

Q: I did the Atkins diet many years ago. I didn’t lose weight, and my cholesterol went up and never came back down. I realize all diets don’t fit everyone, but I’m curious why it didn’t work for me. My own doctor just said that “it happens sometimes.”
A: The Atkins Diet is very low in carbohydrates, also called a ketogenic diet, which the scientific literature has repeatedly confirmed as an effective weight loss plan when followed correctly. It is also a therapeutic diet for epilepsy and cancer and is the antidote to type 2 diabetes and metabolic syndrome. First, let me address the cholesterol issue, and then I’ll explain where you likely got into trouble with the diet.
What typically happens on a very low carb, high fat diet—like Atkins—is that total cholesterol goes up. That means HDL goes up significantly and that’s a good thing. You’ve got a bigger “garbage truck” to carry out the so-called bad stuff. Yes, your LDL probably went up a bit too, but because your HDL is higher, your ratio improved. At worst case, it’s a wash.
Have you had an NMR or VAPS test to take a closer look at your particle sizes? On an Atkins diet, small, dense atherogenic LDL will become large fluffy Pattern A particles, which are desirable. This is a definite improvement in cardiovascular disease risk factors.
Finally, on Atkins, high triglycerides fall way down, even before any weight loss occurs. Elevated triglycerides are an independent risk factor for heart disease—in my opinion even more so than cholesterol.
But you didn’t lose weight, so let’s explore some reasons that could be.
Were you using ‘diet’ or low carb products? Drinking diet soft drinks? These artificial sweeteners, despite their “0” carbohydrate content, are known to stall weight loss and even cause weight gain.
Are you on any medications? Many blood pressure medications, antidepressants and steroids can cause metabolic resistance to weight loss.
Have you had your thyroid checked? If your thyroid is sluggish, the best diet in the world won’t help you lose weight.
Finally, even though you can eat more calories on Atkins vs. a low fat, low calorie diet and still lose weight, it’s possible you were simply eating too many calories. There’s also the issue of too much protein on a low carb diet which I will address next week.
To your health!
Leyla Muedin, MS, RD, CDN
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