The gist of Dr. Atkins’ Diet Revolution can be distilled down to three assertions. The first is that weight could be lost on his diet without hunger, and perhaps without even restricting calories. Atkins said that his patients regularly lost weight eating three thousand calories a day, and that he had one three-hundred-pounder who reduced significantly while eating five thousand. His only explanation was that obesity is caused by the kind of calories we consume and not the quantity, and so if we avoid carbohydrates our bodies function correctly and shed any excess weight. He attributed the absence of hunger to the copious calories, the ketosis (which is probably not the case), the effect of insulin on blood sugar—all overweight people “produce too much insulin,” he wrote, and that lowers blood sugar and makes people hungry—and the secretion of what the British clinicians Alan Kekwick and Gaston Pawan had called fat-mobilizing substance. (Virtually all hormones, with the exception of insulin, will mobilize fat from adipose tissue, but none of them will do so effectively when insulin is elevated.)

Atkins’s second claim was that his diet was inherently healthy, much more so than a low-fat diet, because refined carbohydrates and starches, not saturated fat, caused heart disease and diabetes. Atkins later said that Peter Cleave’s Saccharine Disease had been a revelation to him. In Diet Revolution he discussed the research from Yudkin, Margaret Albrink, Robert Stout, and Peter Kuo implicating triglycerides as a more significant risk factor for heart disease than cholesterol. He also claimed, on the basis of his experience with “ten thousand” overweight patients, that cholesterol “usually goes down” on his diet, despite the high saturated-fat content, and that triglycerides invariably decrease.

His third claim was what he called the “cruel hoax” of calorie-restricted diets: “The balanced low-calorie diet has been the medical fashion for so long that to suggest any alternative invites professional excommunication,” Atkins wrote. “Yet even most doctors admit (at least privately!) the ineffectiveness of low-calorie diets—balanced or unbalanced.” Atkins supported his accusation by invoking Albert Stunkard’s 1959 “comprehensive review of the thirty years of medical literature,” and offering three reasons why calorie-restricted diets inevitably fail. First, they “don’t touch the primary cause of most overweight,” which is a “disturbed carbohydrate metabolism.” They also fail because they reduce energy expenditure. “Dr. George Bray,” he wrote, “has demonstrated that people on low-calorie diets actually develop lower total body energy requirements and thus burn fewer calories.” (Although Atkins didn’t say so, this research had led Bray himself to publish an article entitled “The Myth of Diet in the Management of Obesity.”) And, finally, Atkins wrote, “The main reason low-calorie diets fail in the long run is because you go hungry on them…. And while you may tolerate hunger for a short time, you can’t tolerate hunger all your life.”