The All Meat Diet

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Jan. 1, 2001 -- Eggs and bacon for breakfast, tuna fish with mayonnaise -- hold the bread -- for lunch, two hard-boiled eggs for a snack, and a big T-bone steak for dinner. That's a typical meal plan for 27-year-old Stacy Smith, a recent convert to the fad of the moment: the low-carbohydrate diet.

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The Portland, Ore., resident can eat unlimited amounts of meats and cheeses and other dairy foods, but few vegetables, and no fruits or grains.

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It's almost too easy. No calorie counting. No portion sizes. Just avoid the "bad" foods, which in this case include things like pasta, bread, apples, and pears.

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The plan, which proponents say has been adopted by more than 10 million people since the book Dr. Atkins New Diet Revolution first was published in the 1970s and republished in the late 1990s, flies in the face of conventional advice about calorie reduction and balanced nutrition. Copycat plans like Sugar Busters and The Carbohydrate Addict's Diet follow similar principles. By limiting the intake of carbohydrates, the theory goes, the body is forced to turn to stored fuel -- in other words, fat -- into energy, entering a fat-burning state called ketosis.

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Not everyone is convinced, however. Opponents say that restricting carbohydrate intake isn't a magic formula for fat loss, feeling instead that these plans may leave you lighter in weight but with just as much body fat.

The Low-Carb Shell Game

How can a diet make you lose pounds but not fat? It's all in the way low carbohydrate diets work, says Karin Kratina, MA, RD, a nutrition therapist who specializes in treating weight and eating problems in her private practice located in Gainesville, Fla. She tells WebMD that carbohydrates are broken down into glucose by the body, which in turn either is used immediately for energy or converted into a storage form called glycogen, primarily in the cells of the liver and muscle. Such glycogen is metabolized easily back to glucose, and provides about half of the body's energy supplies daily. Everything from processing a thought to getting from point A to point B requires energy from glycogen, Kratina says.

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"At any [given] time, we have about 1,200 calories of glycogen on board," she says. And for every gram of glycogen stored, so are three grams of water. Therefore, when carbohydrate intake is restricted and the existing stores of glycogen stores are exhausted, the body sheds the stored water, leading to an impressive water "weight loss" within a few weeks.

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Once the glycogen is gone, the body does turn to fat as a fuel source. But in reality, fat is an inferior energy source compared to glycogen. It's like trying to run a car on lighter fluid, says John Acquaviva, PhD, assistant professor of physical education at Roanoke College in Salem, Va. "In ketosis, the body does burn a higher percentage of fat, but overall, less calories are burned," he tells WebMD.

System Shutdown

"People need to remember that there are a lot of ways to lose weight, but not all of them are healthy," Acquaviva says. "Starvation is one obvious example." As the body starts to burn stored fat, it creates byproducts called ketones, leading to the state of ketosis.

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If the determined dieter sticks to the plan despite the unpleasant side effects of this state -- including foul acidic breath, fuzzy thinking, and fatigue -- additional pounds will come off. But like the water loss, it is an illusion. The majority of the loss is muscle, not fat, leaving the dieter with a higher body fat percentage and less lean muscle tissue, Kratina says.

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Then the carbohydrate cravings kick in, she says. The body seeks to replace the missing glycogen and restore balance. Dieter Stacy Smith knows this feeling all too well.

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"I'll suddenly crave things like bread, oatmeal, ice cream," she says. "I'll binge, eating three or four bowls of oatmeal at a time." When she does, her body once again stores glycogen and water, leading to a dramatic "weight" gain. The numbers on the scale quickly rise 10 to 15 pounds, reinforcing the idea that carbohydrates are to blame.

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Smith accepts the label of carbohydrate "addict" and goes back on the plan. It becomes a vicious circle of starve, binge, starve, binge.