Atkins seemed at times to have invented the diet doctor as type—messianic, brash, smart, embattled—and yet, in ways, he’d been the accidental guru.
From his earliest days, he’d wanted to be a traditional doctor. “He was so smart, he skipped a grade,” says his mother, Norma, now almost 95. (Her husband died at 84.) He trained at Cornell as an internist. “He was a blue-blood at first; he believed in medical orthodoxy wholeheartedly,” says Veronica. Later he’d train in cardiology, though the specialty wasn’t for him. He visited a patient at home, saved her life by doing a quick procedure, and, for thanks, was instructed to call her physician in the morning. “He was a technician to her, providing a service,” remembers Stuart Fischer, who worked with Atkins for eight years. “He didn’t want to go through life like that.”
In 1963, Atkins read about a low-carbohydrate diet in the Journal of the American Medical Association. The conventional wisdom was that a diet low in fats and high in legumes and vegetables helped a person lose weight and stay healthy, unsatisfying and almost un-American as it seemed. But the JAMA article argued that the real cause of weight gain wasn’t fatty foods but carbohydrates, like pasta. Atkins, a voracious reader of medical literature (he’d never be spotted with a novel), decided to conduct an experiment with the low-carb approach, using himself as a subject. Atkins had weighed 135 pounds in high school; twenty years later, he’d gained almost 90 pounds. Atkins found the low-carb diet easy to stick to—he lost about 28 pounds in six weeks. For the rest of his life, he said, he never went off it.
In 1972, Atkins published Dr. Atkins’ Diet Revolution—incongruously, the cover seemed to feature a chubby Buddha. Buddy Hackett made fun of it on The Tonight Show. (He was, he laughed, dieting on nothing but steak.) The book was an instant best-seller, selling almost a million copies.
Yet, almost from the start, Atkins’s diet was dismissed as a dangerous fad. A concerned Congress called him to a hearing on fad diets in 1973, where he was labeled not only bad for your health but impudent. How dare he “impugn the reputation” of the noted doctors who told America that the healthy way to lose weight was to avoid fatty foods? one senator asked.
But, clearly, Atkins had an appetite for controversy. He was pugnacious, almost aggressively open-minded, and also, says his wife, “a showman.” (He had spent a summer as a comic waiter in the Catskills.)
And so, unable to gain the acceptance he craved, he set out on another tack. “Okay, I’ll be the best enemy you ever had” is the way his wife describes his attitude. He seemed to taunt the low-fat proponents, like Nathan Pritikin, whose diet book, The Pritikin Program for Diet and Exercise, appeared in 1979, and later Dean Ornish, and particularly the vegans.
Diet is a lifestyle issue, social as much as medical, as much a subject of the dinner party as the examining room. And though scientists dismissed him, his message appealed, for instance, to people who eat. After all, look at how the low-fat side wanted you to live. Like puritans! They made you count calories and cut out delicious, high-fat foods. Dieting, they seemed to say, took vigilance, effort, exercise, suffering. Dieting, in this version, required moral fiber, as well as other kinds.
In contrast, Atkins seemed a libertine. Eat until you’re full—“without counting calories,” said the good doctor—and everything you want, except carbs. Vegetarians pushed legumes, whole grains. Atkins offered an all-American lineup: pork chops, steak, cheese. One of his favorite things to cook was what he called an “internalized cheeseburger”—cheese on the inside—and no bun.
But aren’t whole grains important? “To cereal manufacturers,” said Atkins.
Vegetarianism? Atkins made it seem so boring. “If people want to go on Mr. Pritikin’s diet”—it was largely vegetarian—“and eat beans and peas to lose weight,” Atkins said, “that’s fine.”
Atkins goaded the vegetarians, posing in front of a dining-room-size table of chops and steak. Of course, Atkins also said, “I eat more vegetables than the average vegetarian.” Still, Atkins made his diet sound like luxury, cramping a person’s style as little as a Cadillac. And by the way, he said, it hadn’t harmed his patients’ blood pressure, cholesterol, or cardiovascular system—though there wasn’t scientific proof to support this.
