. It is the familiar diet guru narrative - weight gain, followed by despair, the despair obliterated by a simple, miraculous insight.


He was 6 ft tall and weighed 225 lb. As a man with a big appetite, Atkins knew he would not last on a traditional low-calorie or low-fat diet. But he'd just read an article in the journal of the American Medical Association about a low-carbohydrate diet. He says: ''It was so simple! I hadn't tried a diet before that. It was the only diet that looked like I'd enjoy being on it. I ate a lot of meat, and a lot of shrimp, and a lot of duck, and a lot of fish. And omelettes in the morning, and salad vegetables.''

The diet worked a treat. The pounds fell off rapidly, and, significantly, Atkins did not feel hungry. His cravings for buns and rolls had gone.

Atkins looks across his desk at me and says: ''I knew I had something wonderful.''

As I nod along with what Atkins is saying, I realise what it is that's been nagging at me. It's that I want to believe in him. I want this because, if he is right, I will lose weight. If he's right, I won't have to be hungry. I'll be able to get a haircut and have a shave and wear a suit without looking like a fat nerd.

Atkins and I move on to the subject of hyperinsulinism. The pancreas produces insulin in response to carbohydrates, but if you repeatedly overeat carbohydrates, you reach a crucial tipping point, after which your pancreas produces far, far too much - a veritable deluge of insulin, which causes a corresponding low tide of blood sugar, which triggers a cacophony of craving, which leads to an exponential population curve of obesity.

What a tempting analysis. The problem is carbohydrates! As Atkins says in his book: ''Many carbohydrate addicts could no more walk past a refrigerator without opening it than Venus or Serena Williams could let a short lob drift overhead without smashing it.''

That's why I want to believe Atkins. If Atkins is right, the problem is not us. There isn't something essentially wrong with me. I'm just eating wrong, that's all.

We leave the office and walk down the stairs. Atkins walks east, towards his apartment. The last I see of him he is on the sidewalk, walking past the spot where, in 45 days' time, he will lose his footing on the ice, bang his head and die.

I walk to a restaurant and order a large steak with spinach and no fries. On the plane, I don't eat a bag of pretzels or a second bag of pretzels, and when the stewardess serves me my dinner - beef and vegetables and potatoes - I eat the beef and vegetables, but not the potatoes. I get home and later I buy some bacon and eggs and tomatoes and broccoli, and for dinner I eat another steak and a tomato salad, and go to sleep feeling less bloated than usual, and when I wake up I feel hungry, but not so desperate as before. It was the food. The food was the problem.

The first week is fine. In the mornings, I have bacon and eggs, or maybe an omelette, and for lunch I have an omelette, and for dinner I have steak and salad, or fish and salad, or maybe an omelette with salad. I get better and better at making omelettes. I put three eggs in a bowl, and add some grated cheese, and fry onions and tomatoes, and pour the eggs into the pan, and after a few minutes I put my plate over the pan, and flip the omelette into the plate, and slide the omelette back into the pan, to cook the other side.

My hunger subsides. After a couple of days, I stop thinking about food all the time. After a week, I think about food only a couple of hours a day, at mealtimes. And I must say, not being hungry all the time is a strange feeling, strange and slightly disconcerting. As I get less hungry, I find myself with more time on my hands. One day, after about a week, I'm sitting at home, trying to write something, and I get up to take a snack break. I walk into the kitchen, and something is amiss - I'm not hungry. Temporarily, I am without a purpose. So I pour myself a glass of water from the tap, and drink half of it, and sit back down again at my desk, suffused with a creeping sense of dread.

Maybe I should have some macadamia nuts. No, I've run out of macadamia nuts.

Maybe I should have some bacon and eggs. But I don't want bacon and eggs. I'm not hungry. And I realise there's something I miss, more than bread or pasta. Don't get me wrong - I do miss these things. I miss the rush of blood sugar I used to get after eating a few slices of toast. I miss the crispy outsides of fries and the starchy, comforting gravy-sponge of mashed potatoes. Most of all, though, I miss being hungry.


Leith still misses cakes
Still, I'm losing weight. I lose about 3 lb in the first week and 3 lb in the second week, and I definitely feel less puffy, less tight around the face and neck. My clothes are slacker. After two weeks, I look in the mirror, and there it is - my jacket no longer hangs like the skin of a snake. It's beginning to hang like a jacket.

