FAQ from the Atkins Center
1. Why am I unable to get into ketosis even with zero
carbohydrates? What should I do?
ANSWER: You are either metabolically resistant to weight loss or else
you don't know all sources of the carbohydrates you may be eating. If you are
losing weight and doing well, there is no need to do anything differently. If you
are not doing well losing weight, you may need additional help by adding the
Dieters' Advantage (2 pills, three times daily), or FMF#24 (2 pills, three times
daily) or L-Carnitine. To stimulate ketosis, the best diet is high in fat (cream
cheese, macademias, deviled eggs, etc.), moderate amounts of protein and
zero carbohydrates (see chapter on the Kekwick diet in the book). You may also
need to increase exercise from three times per week, to four or five times per
week. If all else fails, you need to see an M.D. trained in the Atkins system.
2. What is the reason I'm stuck on the diet and not losing?
ANSWER: There are many factors that influence an individual's ability to
lose weight. These may include a) too many carbohydrates having been added
to the Ongoing Weight Loss level of the diet (O.W.L), b) low body temperatures
which indicate a possible sluggish thyroid and/or c) difficulty with the use of
artificial sweeteners. The factors that influence your progress need to be
evaluated individually until a solution to permanent success is found. Too often
we give up at the first roadblock and begin the cycle of failures again.
REMEMBER THAT SUCCESS IS NOT JUST MEASURED BY NUMBERS ON
THE SCALE. Consider the following: are you experiencing more energy and
vitality? Are your clothes fitting you better? Are you free from hunger and
cravings? Are your blood tests improved? If you can answer yes to any or all of
these questions, then you have found the right program and if you require further
assistance, consider scheduling a telephone nutritional consultation (TNC), or
come see us in person (see page on Atkins Center for details).
3. What medical conditions should be monitored by an M.D. during the diet?
ANSWER: All medical conditions requiring prescriptions, and even
some that don�t, like diet controlled diabetes mellitus, need to be monitored by a
physician. This is necessary because the diet and nutritional supplements
improve so many conditions that the prescriptions often become an overdose or
4. Are there any medical conditions that can interfere with a person's ability
to be on the diet?
- Far advanced kidney disease, gout, urate kidney
stones, or unmanageable constipation or allergy to the primary foods on the
diet, such as meat, cheese, etc.
- The absence of digestive enzymes needed to digest fat and protein
make the diet difficult to handle-but this can usually be corrected.
- Underweight or normal weight people should not use the induction
phase of the diet, but rather a modified version which we have adapted.
- Known previous bad reactions diosyncratic) to the diet.
5. What medications interfere with or need adjustment during the diet?
ANSWER: Virtually all medications interfere. The most incompatible medications are:
Fortunately, doctors who work with the diet can usually use it and certain
supplements to help you get off each and every one of the above or taper you to
minimal doses. Please DO NOT COME OFF MEDICATIONS BY YOURSELF
without medical supervision.
- Diuretics (water pills)
- Psychotropic drugs, including prozac, zoloft, lithium, etc.
- Hormones and steroids, including estrogen (premarin), birth control
pills and prednisone.
- Arthritic drugs, especially NSAIDS (Non-Steroidal Anti-Inflammatory Drugs)
- Cholesterol lowering drugs.
- All anti-diabetic medications, including insulin with the exception of
- Seizure medications.
6. If some of my medications can affect the diet, what can I do?
ANSWER: There are certain medical conditions that require tapering
off medications ONLY under the supervision of a physician familiar with the diet
and the use of nutritional supplements. However, there are some options open
to you especially if your health care practitioner is willing to monitor you during
the tapering process.
Blood Pressure Medications: In our practice, we can always discontinue
the use of diuretics and other medications for blood pressure management by
using nutrients such as the AH#3, Taurine, Asparaplus, Magnesium, L-Carnitine
and CoEnzyme Q10.
Allergy Medications: During the allergy season we usually can keep our
patients comfortable using our Allergy #13 Formula and Pantethine without side
effects such as drowsiness. These nutrients can also safely be used by people
who can't use anti-histamines due to potential complications of other medical
Antibiotics: Since the use of antibiotics can stimulate candida (yeast)
overgrowth that can interfere with weight management, we rely on our special
formulation, AI#6. Taken at the onset of symptoms, this formulation of special
nutrients supports the immune system during the crucial first days of infection.
Often this can prevent the need for antibiotic treatment.
Arthritis Medications: Due to the chronic nature of arthritis, relying on
non-steroidal anti-inflammatory drugs for arthritis can affect weight loss.
