The claim is that she sold it and I merely was repeating that claim until it can be proven different. But pretty much everything else I shared about her has been found to be 100% true. THANKS for your comment!

Once again, I fervently hope that many contemplating this health-endangering starvation diet will get a chance to hear your words and make an intelligent and informed decision AGAINST following Kimkins. I’ll be blogging later today and will place a new link to this great podcast there!

I noticed that study was done on rats straight off. I hate including rat studies and never usually mention them but considering what it was about I figured it was worth mentioning there plus it serves to remind me to find more and thus I eventually added it to the page. I have been trying to find out if they were obese or not and have emailed the author but if you do read the full text they do say that there were large amounts of fat on the control rats.

The diabetes study, as I said previously, it was suggested, this wasn’t something they were expecting or trying to show. None the less, that doesn’t make it any the less interesting.

Also this bit here caught my attention:
“The metabolic situation in extremely low-calorie diets may be comparable to that in starvation. An attempt is made to explain our observation concerning the induction of a diabetic state during such diets, on the basis of increased insulin resistance in states of starvation and anorexia nervosa, with a concomitant role in stress hormones.”

That seems to be suggesting that it happens in states of starvation and anorexia?

You mention the sudden deaths and electrolyte imbalance, I don’t disagree with you there but how is that not a possible risk of a VLCD diet? What makes it worse is salts seem to be discouraged.

Okay you agree on 500 calories not being a good idea, that is what the majority of people on kimkins follow. The purpose of this page is to show that there are potential risks involved in the hopes they will research further and if necessary do so under proper care by an experienced doctor. I sure as heck ain’t going to suggest to someone that the quality of their diet is moot simply because they are fat.

Furthermore, many people on kimkins are within a healthy weight range or continue right through until they are slim when the risks are certain to be even more great. Also calories appear to stay very low after they reach goal, they seem afraid to eat.

The Jama study, firstly the abstract, is all I have access to, I have not found it in full online. All I can say is, I am not satisfied that these risks don’t exist based on that and even they state:

“Current VLCDs are generally safe when used under proper medical supervision in moderately and severely obese patients (body mass index [weight in kilograms divided by height in meters squared] > 30)”

I certainly don’t think that would vouch for a diet like Kimkins.

I am quite happy with the studies I have put up and feel they certainly tie in with peoples own experiences on diets like kimkins.

In regards to starvation mode, maybe the answer to this depends on what you define as starvation mode.

Just quickly I have seen two studies recently that are in support of VLCDs both had an interesting comment which I hope to find time to look into:

“Weight loss followed by rapid regain, on the other hand, may be harmful. We have observed, along with others, that patients seem to have a more difficult time on VLCD programs which follow previous weight loss and regain [Kelly Brownell, PhD, personal communication].”
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1646394&blobtype=pdf

“Two negative ratings-disruption of normal social eating and thinking about food(and wanting to eat) increased after 2mo of the VLCD. These data are consistent with the suggestion that there is a fatiguing effect after 8 weeks (49) of a VLCD, making adherence more difficult.”

http://www.ajcn.org/cgi/reprint/55/4/811

Oh I recall your mentioning that metabolism doesn’t increase upon eating more calories, I have read many times that it does, maybe its mentioned in one of those studies I put down under RMR.

Okay I think I remembered everything I wanted to say

You and I may be polar opposites from a political standpoint–did my research– but I think that one thing we can agree on is that this woman MUST be stopped. This ‘die-t” is very dangerous. I did it for a 1.5 months and got so sick I missed a family reunion because I couldn’t even get out of bed. Horrible. Furthermore, it messed up my thyroid–all better now–but NO fun when it was happening. Hair loss, intestional issues, NO energy, muscle/bone pain. My heart goes out to everyone who was taken. I personally have been banned from the “New and Improved Kimkins site”–whatever that is, for sharing my story and offering information to other disillusioned victims. I know–I asked for it. But I feel compelled to let others know how WRONG KIMKINS on EVERY level. Also, those of you who were made sick by this women’s lack of conscience are forthwith invited to participate in the vast number of class action suits that are piling up out there. It’s literally as simple as signing your name and you will be contacted to share your story. KIMMER/HEIDI–whateverthefreakhernameis, knows this is coming. Karma is a bear!!!!

Other than that, GREAT Podcast! I loved listening to you rip apart her story piece by piece.

I prefer both anecdotally supported AND evidence based approaches. Certainly, real world experience is essential, but in a valid debate it weakens an argument to say, well I know it is true because it is true for ME. Or true for my neighbor’s cousin. There are too many variables to know what is going on.

A person loses weight on a low carb diet (and of course, I believe that low carb diets work and that it bears out in the lab evidence as well as experience)–but what else are they doing? Did they change their portion sizes? Their activity level? Does the higher fat level provide greater satiety? Does their belief in the approach provide a placebo effect?