And, as the weeks go by, I stop craving carbohydrates. In restaurants, it's easy - I just have a salad instead of the fries, or the mash, or whatever. When I want a snack, I eat macadamia nuts. I keep buying these packs of macadamia nuts, 75 grams, which is slightly too much for a quick snack, but I pour them all into my mouth, and I love them, and they hardly make me feel sick at all.

I keep having to explain to people how a low-carb diet works. I explain about the blood sugar. How carbs make you hungry. The addiction angle.

And sometimes people get testy with me. ''But what about bread? Huh? Are you telling me I shouldn't eat bread?''

''I'm not telling you you shouldn't eat anything.''

I have a lot of conversations like this. I'm always making the same point, which is that, conducted properly, a low-carb diet is not about eating more meat, or more fat, or more cheese, or more cream - it's about eating less carbohydrate. It''s about taking away something bad.

It happens on a Saturday evening in March, and I've lost something like 20lb. I'm wearing a brown corduroy jacket, blue jeans, brown shoes, a blue shirt, and the jacket is hanging just so, or rather not quite just so, but almost just so. I'm walking differently, picking my feet up, I've lost my apologetic slouch, and my knees hurt less when I go downstairs. Soon I'll be able to do normal things, such as run, and I'm standing in a doorway at a party, holding a bottle of San Pellegrino. I wish I could say San Pellegrino 1996 or whatever, but they don't put the year on the bottle, with water the year is immaterial, and someone I know spots me and nods, and that's when it happens.

He says: ''Hi, fatboy.''

Finally. I'm getting somewhere.

I have, I believe, located my central problem. My problem is carbohydrates. I'm a recovering carbohydrate addict. I eat meat, vegetables, eggs and nuts. I am planning to reintroduce fruit into my diet, and I'm still not drinking alcohol, and I'm happy, I think I'm happy, and I'm losing weight, and of course I'm not entirely happy because I want...

I'm not quite sure what I want.

Extracted from 'The Hungry Years: Confessions of a Food Addict' by William Leith (Bloomsbury). To order a copy from Telegraph Books Direct for £10.99 plus £2.25, call 0870 155 7222
18 July 2005: Let me eat cake [first extract]

http://www.telegraph.co.uk/health/m...9/hatkins19.xml

When that man wrote about how LC cured his problem, yet he still missed being hungry, in a bold short sentence, he summed up what it means to be a food addict. He illustrated perfectly exactly how I feel now. LC cured my body, it taught me how to eat, but it didn't undo the damage of an entire life of developing an emotional dependence on food.

I think food addiction is basically carb sensitivity, combined with a substance-like dependence on the results of uncontrolled carb sensitivity. When you live your entire life obsessed with food, hunger, eating, when your emotional state is hinged upon your plate, it's really hard to fix all that by going on Atkins alone. Once the sensitivity is under control, many find a void is left that was once occupied by food obsession. You miss your friend.

I am lucky. I have turned my habit into more a "casual usage" of food. Sometimes I tightly control my blood sugar all day, under eat, only to purposely mess it up just a little bit, this way at night I am hungry & craving so I can enjoy food more. This may sound strange to non-food addicts but I love it, feeling hungry and knowing I will get to indulge. I enjoy the feeling of anticipation of craving and looking foward to eating. I am fortunate that I can "dabble" like this, a lot can't. It's a very fine line between a peak in hunger and shaking/buzzing ravenous for food, also, so I must be careful. In fact, I think that my strategy of indulging the food addict at night is what is helping me control it 90% of the time during the day. I think if I made the mistake of denying my emotional need for food, I wouldn't have been nearly as successful.

Hunger is much more gentler and kinder on this WOE. This was an excellent essay. I am glad to see that it is in the UK since I had heard that low carb dieting was not popular there.

Wow, is this original, and heavy. Ive never really thought about things that way-I know I miss certain textures and carb "treats" like pizza on a friday night or ice cream with the kids, etc. And knowing I cant have a beer with pals really sucks-its water, tea, or if I feel like I can afford it, a cocktail. I feel like there is almost a community around consuming carbs, its what we celebrate with, and Im missing out. I have actually had crying jags over that one, because I dont have any "fun" food to look forward to! I dont think its a food addiction....mainly because hunger was always an irritation to me. I loved feeding cravings, because I enjoy eating and listen to my body and what it tells me it needs. But turning off the hunger switch was a huge relief to me.