On the Tomorrow show in 1981, Atkins appeared with Pritikin, who’d developed his diet after a diagnosis of heart disease at the age of 41. (Diet doctors weren’t just healers, they were seekers too. No wonder this was personal.) Onstage, the two diet gurus screamed at each other.
When Pritikin charged that Atkins’s diet “sets you up for heart disease and stroke . . . and clogs your arteries,” Atkins had had enough. He threatened to sue Pritikin for $5 million for slander. This got him more attention—which likely was the point. Even afterward, Atkins and Pritikin continued to go on TV together, a tandem always on the verge of a fight. (One TV exec compared their performance to the televised encounter between Jerry Falwell and Larry Flynt.)
And for Pritikin, another diet martyr, albeit a more self-conscious one, death seemed just the opportunity he needed to prove his point. He killed himself in 1985 at the age of 69 after a recurrence of leukemia. But before he went, he directed that his body be autopsied. A letter to the New England Journal of Medicine reported the results: low cholesterol and a near absence of clogged arteries. It’s a finding his disciples trumpet to this day.
Screaming on TV might be great entertainment, but it was hardly favored medical style. A doctor ought to be measured and stand behind his research. But Atkins was a physician treating patients, not a scientist. He flouted medicine’s foundational pieties. “We weren’t so tied to evidence-based medicine,” explained Fred Pescatore, one of Atkins’s associate medical directors. “We were into experiential medicine. We tried different things and saw what works with our patients.”
A well-developed clinical instinct is, of course, respected in medicine. Good doctors were supposed to have a nose for the right approach, even if it seemed out of the ordinary. Atkins, though, took this to an extreme. He seemed willing to try anything that might work. There was hardly a disease that he didn’t treat at his center on 152 East 55th Street—multiple sclerosis, cancer, HIV, chronic fatigue, depression, arthritis, you name it. “I don’t want to be known as the diet doctor,” he told his wife.
Of course, there may have been another reason. In the eighties, low-fat reigned, which wasn’t good for Atkins’s diet business. In fact, by the nineties, he’d changed the name of his business to the Atkins Center for Complementary Medicine and began to supplement his Western training with the medicine of other cultures. At one point, his center had 90 employees and may have been the largest alternative-medicine facility in the world. Even here, however, he was ostracized. After all, what self-respecting alternative healer would proselytize for meat?
Still, Atkins employed herbalists, acupuncturists. (“I thought he was a quack” at first, says Jacqueline Eberstein, a nurse at the center.) He often used himself as an alternative-medicine guinea pig. During meetings, he sucked on a metal lollipop to build his immune system, and had his irises examined by an iridologist.
In the early nineties, he administered ozone intravenously, a cancer treatment that he’d read was being tried in Europe. When, in 1993, a 77-year-old woman with recurrent breast cancer had a bad reaction—numbness in one leg, blurred vision, dizziness, weakness in both legs—Atkins’s medical license was summarily suspended. A court reinstated his license, but a bruising administrative trial followed. He considered it persecution by traditional medicine.
By the mid-nineties, high-protein diets were making a comeback, and Atkins was in the lead. His Dr. Atkins’ New Diet Revolution, published in 1992, became a best-seller a few years later. And Atkins Nutritionals, the company he’d formed in 1998 to create food products for those on his diet, was the real moneymaker, its revenues eventually reaching a reported $100 million.
Atkins understood that controversy—or at least the publicity it generated—moved product. As one of his lawyers, Sam Abady, explains, “He was a visionary in terms of understanding the medical marketplace.” Long before the pharmaceutical industry launched ad campaigns aimed directly at consumers, Atkins “understood that consumer interest would have to be accommodated by the medical industry,” says Abady.