What the doctor ordered
February 17 2003
Can pigging out on red meat and fried eggs really make you slim? William Leith meets Robert Atkins, the world's most influential diet guru.
Robert Atkins is telling me about a moment in history when the world changed for ever. "In November 1963," he says, "two things happened. I gained an awful lot of weight from Thanksgiving, and John F. Kennedy was murdered." This was the moment that Atkins, a chubby young doctor from Dayton, Ohio, decided to lose weight.
"I was just sitting there watching television," he says, "watching all this sad stuff. And I made up my mind. I felt I had to do something. So I went on a diet." Historians were quick to grasp the importance of the Kennedy assassination. But it has taken the world four decades to understand the huge significance of the Atkins diet.
Now Atkins is the most influential diet guru in the world. His first book, Dr Atkins' Diet Revolution, was a hit in the early 1970s. But his more recent book, the very similar Dr Atkins' New Diet Revolution, is much, much bigger.
This is his second coming. He has been cited as one of the 10 most influential people in the world. He believes he knows how to save Western society from its devastating twin epidemics of obesity and diabetes. He thinks he has unlocked the mystery of why we put on weight, and why we find it so difficult to lose the weight we put on.
The key, he believes, is insulin, a hormone secreted by the pancreas gland. He describes insulin as "the fattening hormone". In terms of diet, his idea is very simple. If you cut down radically on carbohydrates, you'll lose weight, even if you eat steaks and chops and fried eggs - and, importantly, bacon. To Atkins, carbohydrates, particularly refined carbohydrates, are the core of the obesity problem. Calorie intake is comparatively unimportant. Fats are not so worrying.
"If you believe that weight loss requires self-deprivation," he says, "I'm going to insist on teaching you otherwise." And the Atkins diet seems to work. People who follow the Atkins plan - it is known as "doing Atkins" - do lose weight. He has sold more than 10 million books, which have been read by perhaps 30 million people. This is much bigger than Audrey Eyton's F-Plan Diet, which advocated eating large amounts of fibre, or Harvey and Marilyn Diamond's book that suggests followers try not to eat proteins and carbohydrates at the same time.
Atkins estimates that tens of millions of people have lost weight by following his methods. Geri Halliwell and Julia Roberts have lost weight, and kept it off, on the Atkins diet. Minnie Driver, a follower of Atkins, looks sharp and angular these days. Catherine Zeta-Jones slimmed down for her performance in the musical Chicago on Atkins. Al Gore does Atkins. Fleetwood Mac's Stevie Nicks, who had blobbed out, got her figure back on the Atkins diet.
Atkins is sitting in his office at the Atkins Centre. This is a man who goes to work in a big, chunky office block in midtown Manhattan with his name above the door. He is a trim, nice-looking 72-year-old wearing a tweedy jacket and spiffy tasselled loafers. You would never guess that he used to weigh more than 100 kilograms.
In 1963, he says, "I looked at a picture of myself and realised I had a triple chin." He was 33. 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 kilos fell off rapidly and, significantly, Atkins did not feel hungry. His cravings for buns and doughnuts had gone. He felt perky and energetic. He began to realise that something was happening, something which contradicted general medical opinion. He was eating a lot of calories, and a normal amount of fat, but he was losing weight. Why was this? He decided to try his diet on patients to see if it worked on them, too.
Meanwhile, all over the Western world, overweight people were being told to eat less fat, and to replace the fat in their diet with "healthy" alternatives - complex carbohydrates such as pasta, potatoes and rice. The trouble was, they were getting fatter. Even when they cut their caloric intake, they still got fatter. In the mid-'70s, fat made up 40 per cent of the typical Western diet. Twenty years later, that figure had dropped to 32 per cent. Health-conscious people were replacing the fried foods in their diet with cereals. And they were putting on more and more weight. The more people tried to avoid fat, the fatter they got.
Back in the mid-'60s, Atkins put 65 overweight patients on an early version of the Atkins low-carbohydrate diet. All reached their target weight. Atkins says, "I knew I had something wonderful."
But how does it work? How can you lose weight without cutting calories? How can you eat fat and not get fat? How can you switch to a diet which is less bulky and yet feel less hungry?
Atkins speaks in a slow, measured way but you can tell he is burning with zeal. As a diet guru, he was in the wilderness for decades, but he feels that now, at last, the world is listening.
"You have to understand the role that stored fat plays in our bodies," he says. "It is the No.2 fuel system for energy. And there are only two fuel systems. The No.1 is glucose, which is made from carbohydrate. When you cut out carbohydrates, you cut out glucose, and then fat plays the role of the primary system."
Atkins says that if we eat fat but no carbohydrates our bodies burn fat, but if we eat carbohydrates our bodies find it more difficult to burn fat. Cutting out carbs, says Atkins, gives you what he calls a "metabolic advantage".