Maybe Im one of the lucky ones. But then again, Ive been pretty depressed lately..wondering if its in part because I dont have the pleasure of treating myself with food! I dont get that reward! I dont have it to look forward to. Tonights treat was that filet mignon Ive been saving, and it was..almost boring, even though it was delicious! Hmm. Maybe Im more addicted emotionally to food than I think.

So whats the key? Finding other ways of rewarding ourselves? Finding other pleasures? Other addictions? Learning to be satisfied with what we CAN have?

I tell you what I DO enjoy...looking at myself naked in the mirror and thinking, wow-Im almost attractive! I actually did that tonight. 2 months ago, I couldnt catch a glimpse of me in a plate glass window-fully dressed-without wincing! So there!

The "Fatboy" comment makes more sense if you read the earlier excerpt:

Let me eat cake
(Filed: 18/07/2005)

I wake up on the fattest day of my life, 20 January 2003. I am just over six feet tall, and weigh... how much? I step on the scale and off it very quickly, to limit the damage - 16st 12lb.

This is how I feel: light-headed, shaky, with a raw sensation, almost a pain, just below my ribs. I can feel the acid wash of heartburn in my gullet and the gurgle of juices in my guts. Hunger.

I'm hungry most of the time. I also feel bloated most of the time. I am always too empty, and yet too full. I am always too full, and yet too empty.

I want toast. I swing myself out of bed, my belly tight and sore under my T-shirt. When I was slim, I slept naked, but now I dress for bed, or rather don't fully undress; I wake up damper, hotter, hungrier. My hunger frightens me. The fatter I get, the more I want to eat. The fatter I get, the more comfort I need.

The bread is brown. Damn. Still, I put two slices in the toaster, and, while I'm waiting, I take another slice from the loaf, butter it, fold it over, and eat it in three bites. I am in a toast frenzy - it's like a nicotine fit.

I open the fridge. Nothing for me in here. Tomatoes, bacon, eggs, salad vegetables. On the worktop next to the fridge, there is fruit in the fruit bowl. I am not interested in any of these things. I am like a gay man looking at a girly magazine. I want bread, cereal, croissants, bagels. I could eat a baked potato, or some pasta, or some fried rice left over from a Chinese takeaway.

My breakfast is ready. Two slices of buttered toast. No plate. I eat standing up. These days, I do a lot of eating standing up. People seem to disapprove. Perhaps that's why I do it.

I eat the first slice, munching through it like a praying mantis eating a leaf. Then I eat the second slice. And, for a moment, I'm in a bad place - already bloated, but not yet sated. Too full. Too empty. Clouds of self-disgust are gathering on the horizon.

What happens to me is this: I get fat. Then I get fatter and fatter, over a period of years, until I'm fatter than I've ever been. Then I get slim again. But when I get slim, I'm never as slim as I was the time before. And when I get fat, I'm always fatter than I was the time before. Right now, at 16st 12lb, I am close to obese.

Perhaps there will come a point, perhaps quite soon, when it is just too late. Perhaps when I cross the border from fat to obese I will be stuck, never again able to claw my way back to slim. I'll be a lifer. Might this happen? It happened to Orson Welles, to John Belushi. It looks like it's happening to John Prescott and Johnny Vegas.

I am fat. Therefore everything I do is fat. This morning I take a fat shower, squirming around in the suds like an oversized cherub. Fatly, I towel myself dry. This is not like the towelling-dry of a slim person. Fat people absorb water like sponges. Fat people sweat more. Fat people don't want to walk, half-naked, out of the bathroom to a place that is less hot and steamy. Fat people don't like being exposed. Fat people take their clothes into the bathroom, so that they can emerge, magically, fully dressed, if damp and uncomfortable. Fat people wear fat clothes. Right now, I tend to wear tight jeans, and I tuck my shirt in, to advertise the extent of my fat belly. I know that the next stage, wearing loose, baggy clothes, will be the end. When you ''go floaty'', you have admitted defeat. There is still some fight left in me.

