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Dr. Atkins describes insulin as "the hormone that makes you fat" and also talks about a "carbohydrate-induced metabolic disorder". He contends that overweight people produce too much insulin, which lowers their blood sugar and results in hunger. Also, they have been advised to eat more calories from carbohydrates and he feels that carbohydrates feed into this excessive insulin mechanism.
à Insulin, and more precisely the insulin to glucagon ratio is very important in the control of body weight as well as in the supply of fuels for the body's functions. It is true that coma can result from a blood glucose level that is too low since the brain requires a certain amount of glucose at all times. Insulin is an integral part of calorie homeostasis and blood sugar control.1 Dr. Atkins takes a very simplistic view of this very sophisticated and highly regulated control system.
There is no solid evidence that high insulin levels make you fat. It is true that obesity is associated with an increased number and/or size of adipose (fat) cells. These cells contain fewer insulin receptors and thus respond more poorly to insulin. This leads to higher fasting blood sugar levels and higher levels of circulating insulin. However, this is not caused by increased carbohydrate intake but is most likely due to the decrease in the number of insulin receptors.1
Obesity is simply an excess accumulation of body fat. The causes of obesity include genetics, environmental and psychological factors as well as some rare illnesses. In humans there are multiple genes involved in the genetic factor; i.e. we are not like rats with one single gene that is responsible for obesity. Also, the genetic factors are difficult to separate from lifestyle factors since families often share the same lifestyles. The environmental factors of obesity include diet and activity level. People who consume a high-fat diet tend to be more overweight than those that consume fewer calories from fat. This is because high fat foods are more caloric dense so people tend to eat more calories when they eat a majority of high-fat foods. By the same token, many people remain lean on diets extremely high in carbohydrate (by U.S. standards) and correspondingly low in fat. There is no reason to associate a diet rich in carbohydrate with obesity.2
What most people don't realize is that the body weight of many adults fluctuates only slightly during the year. This is due to the body's exquisite control in balancing caloric intake and daily energy expenditure. However, a very small but prolonged excess in calories will cause weight gain. This small excess of calories (from any source) is most likely the cause of most obesity.3
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