"The Treatment of Obesity
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(2008 Jan blog post)
INTRODUCTION : Many critics of Dr. Atkins and his lowered-carbs diet seem to think he pulled his diet out of thin air. The critics seem to lack the will to look up the texts that he credits with leading to his diet proposals. Ironically, many of his strongest critics are doctors in the AMA, American Medical Association --- and Atkins got his inspiration from papers published in the JAMA, Journal of the American Medical Association.
Further irony: The 'Atkins diet' (actually, a lifetime-way-of-eating methodology) was not invented by him. Atkins was actually trying to popularize medical study results that he had read about in medical journal articles published back in the early 1960's --- for the benefit of his patients, for the citizens of this country, and for the citizens of the world. In other words, he was trying to communicate important health information that was "locked away" in stuffy old medical journals, in and among pages of mind-numbing verbiage. To quote Atkins in his book "Atkins for Life", 2003, page xii: "The first published documentation [link to a PDF file] of the success of a controlled carbohydrate dietary regimen appeared in the 1800s, but we needn't go back that far. It was after reading a scientific study on the effectiveness of several low carbohydrate weight-loss programs in the October 1963 issue of the Journal of the American Medical Association [JAMA] that I decided to put a similar approach into practice. We now have, on our web site www.atkinscenter.com, summaries of close to four hundred [ 400 ! ] scientific studies that support the principles upon which the controlled carbohydrate nutritional approach is based." And in the back of the book "The Atkins Essentials" (2004) that was published after Atkins' death, there is a bibliography of 15 peer-reviewed studies, published in 2001 to 2003, that specifically focused on the outcomes that result from the "Atkins Nutritional Approach". Many of these recent studies come from respected researchers at institutions such as Harvard and Stanford --- again, members of the AMA. I find it amazing that people (many of them doctors and dieticians) who debunk lowered-carbs diets can simply ignore these studies, or pass them ALL off as invalid. Hopefully, these more recent studies were done with even more rigor than the study documented on this page. I would have liked to see the weight-loss results of this study presented as %-of-body-weight as well as in pounds and kilograms --- to accomodate the different sizes of the 62 men and women in the study. Because these were obese patients, the women probably weighed much more than 150 lbs and the men probably weighed much more than 200 lbs. Hence the goal of a 20 pound loss in any of them, no matter their height or their recommended weight, was apparently considered appropriate, in the limited time-frame of the study. In spite of the way the weight loss was presented, I think that you will see below that there is good reason to try to maintain a "lowered-carbs" diet, like the one reported here (35-35-30, protein-fat-carbs) --- based heavily on vegetables and some fruit, as well as protein sources --- soy protein, for vegetarians. The typical ratios recommended in "low-fat" diets is 35-20-45 protein-fat-carbs, or thereabout. Note the high proportion of carbs, substituting for fats. This study suggests that such an increase in starchy carbs is NOT a good idea. Simplification of the Atkins Diet : If you don't like to try to keep track of the ratio of protein-to-fat-to-carbs that you are eating (I sure don't) --- and if you don't like to count calories and grams (I sure don't), as a simpler alternative, then just try the 'No Flour, No Sugar Diet' proposed by Dr. Gott M.D. in a book by that name. Dr. Gott realizes that it is just too much to expect that people can and will do food-components data-gathering and calculations --- especially on a day-to-day basis. By the way, Dr. Gott, I would guess, is a member of the AMA --- unless he has been driven out by anti-lowcarb-diet doctors high up in the AMA hierarchy. Dr. Gott's "lowered-carbs"-views, and, especially, the publishing of those views for the world to see, must have made him the target of powerful 'sugar-and-starch carbohydrate interests'. I have to wonder what is driving those anti-lowcarb-diet AMA doctors to 'bad mouth' Atkins so vehemently. Monetary ties to soft-drink-AND-candy-AND-processed-foods-AND-drug-AND-insulin industries ??? Medical reports that inspired the 'Atkins diet' : The "scientific study" link above takes you to a web page at this site that gives you the majority of the text of the Oct 1963 report that Atkins refers to --- i.e. the study that led to his many years spent in formulating and fine-tuning and promoting a lowered-carbs way of eating, to help many of his patients --- and ultimately anyone who was in need of help and who would listen. I could no longer find the Oct 1963 article on-line on the internet. Even the JAMA web site does not have journal articles on-line that the JAMA published before the mid-1960's. So I found the article in a university medical school library --- and I have devoted some hours to keying in the major part of the text, so that the article is preserved on-line. In finding that Oct 1963 JAMA article, I ran across a Dec 1963 JAMA article that Atkins probably saw --- the text of which appears on this page.
NOTE: The Dec 1963 article takes a more "clinical-data-only" approach, than the "biochemistry-oriented" Oct 1963 article, in pointing out the benefits of a lowered-carbs diet. The results come from a "dietetic outpatient clinic" --- and the paper says in the introductory summary, that patients "came to eat a low-carbohydrate, high-protein diet". That probably caught Atkins' eye --- along with the term "obesity" in the title. Since that article probably erased any doubts that Atkins may have had about the likelihood of success in trying a lowered-carbs way of eating, I have keyed in a majority of the text of that Dec 1963 article ... below. Read the Oct and Dec 1963 texts yourself. See if you would have come to the same course of action that Atkins pursued, if you had a medical practice like he had. |
Start of the paper :
The Treatment of Obesity
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Table [from the paper] :
Results of Dietary Treatment of Obesity
[ Introduction to the table : ] "Only series of more than 30 cases which include results of all patients starting diet are listed. Table is based on Feinstein [9], except for the six series with reference numbers. Musgrave [19] has reported extraordinarily good results with male Air Force personnel under military discipline. For these men, the potential loss of flying pay constituted a very strong motivational factor."