I'm fat, obviously, because I eat too much. But I don't think that's the real problem. Like many, even most, fat people, I am fat because I have other, deeper problems. One of them is a desire to procrastinate. Being fat is like living on one side of a valley and looking across at the promised land of slimness, which can never disappoint you until you visit it. Deep down, every fat person is a little bit frightened of crossing the border into the slim world. What if it's not as good as it looks in the brochures? What then?


In the street, a fat woman cruises towards me. She is walking splay-footed, with effort, taking careful steps as if walking up a steep path. Being fat is an uphill struggle. I look at her, at the eaves of flesh hanging from her sides, and feel the fat person's twinge of fear and self-pity: will I get like that? The woman is in a much fatter place than me though - if I lost, say, 15 or 20lb, my fatness would be mentionable. This woman would need to lose 100lb. She might not have spoken about her weight for years. Every day, I guess, she lives with this dreadful, lonely secret, that something has gone terribly wrong with her life, and nobody will talk to her about it.

If I lost 20lb, my friends would come up to me and say: ''Hi, Fatboy.'' That in itself would feel like an achievement. Nobody calls me Fatboy any more. I'm too fat.

I have a problem, and I need help, but I don't want to talk about it, because I'm a guy, and guys don't have problems like this, and if they do they sort the problems out on their own. My problem is: I overeat. My problem is: I am hungry. I'm hungry for food, but I know it's not really food that I crave. It's something else.

It's everything. I'm hungry for sex, for drugs, for alcohol. I want to go out and spend money! I can't keep still.

If we have a core problem, here in the Western world, I am an embodiment of that problem.

I'm hungry, and I'm out of control. My hunger is emotional, but this is something I find hard to admit. I have a very powerful, top-of-the-range psychological override mechanism, which I use to disengage my emotions. And this mechanism runs on heavy fuel. It needs a lot of food and drink and drugs and sex. To use the technical term, I'm a binger.

I read books about bingeing all the time. I binge on them. Elizabeth Wurtzel writes about bingeing on drugs, Caroline Knapp about bingeing on alcohol, the former Arsenal and England soccer captain Tony Adams about bingeing on alcohol, William Donaldson about freebasing cocaine.

And all of these bingers have something in common. There's something hollow, right in the middle of their psyche. Something missing. Something they've spent their lives not wanting to talk about.

And I wonder: how did I get here? I didn't get fat until I was eight years old and my family moved to Canada, and I suddenly started thinking and acting like a fat person. When I tell people this, they say it must have been something to do with the burgers and the fries and the popcorn and the hot dogs. And I say that, yes, the food might have played a role. But what made me fat came from inside my head. When I went to Canada, I was one person; when I came back, I was another. I was fat.

I stayed fat until I was 10. That doesn't sound like a long time, but it was. At 10, I discovered sport, and got slimmer. I played soccer and rugby and cricket. I swam. I got in the school teams. But I still wasn't quite right. I still felt fat on the inside. My weight fluctuated. I had to watch myself around food. Sometimes I binged.

By the age of 17, nobody would have looked at me and seen a fat guy. I was more or less slim. The only person who knew my secret was me. When I went to university, I was still more or less slim. My weight still fluctuated. Sometimes I thought I was getting fat. But this was nothing compared to what would happen later. At the age of 20, I once got up to nearly 14 stone. Big deal. This was when I was living in a house with some dope-smoking bums. I was one of the bums. Our idea of a good meal was fried ''eggy bread'' - large doorstep slices of white bread dipped in egg, fried in butter, and covered in brown sugar. We spent our time lounging in odd positions, listening to obscure rock albums, making rounds of eggy bread through the night. But I wasn't really fat. I looked like a slim person who had become a slob.

After this, I lost weight again. I was slim until I was 26, the year I left university. By the time I met Anna, though, when I was 27, I was 14st 12lb - fat enough to make a difference. During my time with Anna, I peaked at 15st 10lb. At 31, I slimmed down. I was perfectly slim - 13st 8lb - at 31 and 32. Later, when I met Sadie, I was back up to 14st 4lb.

It was a gradual ascent, but this time it felt inexorable. There were some plateaux and some dips. There were diets. I sometimes lost a pound or two.