"You actually lose more weight, calorie for calorie, than you do on balanced diets or low-fat diets," he says. I can see the excitement mounting in him. You lose fat because of a process called ketosis - the transformation of fat into fuel. "And that's been proven by study after study," he says. "All of a sudden we've reached an era where people are doing these studies, even people who felt that my diet was wrong, and finding out that it gets better results than the diet they previously recommended."
Why does he think carbohydrates are so bad for us? This is where insulin comes in. Carbs, says Atkins, tamper with the insulin in our bodies. Refined carbs, those with a high "glycaemic index" - those that produce a lot of glucose - are worst. When we eat carbs, the glucose released into our bloodstream raises our blood sugar, and sometimes gives us a blood-sugar rush. That's the feeling you get in the middle of the morning when you eat a doughnut; your mid-morning torpor is suddenly gone. You feel boosted.
When glucose enters the blood, the pancreas releases insulin, the hormone which turns glucose into energy if you are physically active, and fat if you are not. But it's easy to eat too much carbohydrate and when this happens over time, the pancreas begins to overproduce insulin, a condition known as "hyperinsulinism". Eating a doughnut will give you a blood-sugar rush, but if you eat doughnuts for a few weeks, this rush will be followed rapidly by a blood-sugar crash, because the large amount of insulin in your blood is metabolising the glucose very rapidly.
And what do you want when your blood sugar crashes? Another doughnut, of course. Low blood sugar produces cravings. When you see an obese person, this is likely to be the reason for their problem. "Food compulsion," says Atkins, "isn't a character disorder; it's a chemical disorder."
The poisonous combination of carbs and too much insulin makes us fat and, horribly, the food we crave makes us hungry. It's a vicious cycle. Of course, all of this must have implications for diabetes. In the past four decades, when Western society reduced its fat intake and increased its carb intake, diabetes as well as obesity has sharply increased. "We eat our way towards it, three meals a day, a thousand meals a year, ten thousand meals a decade," says Atkins. Overconsumption of carbs, which leads to overproduction of insulin, leads in turn, he believes, to a condition known as "insulin resistance" - with so much insulin aboard, our bodies become desensitised to it.
So, in the worst-case scenario, eating carbs makes you want to eat, which makes you fat, which makes you tired, which makes you want to eat even more carbs; you're hungry all the time, and eventually you significantly upset the balance of your blood sugar.
Atkins believes firmly in the link between diabetes and obesity. "So much so," he says, his eyes glinting, "that I call it 'di-obesity'. And that'll be the title of my next book."
Atkins is aware that many people doubt him. He's very big on his critics. He finds it upsetting that people should set themselves against him so staunchly. His critics say that ketosis is a bad thing. Atkins says that's because they are confusing it with ketoacidosis, a different condition altogether. They say the Atkins plan is low on roughage. Atkins says this is not true - if you replace potatoes with broccoli or salad or cabbage, you're going to gain it. Also, Atkins recommends psyllium husk, a soluble fibre, to be drunk with large amounts of water if you feel you're not getting enough fibre.
They say that too much protein is bad for the kidneys. Only if you have a kidney condition, says Atkins. They say you don't get enough calcium if you don't drink milk. He says you'll get enough calcium from cheese which, of course, is milk, and green vegetables such as broccoli.
Another thing is that Atkins comes in several phases, the most important of which are "induction", which is supposed to last for two weeks during which you cut out almost all carbohydrates, and "maintenance", which is much less spartan. People who rail against Atkins, says Atkins, are often railing against induction.
Atkins, of course, has been doing Atkins for longer than anybody - he's been doing it for more than 39 years. He tells me what he had for breakfast: "Ham and eggs. And onions. Very dark fried onions." He has long since lost his carb-induced food cravings. It's getting dark outside and he hasn't had lunch yet. "I sometimes just eat some macadamia nuts or something like that when I'm working. Just something to tide me over until dinner." He's looking forward to dinner. "Tonight it's going to be some fish and about three or four vegetables, plus a salad. My wife gives me about five or six different vegetables in that one meal."
Is Atkins a quack? Possibly not. His diet definitely works. Lots of people stay on it because it cuts out food cravings, rather than producing them. Now he's paying for research to be done to back up his theories. "Nowadays," he writes in his recent book, "the tide is flowing strongly in my direction."
The New York Times recently published an article in favour of Atkins, in which Richard Veech, a prominent scientist who studied under the Nobel laureate Hans Krebs, was quoted as saying, "Ketosis is a normal physiological state. I would argue it's the normal state of man."
Atkins and I walk into the lobby of the Atkins Centre. There is a cartoon on the reception desk which depicts Santa, having come down the chimney, looking at a plate of food which has been left out for him. The plate contains a steak but no chips. The caption is, "******* Atkins diet". He shakes my hand and walks down the street, towards his wife, towards the fish and possibly six vegetables she is preparing for him.
The Observer
Dr Atkins' new book, Atkins for Life, will be available in Australia next month.
http://www.smh.com.au/articles/2003...5330470060.html
The Sydney Morning Herald Interview with Dr. Atkins
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