[Note:
[NOTE: |
Weight Loss, % of patients | ||||||||
---|---|---|---|---|---|---|---|---|
Series, Year | Environment, Technique | Calories |
No. of patients |
Less than 10 lb (4.5 kg) |
10-19 lb (4.5 - 8.6 kg) |
20-39 lb (9.1 - 17.8 kg) |
40 lb (18.2 kg) or more |
20 lb (9.1 kg) or more |
Munves, 1953 |
Individual interviews or group discussion |
1,200-1,800 | 48 | 71 | 21 | 8 | 0 | 8 |
Joliffe, 1951 | Nutrition clinic; citrus juice as anorexigenic | 1,000-1,400 | 73 | 53 | 36 | 11 | 0 | 11 |
Stunkard, 1959 | Nutrition clinic | 800-1,500 | 100 | ... | ... | 11 | 1 | 12 |
Evans, 1931 [14] | Private office; occasional use of thyroid | 600 | 130 | 59 | 19 | 17 | 5 | 22 |
Bauman, 1928 | Obesity clinic | 1,200 | 183 | 50 | 27 | ... | ... | 23 |
Weight Loss, % of patients | ||||||||
---|---|---|---|---|---|---|---|---|
Series, Year | Environment, Technique | Calories |
No. of patients |
Less than 10 lb (4.5 kg) |
10-19 lb (4.5 - 8.6 kg) |
20-39 lb (9.1 - 17.8 kg) |
40 lb (18.2 kg) or more |
20 lb (9.1 kg) or more |
Harvey, 1954 | Group psychotherapy project | 1,000 | 290 | 47 | 30 | ... | ... | 23 |
Roberts, 1962 [15] | Private office (cardiacs); started on liquid formula, continued on solid diet | 900-1,000 | 78 | 27 | 48 | ... | ... | 25 |
Fellows, 1931 | Employees clinic | self-selected | 294 | 47 | 27 | 21 | 5 | 26 |
Gray, 1939 | Nutrition clinic | 900 | 314 | 52 | 20 | 21 | 7 | 28 |
Young, 1955 | Experimental nutrition clinic | Various diets | 156 | ... | ... | 25 | 3 | 28 |
Hawirko, 1946 | Private office; routine amphetamine | 1,100 | 162 | 55 | 17 | 23 | 5 | 28 |
Osserman, 1951 | Metabolism clinic (diabetics); routine amphetamine | 1,000 | 55 | 35 | 36 | 27 | 2 | 29 |
Barnes, 1958 | Weight reduction clinic; routine methamphetamine HCl + phenobarbital (ambar) (anorexigenic) | 800-1,100 | 50 | ... | ... | 26 | 8 | 34 |
Fineberg, 1962 [16] | Obesity-diabetes clinic; routine phenmetrazine HCl | 1,000 | 43(?) | ... | ... | 42 | 0 | 42 |
Hendon, 1962 [17] | Endocrine clinic; routine diethylpropion HCl | ? | 40 | 38 | 20 | 37 | 5 | 42 |
Weight Loss, % of patients | ||||||||
---|---|---|---|---|---|---|---|---|
Series, Year | Environment, Technique | Calories |
No. of patients |
Less than 10 lb (4.5 kg) |
10-19 lb (4.5 - 8.6 kg) |
20-39 lb (9.1 - 17.8 kg) |
40 lb (18.2 kg) or more |
20 lb (9.1 kg) or more |
Berkowitz, 1960 [18] | Union health officer; routine amphetamine | ? | 100 | 22 | 17 | 35 | 7 | 42 |
Halpern, 1961 [9] | Private office (?); amphetamine or vitamin-mineral candy for most patients | up to 1,200 | 80 | 14 | 39 | 46 | 1 | 47 |
Feinstein, 1958 | Obesity research clinic; low-protein liquid formula | 900 | 57 [a] | 23 | 21 | 30 | 26 | 56 |
Blondheim et al, 1963 (this paper) |
Outpatient dietetic unit; no anorexigenic agent, occasional use of tranquilizers |
1,000 [+/- 200] |
61 | 6 | 21 | 57 | 16 | 73 |
Series, Year | Environment, Technique | Calories |
No. of patients |
Less than 10 lb (4.5 kg) |
10-19 lb (4.5 - 8.6 kg) |
20-39 lb (9.1 - 17.8 kg) |
40 lb (18.2 kg) or more |
20 lb (9.1 kg) or more |
[a] Only patients starting treatment in clinic included. [Feinstein, 1958]
END OF THE PAPER.
FOR MORE INFO : Many more links to informative diet sites --- including before-and-after photo sites --- are on this site, on the Health (Diet) Links page To get some more info on this subject of Atkins and low-carb diets and his critics, you can try WEB SEARCHES on keywords such as: |
Bottom of this page of text from the A JAMA 1963 October paper and this paper were motivators of Dr. Robert Atkins, leading him to fine-tune and promote a lowered-carbs diet.
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This blog content was posted 2008 Jan 29.
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