Anecdotal evidence is valuable–but it doesn’t do much to tell us WHY something is working or to truly evaluate and compare one set of approaches to another.

The value of controlled laboratory experiments is that careful experimental design allows us to control a lot (but of course not all) of the variables in order to isolate each of them and test their impact.

For instance, until the proper experimental designs were employed and analyzed, we had no hard evidence that low carbohydrate diets are merely another form of calorie restriction. Thanks to some carefully analyzed experiments from the past, and well-designed experiments in the present we now know that there is a clear metabolic advantage to low carbohydrate above and beyond calorie restriction though it is not exactly clear why. Dr. Eades has some good ideas about this and I’ve enjoyed reading his theories which are as sound as any, though not clearly bore out in research yet.

This is crucial information–particularly for type II diabetics and those who need to lose weight efficiently.

The internet is a great place to share valuable anecdotal evidence, but it can also proliferate a lot of myths which only gain momentum as they get passed around. As we know from low-fat, this can convince people that something which is merely hypothesis, or worse, a complete falsehood, is objective fact.

Sorry, Jimmy, you are probably sick of me by now, so this will REALLY be my last post on this thread.

Nice to meet you, Kevin M.

BTW, the value of “anecdotal” evidence is to show what actually happens in real life, too much faith in theory is just as dangerous, as we have seen with the low-fat/low-cal brainwashing campaign. Anecdotal evidence is critical to check the research for integrity. Low carb is still largely based in overwhelming experience success rather than research success. Low-fat and low-cal never worked in the lab and never really worked in real life either (we have 30-70 years of anecdotal evidence for this). That’s the real reason we know they are bogus, and are now calling 70 years of “accepted” research into question.

A few points though–what is your background by the way? I don’t want to insult your education if this is something you already know.

But several of the studies you cite are not of any significant power and should therefore be taken with a grain of salt.

For instance, you claimed to have seen studies that refer to reduced organ weights in the obese. That study, I’m sure you noticed at second glance, was on rats. And no mention of whether the rats had an ample fat layer or were lean. I would imagine that folks who are lean and go on SS diets would lose organ weight. But not the obese. (I would guess, but hey I could be wrong.)

So not a very compelling study there.

Further, several studies only cite small numbers of patients who were observed in poorly controlled environments. The language in the abstract on diabetes uses the term “may” quite a bit because they realize they have very little data to rest on and are merely trying to inspire conversation. This is not a sufficient study and not even the authors intend to present it as such–they’re just like, “hey, we noticed this, we’ve got a theory…” . I’d be very interested in knowing if you come up with a study on this subject with more power. (I doubt you will but hey, I’m open to it.)

In studies this weak, based on patient observation, the most one can hope for is that they will spur on further study.

Most of the studies done on very low calorie diets are not done on diets that truly provide adequate protein and the more prudent doctors that use VLCDs keep calories to between 700 or 800 calories in order to provide the breadth necessary for adequate fat and protein. So that answers your other question. Yeah, 500 calories is mathematically insufficient to provide adequate fat and protein. We agree on that one.

700 calories is roughly what one needs (on average) for healthy cell function so to err on the side of prudence, 800 is a pretty good guideline.

I’m really not interested in hanging Diaz out to dry (she’s done a good job of that herself) I’m interested in whether or not it is true that using a very low calorie approach in tandem with very low carbohydrate approach has validity for the metabolically resistant or those with encroaching type II complications who would do well to get that hyperinsulemia-inducing fat layer off as quickly as possible.

As for what you asked me to think on–gee, I thought it was kind of obvious that I think on this subject a lot, but I guess not–I’m referring to the metabolic state that got us to being overweight in the first place. If calories serve the function of stoking metabolism, why doesn’t overnutrition lead to a raging metabolism? I don’t think calories have much to do with RMR/BMR–I think quality of calories does. 700 calories of cheerios or a sugary diet drink is much different than say of lean beef, chicken, or steak fish.

It is an interesting theory that dieting damages the metabolism and leads to yo-yoing but it is always stated as fact. My point is it is not a fact at all, merely speculation based on weak data and passed around as fact. So far the info you’ve provided has confirmed that.

Another study you printed on your link page actually confirms what I’ve been saying all along–that the higher the body mass the better the low calorie diet is tolerated. So if you want to make an argument against VLCDs in the morbidly obese that’s probably not a good study to put in your arsenal.

And as for the heart irregularities–particularly the prolonged QT intervals the study with the strongest language is dated from 1979. They are calling it acquired prolonged QT intervals–but another study in your list acknowledges that this is often the result of hypokaelemia which is a low potassium level. HENCE THE TAKE A POTASSIUM AND MAGNESIUM SUPPLEMENT warning.

This is probably a risk true of any person with antecedent obesity who takes on a low-carbohydrate diet–the diuretic effect is powerful and can and will result in temporary hypokaelemia which will cause arrhythmias, most of them benign and correctable with an OTC potassium supplement. They have these infamous instances of fatal, ventricular arrhythmias. I haven’t seen a lot of data published on this though it made headlines at one point. I imagine that most of us take a bigger risk every day when we get into a car and drive to the corner store. Again, how small is that risk compared to advancing type II diabetes?