Many patients can quite comfortably use our special formula, Arthricare,
often in combination with Essential Oils Formula, Sea Cucumber, Pantethine
and Glucosamine Sulfate.
7. My doctor has given me diuretics (water pills) because I retain water
especially before my period. How can I get off these pills?
ANSWER: If water pills are prescribed simply for water retention and
not for the treatment of heart disease or high blood pressure, there are several
nutrients that should allow you to safely stop these drugs. Supplements such as
B6, Taurine, Asparaplus and herbal preparations can be very useful. In addition,
the use of the low carbohydrate diet has a strong diuretic effect which helps to
manage fluid problems. Of course, if these drugs are being used for treatment
of heart disease or high blood pressure, any changes must be made under
8. Can a person with kidney problems be put on the diet? If so, how is the
ANSWER: The diet can be used safely by any kidney patient whose
creatinine level is under 3.0. However, monitoring creatine levels every 2 weeks
is required. Creatinine levels above 3 require a doctor's management.
9. Can patients with high uric acid (gout) be put on the diet? If so, how is the
diet adjusted and will gout medication need to be changed?
ANSWER: Gout can be aggravated by the diet. It usually requires
slowing the weight loss down to less than 2 lbs per week and taking 300 mg of
allopurinol (a prescription drug). If uric acid stays down, allopurinol may be
tapered down and stopped after 1 month under a physician�s care.
10. I have kidney stones. Will the diet cause an attack?
ANSWER: There is no evidence to indicate that this has happened to
those on the diet any more frequently than those who are off the diet. You must
observe the rule about drinking 8 or more glasses of water per day, and more if
sweating, vomiting or diarrhea takes place.
11. Can I go on the diet while taking heart medications? Will they interfere?
ANSWER: Diuretics and cholesterol medications interfere. The others
are acceptable, but see answer #4.
12. Can Type I and Type II Diabetics both follow the diet?
ANSWER: For a type II diabetic, the diet is a Godsend. In fact, it is
usually "curative", allowing for normal blood sugar without medication.
For type I, it usually helps to at least cut down on the insulin
requirements, but this can only be done if managed by a doctor extremely
familiar with treating type I with this diet.
13. Should overweight cancer patients be on this diet? Won't it overburden
the body and cause toxicity?
ANSWER: My overweight cancer patients have done extremely well on
this diet, but the decision rests on evaluating the severity of the cancer versus
the severity of the obesity problem. I've seen no toxicity.
14. How long can a person be on 20 grams or less of carbohydrates per day?
ANSWER: As long as that person remains overweight and feels well.
15. Why do I have bad breath on the diet and how can I improve this problem?
ANSWER: Bad breath is from the production of ketones as you burn
body fat and is a good sign that the diet is working. Ketone production is
necessary for continuing weight loss. To counteract the odor, you may increase
to a slightly higher carbohydrate level; however, this can slow down weight loss.
You may also use chlorophyll (must be sugarless), eat more parsley and
dark green, leafy vegetables, and be sure that your water intake is at least 8 or
more glasses daily (use water, not another flavored beverage).
16. What is the highest level of carbohydrates per day recommended for
ANSWER: Read the chapter on maintenance and understand the
principle of CCLM (Critical Carbohydrate Level for Maintenance). You should
look for the highest level of carbohydrates that won't allow you to regain or cause
hunger and cravings.
17. Why isn't sugar or caffeine allowed on the diet?
Sugar: It's the worst food of all. If you don't
understand why, we suggest you re-read the book until you master all of the
Caffeine: Caffeine stimulates an overstimulation of insulin, which
ultimately promotes weight gain. The biggest need is to stop a caffeine
addiction. Once you go 2 weeks without caffeine, you may have it again as long
as you don't become dependent on it for energy.
18. Why is the diet so low in fiber? Will this be a risk for my colon?
ANSWER: The diet is low in fiber because most fiber-containing foods
are also high in carbohydrates. Don�t forget to eat salads. There is a colon risk
only if you get quite constipated. Use 2 tbsp of psyllium husks in 2 glasses of
water every morning and/or 2 tbsp of unprocessed Miller's bran if this is a
concern. If constipation persists, magnesium oxide may be helpful as well as an
herbal laxative tea.
19. Why do you allow "fried foods"? They are a known health risk.
ANSWER: Fried foods allow you to enjoy the diet more, and do not
adversely affect the body's new metabolic state (lipolysis, or "fat burning") which
is created by the diet. However, I do agree that given a choice, broiling or
roasting of meat is preferable; both of these two ways of cooking eliminate the
"trans fats" that are created by the ultra-high heat of frying.
