Personal Views: Occasional notes: Doctor did Atkins
Authors: Daniel Wheeler
Journal: BMJ (2004)

“We've got another one, Mary.” So said the lady behind the League of Friends' tea bar to her colleague when I asked for a smoked mackerel salad rather than the usual sausage sandwich and caramel slice. “That must be 12 now,” came the reply, “they're all doing it.” It was August 2003, and clearly I was just one of the many hospital tea bar regulars who, at the height of the hype, had forsaken carbohydrates and taken up the Atkins diet in a quest to be the next Jennifer Aniston. I had been shocked into action after a rare interaction with the bathroom scales gave me a nasty surprise and a quick calculation suggested my body mass index was nudging 35. The final straw was when my mum's fancy scales that measure body fat informed me that soon I would be mostly adipocytes. Why did I try Atkins? I'm not quite sure. I too had sniggered at those sorry creatures following the latest “fad diet” and dismissed the crackpot theories about how it worked.

Two weeks into the diet and my wife is on the verge of telling me to stop. I'm told I look grey and sweaty, like a man about to have (or actually having) a heart attack. I feel peculiar between meals, but at least I'm not hungry. I have less energy than I used to; I have continued cycling to work but am now finding it pretty tough. Sometimes I'm like a bear with a sore head. I never want to see another olive again.

The family are subdued before the first weigh in. There is a hush as I enter the bathroom. The wife is ready to issue her ultimatum. What's this? I've lost 7 kg. Joy unalloyed! So I keep going.


I had been shocked into action after a rare interaction with the bathroom scales gave me a nasty surprise


A year later and I've lost 30 kg. Body mass index, body fat percentage, and cholesterol are all normal. Friends tell me I'm perfect fodder for one of the women's weeklies, photographed resplendent in my old suit, holding out the waistband in a comical style. I'm playing rugby league and boxing and have dispensed with the bike for the daily commute in favour of running. I have bundles of energy and the zeal of a convert.​convert.




Figure 1





Live and let diet

Credit: MB PICTURES/REX FEATURES




Now I save my loudest guffaws for the usual suspects wheeled out for the newspapers and television to say the Atkins diet doesn't work. I have discovered a new level of evidence, one more exalted even than the randomised controlled trial and meta-analysis: personal experience. I'll tell you exactly how Atkins works: eating lots of protein fills you up and keeps you feeling full. Simple carbohydrates don't, so eat complex ones instead. Eating fat seems optional. My neighbour did the South Beach diet (a low fat version of Atkins) with similar success. My daily energy intake is half what it was, and I feel less hungry now than when I weighed almost 100 kg.

So the experts can bang on as much as they like about the evidence, the data, and the trials, and I'll just quietly get on with not being fat any more. Robert Atkins may not have been absolutely right about how his diet works, but who cares? Perhaps we need to recognise that our scientific methods are simply not up to answering some questions, and maybe we should start listening to our patients properly. My grandmother once told me that furosemide made her feel drowsy, and I told her that she was bonkers. Now I'm not so sure.