I joined a gym. That didn't work. I started to use the gym. That didn't work either.

Getting fat does not feel like an ascent. There is no sense of having a better view, a clear vantage point, or anything like that. Getting fat feels more like burrowing, like tunnelling. Getting fat is like sinking, like being sucked down by quicksand. You panic. You feel hopeless. You are stifled and squeezed, loaded down by a strong force that seems to be outside your realm of control. Your self-hatred grows as you lumber around, pretending not to notice.

Fat people are liars. You try to fool other people into thinking you don't think you're fat. A lot of fat people avoid the subject of fat in order to mimic the slim. But it's a poor imitation: slim people talk about fat all the time. I know. I've been slim.

What it boils down to is this: I am fat. I don't want to be fat. And I know how to be slim. But these three things don't add up. Why, then, am I not slim? Somewhere inside my psyche, I am untrustworthy. I am a self-deceiver.

This is because I am fat; it is also the reason I got fat in the first place.

I like to believe that I am fat, not through my own agency, but through the agency of others. I like to think I'm fat because the world around me is making me fat. I am looking for a quick fix.

Today, on the fattest day of my life, I am on my way to New York to interview the diet guru Dr Atkins. I like the idea of the Atkins diet because I think it might be a quick fix. When I see something that looks like a quick fix, I am capable of trusting it with a faith bordering on the religious. This is because I am a liar and a self-deceiver.

I want a quick fix because I don't want to look into myself too deeply. I am afraid that I might look into myself and despair.

Wow... I'd really like to read this book. The author has some really interesting insights. I like his writing style; how he jumps around a bit between time periods but still connects the dots.

Woo, I know what you're saying about "appeasing" the addiction issues with "casual use". I'd be lying if I denied doing that. I've also taken up kitchen hobbies: cooking, indoor veggie/herb gardening, scratch baking and homebrewing. I turned the self-destructive attitude toward food into an outlet for creativity. They're imperfect solutions, but they work for me.

Hmmm, I wonder what would happen if someone did a study on the correlation between going on a diet and starting/indulging another addiction: chewing gum, smoking, shopping, watching TV, surfing the Web, Dianetics?

I agree the book looks very interesting and I like his style. The book is due out in mid August in Canada but has been out for a long time in the UK.


Definitively one for the wish list

This sums up though why a lot of people stall out on atkins. Instead of taking this fact and cutting out the bad carbs, only eating the good, they go the other way by replacing the carbs with fat.
I was guilty of greedily stuffing myself full of butter, cream, animal fats until i felt sick somedays.

People need to realise this point quoted above, you must take out the carbs, and replace them with healthy stuff like fruit and veggies, but NOT get obsessed with eating over 2000 cals a day full of fatty things.

Good article by the way. I enjoyed it very much

I respectfully disagree with that. I can't think of many people that I've observed around the forum who are stalled out because they're "greedily stuffing themselves with animal fat." A minor exception is a few folks who have specific issues like a hypothyroidism, who have to watch their calories. Just as many people, if not more, experience that kind of lack of control problem to a much worse extent with so-called "good" carbs, and that's why LC authors agree that you should only add them back to your individual tolerance.

By the way, what's wrong with animal fat? If the hypothetical Atkins-stalled folks traded the animal fat for vegetable oil, would they be magically better off?

I know we all develop our own perspective on things based on our own successes, and it's hard not to project that onto everyone else; but I rather greedily stuff myself with animal fat on a regular basis and even well into maintenance, I've never looked or felt better.

You just can't substitute all the calories from carbs, with veggies and low carb fruits. When you remove what may well have been 50-60% of your calories, you HAVE to increase your fats and protein. You NEED to increase your fats and protein. Let the fats and protein do their job of assuaging your ravenous hunger, and the total calories will modulate themselves.

Great stuff, and thanks for adding the second passage. I was a bit confused by the fatboy comment at the end of the first passage. When I read it I thought he had not made enough progress. After seeing what it meant, I laughed out loud.

WOW....I can't wait to read this book...the exerpts I read here sound like this guy was wholesale taking experiences out of MY head...more power to him for his journey and what INSPIRATION!

South-beach verses Atkins, much of it comes down to fruits verses animal fat.