20. How much water should a person on the diet be drinking?
ANSWER: Eight (8) glasses is the usual recommendation. Coffee, tea
and diet sodas should not apply to this minimum. If it is difficult to drink 8
glasses, then drink as much as you comfortably can.
21. What nutrients play a special role in weight loss?
ANSWER: L-Carnitine, CoQ10, Dieters' Advantage, FMF#24, and chromium.
22. Should I take the Essential Oils during the diet even if my cholesterol is
ANSWER: Yes. If your cholesterol is good, 3 daily is enough; however, if
either cholesterol or triglyceride levels are high, use 6 daily.
23. What is best for leg cramps?
ANSWER: Supplements of potassium, magnesium and calcium are
needed. Potassium is best replaced by a potassium chloride salt substitute
from the supermarket (used liberally).
24. Saturated fat lowers insulin sensitivity and is not recommended in high
amounts by leading health organizations. Why do you allow so much?
ANSWER: I have not found any benefit from cutting down on saturates
and replacing them with monounsaturates. However, medium chain fats (MCT's)
may be helpful. The reason for including meat, chicken, egg and cheese fats is
to maintain the maximum enjoyability of the diet, especially since no harmful
effects have been shown.
25. At what age can a child be put on the diet?
ANSWER: Babies, if showing signs of obesity, should be moved in the
direction of this diet as soon as the tendency is noted (no sugar, less fruit and
juice, and more protein). If this fails, the carbohydrates should be increasingly
restricted. Please do not do this without the guidance of a knowledgeable
26. Is the diet okay for pregnant or breast-feeding women?
ANSWER: Pregnant women do well on a maintenance level of the diet,
but should not use the weight losing level. Nursing women do well if they take
extra vitamins, especially 5 mg of folic acid. Please do not do this without the
guidance of a knowledgeable obstetrician.
27. Is the diet good for athletic people? If so, how does it need to be
ANSWER: It is excellent for athletes. However, in stamina competition such as
marathons, triathons, etc., carb-loading before competition may be necessary/
28. Can I drink alcohol on the diet?
ANSWER: Alcohol is absolutely forbidden on the induction diet. One
should only drink it during the maintenance phase of the diet and then not as the
first thing that�s re-introduced after the induction diet. The best alcohol products
to have are the hard alcoholic beverages like scotch or rye, followed by vodka
etc. Rum, as it is made from sugar cane should always be avoided. Likewise,
wine should be avoided because it is made from grapes which are very high in
sugar. Despite all the reports that there are plenty of benefits that may be
obtained from red wine, you can take this in the form of a supplement known as
grape seed extract. There are many versions of this product; we recommend a
product known as Activin to patients at the center.
29. In the book, Dr. Atkins says we can have bacon. But isn't bacon cured with
sugar? How can I find bacon, sausage and other meats without nitrates and/or
ANSWER: Bacon and many other cured meats, including ham are cured
with sugar. Most however in the curing process lose the sugar and it does not
become a factor when determining sugar and carbohydrate contents. There are
many brands that may be available in your area. I would suggest contacting a
local butcher who should be able to provide you with the information you need.
30. I just started the diet and I have a severe headache. What can I do to
alleviate this symptom?
ANSWER: Don�t worry; your headache will go away after the third day.
Sometimes patients will get withdrawal headaches from all the caffeine and all
the sugar they are used to eating. Usually this resolves in the first three days and
then your body will be able to start on its new efficient fat burning self. If these
symptoms do not resolve, you should contact your local physician. This usually
convinces people of the addiction they may have had to either caffeine or sugar
31. Can a vegetarian be on the Atkins Diet?
ANSWER: Animal proteins are a vital component of the Atkins Diet and
the diet cannot be done as successfully without them. They contain many
essential fatty acids that cannot be found in any other sources. There are
patients, however, for whom we derive a modified ovo-lacto vegetarian diet;
they can eat eggs, cheese and tofu for their protein (although it is usually
necessary for a person to be able to eat fish, in addition, for the diet to be
enjoyable). Our food products, such as Advantage Bars, bake and shake mixes
can also be used as meal replacements.
A vegan cannot be on the Atkins Diet. A pure vegan diet could never be
low enough in carbohydrates, because there are no plants that are carbohydrate
We seriously urge vegetarians with a serious weight problem to rethink