Dr. Atkins Diet Revolution turned the world of weight loss upside down with its revolutionary low carbohydrate thinking. His diet plan has now been promoted for over twenty years and has outlasted hundreds of highly popular short-term fad diets over this period.

Dr. Atkins' diet plan has been through some modifications during that time, though in essence still retains its basic premise - that carbohydrates (particularly sugars and starches) stimulate insulin production, and that insulin is a "fat hormone".

Some say that Atkins "pioneered" the concept of low carbohydrate, high protein weight loss dieting. This is untrue. He was preceded by Dr. Herman Tarnower, whose "The Complete Scarsdale Medical Diet" was popular in the 1970's after having been recommended to patients since the early 1960's. And, thousands of years prior to that, anthropology teaches us that our paleolithic ancestors had predominantly high protein, low carbohydrate diets.

Still, Atkins took the concept to greater extremes. Even lower carbohydrates and even more proteins and fats than "Scarsdale".

Low-carbohydrate diets have been the subject of heated debate in medical circles for three decades [1]. They are still controversial and only recently has any serious research supported some aspects of Atkins' claims, especially for short-term weight-loss (6 months or less).

But the broader consensus of the scientific community also raises serious concerns:

• The National Weight Control Registry, funded by the National Institutes of Health (NIH) tracked the habits of successful dieters over a longer term, 10 years. Despite this diet's overwhelming popularity compared to other diets, of the 5,000 Americans confirmed to have lost an average of 70 pounds and able to prove they have kept it off for at least 6 years of the decade of NIH’s data-keeping, less than 1% were confirmed to be Atkins adherents.

• Even in studies only one year long, this diet can fail to produce the greater weight-loss which is claimed to come from factors other than calorie-reduction such as ketosis: It was compared to dieters on Dean Ornish ’s diet, Weight Watchers, and The Zone Diet for 1 year. The Atkins Diet came last in terms of weight lost at the end of the year. (Dansinger, M.L., Gleason, J. L., Griffith, J.L., et al., "One Year Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in Decreasing Body Weight and Heart Disease Risk", Presented at the American Heart Association Scientific Sessions November 12, 2003 in Orlando, Florida.)

• The May 2004 Annals of Internal Medicine study showed that Atkins Dieters had significantly more diarrhea, general weakness, rashes and muscle cramps. Atkins.com now suggests a fiber supplement.

• Also, acidity from the typically high protein intake can cause osteoporosis (Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Milk, dietary calcium, and bone fractures in women: a 12-year prospective study. Amer Jrnl Public Health 1997;87:992-7. See also follow-up in February, 2003 issue of the American Journal of Clinical Nutrition (Vol. 77, No. 2, 504-511); this includes 72,000+ people and 18 years of data. Cumming RG, Klineberg RJ. Case-control study of risk factors for hip fractures in the elderly. Amer Jrnl Epidemiology 1994;139:493-503.

With its emphasis on fatty foods, the Atkins diet has generally been considered by most medical and nutritional experts to be unsound. It also violates the food pyramid, which states that amounts of carbohydrates, protein and fats (in that order) must be regularly consumed to stay healthy. Some experts have even suggested Atkins' plan is quackery. Among those criticizing the healthiness of his diet, if not also skeptical of the claims of greater weight-loss than other, safer diets, are such reputable organizations as:

a. “...the Atkins diet, as recommended, poses a serious threat to health.” --Chair of the American Medical Association's Council on Food and Nutrition, testimony to Congress

b. "unhealthy and can be dangerous." --C. Everett Koop (Shape Up America! news release, 29 December 2003)

c. "a nightmare of a diet." --Journal of the American Dietetic Association 102 (2002): p.260

d. Also condemned by National Institutes of Health in NIH Publ. No. 94-3700, 1993.

e. Condemned by ACS in American Cancer Society; Weighing In on Low Carb Diets, 2004.

f. Condemned by the American Kidney Fund in American Kidney Fund news release, 25 April 2002.

g. Condemned by American Heart Association in Circulation 104 (2001): p.1869.

h. Condemned by Johns Hopkins in Diabetes 2004. Johns Hopkins University White Paper, 2004

i. Condemned by the American College of Sports Medicine in Medicine and Science in Sports and Exercise 33 (2001): p.2145.

j. Expressing a general sentiment was the conclusion: “runs counter to all the current evidence-based dietary recommendations.” --Journal of the American College of Cardiology 43 (2004): p.725

Opponents of the diet also point out that the initial weight loss upon starting the diet is a phenomenon common with most diets, and is due to reduction in stored glycogen and related water in muscles, not fat loss. They claim that no evidence has surfaced that any diet will cause weight loss unless it reduces food energy below the maintenance level, and reports have indicated that successful weight loss due to the Atkins diet may be the result of less food energy being consumed by the dieter, rather than the lack of carbohydrates.  They further point out that weight loss on fad diets, which typically restrict or prohibit certain foods, is often due to the fact that the dieter has less food choices available. Also, a diet of low-carb foods may quickly become dull to many people, meaning that their appetite is somewhat naturally suppressed as they become hungry for carbs, but the dieter either has none handy or resists this hunger.

There is also bad breath and fatigue, which are only the milder symptoms of the purposefully-induced ketosis, yet Atkins accuses other diets of causing fatigue: and Cleveland Clinic Journal of Medicine 68(2001): p.761

In addition, Atkins' claims that high carbohydrate diets cause obesity are contradicted by the fact that societies which treat carbohydrates as a staple, in particular countries in East Asia such as Japan, China and Thailand, where rice is often consumed at each meal and drinks and snacks are also made from the grain, often have remarkably low rates of obesity. However, given other factors, such as an increase in sedentary recreational and work activities over these decades, there is only correlation between this higher-calorie diet and the rise in obesity, but no conclusive, causal relationship between any diet and America's obesity; one can even turn Dr. Atkins' spurious (not supported by the data) correlative argument against the Atkins Diet itself, by pointing out that this obesity rose in concert not with higher carbs and lower fat, but it HAS risen as low-carb diets were created, and got worse as they got more popular.

Dr. Robert Eckel of the American Heart Association says that high-protein, low-carbohydrate diets put people at risk for heart disease.

Users of the diet must exercise significant caution when manipulating their body's natural metabolic state.

It should also be noted that for individuals who participate in sports, this diet is not good. Athletes require carbohydrates as they are easiest for the body to utilize for energy (ATP). Fats must be beta-oxidized , but this requires extra oxygen, reducing the advantage of a high VO2 Max. Less oxygen is going into making energy, some is going into a conversion instead. Protein nucleotides can also be used to directly synthesize ATP, but at this stage, the free fats and carbohydrates stored within muscles have been depleted. This can result in an athlete "bonking" and suffering from very low performance.