Obviously, we’ll agree to disagree but I thought it was a useful opportunity to talk about interpreting studies. Google is a great tool but one has to know how to use it.

(Not that it gives my argument more power but to be clear I used to be a medical writer and have a degree in philosophy with a specialization in history and philosophy of science.)

I’m particularly persuaded by JAMA publishing a paper announcing that VLCD’s are safe. That’s a pretty big claim and doesn’t say like many of the studies you site “may be” safe.

Your site is a useful resource, Sherrie, and I’ll keep tabs on your VLCD research. Thanks for posting it.

All of this is to say–there is no compelling study available (though quite a few that raise some interesting questions) that make this “starvation mode” theory a fact of nutritional science. At best, it is a plausible theory.

One that I’m actually thumbing my nose at, at the moment. Especially since it gets thrown around weight loss boards all the time. Oh you need to eat MORE.

Most stalls that exist are there because people are eating too much or are miscalculating both carbs AND calories.

Few people are actually starving.

We have a culture of plenty that makes us abhor the idea of self-denial. But sometimes, particularly after a period of extended gluttony, self-denial is 100% necessary.

Again, great debate.

Again I disagree.

Firstly with your comment about Heidi Diaz and her fraud. To be frank, part of me doesn’t give two hoots about her fraud other then her being convicted of that might stop her dangerous (yes dangerous) dieting advice.

“And last I checked folks stall on low carb plans that are higher in calories as well. So lets not use that as proof positive of a “starvation mode” in the clinically obese.”

Regarding this comment, you are correct that they stall too but there is a BIG difference. They are still eating over their BMR and have room to cut more calories as their body adapts to their calorie level. But what about a person on 500 calories? are you going to suggest that they are eating too much? someone eating too much on even 800 calories?

Surely logic would say that you can’t seriously be eating too much on such a low calorie level and that something is not right?

A person has a very efficient BMR? why do you think that is? what do you think starvation mode is?

Have a think about that.

Regarding the 12 week comment, I have seen that comment many times whilst researching VLCD diets, even ones in support of VLCD diets still only recommend less then 12 weeks as well as strict medical supervision and only if they fit certain criteria. Have read of some and you will see for yourself.

I certainly don’t have the answers for you, I am no expert either but there clearly are risks which can be dangerous and a lot of Heidi’s advice well that is just plain dangerous, pure and simple.

Regarding wanting to see research studies on the risks, I am working on a page that links to such studies, it is not complete but there’s lots there already, the diabetes one I have put on top because I found that really interesting and hope to remind myself to look for more on that topic:
http://www.apinchofhealth.com/resources/lowcarb/VLCD-Research.html (hope you don’t mind Jimmy!)

I’m sure more patients would rather listen to a guy who lost nearly 200 pounds and kept it off than their own doctor spouting off a robotic “eat low-fat, low-calorie diet” line.

I’d strongly encourage people not to conflate the Diaz-Kimmer issue with low calorie diets. To defend one is not to defend the other.

Sherrie–I appreciate your point of view and I’m open to being convinced that it is true. (Heck, what foodie wouldn’t like to be told she has to eat MORE?) I’d sincerely be interested in seeing citations for the studies done on obese populations that show the results you describe. Seriously, send them to me! I’m researching this very carefully and need the info.

And insulin resistance? Get out of town! Were they on low calorie and adequate protein? I’d be VERY surprised to see a convincing study of adequate power that demonstrated that. In fact, I’d consider it a coup d’etat about everything I think I understand about type II and insulin resistance. But hey, I’d love to see it!

I think everyone knows this: VLCD are used quite widely to treat obesity and concomitant disease in the medical profession. The Cambridge Diet is still alive and well, for goodness sake. Folks don’t have a very good record keeping it off on these types of diets. What else is new? Just because Bob Greene said Oprah killed her metabolism on it doesn’t make it true.

The point is on very low calorie diets: it is unclear and the word “dangerous” is a really strong word that I think gets thrown around too easily in order to win an argument.

Let’s not let zeal to convict Diaz of fraud (which is in right order) lead us to make religious like judgment on different nutritional strategies for treating clinical obesity.

Most of us here agree adequate protein and fat is essential and has a metabolic advanatage over low fat calories–but as to a magic NUMBER of calories, I’d say there has to be a LOT more research before folks should start throwing the word DANGEROUS around. Remember, there are a lot of folks who use that word around low-carbohydrate diets.

Let’s also remember that Dr. Atkins promoted the use of a very low calorie approach for the weight loss resistant. It’s in all the versions of his books. And how does one define “limited time period” is 12 weeks an extended time period? Really? Is there evidence that this is the case? Is 11 weeks okay but not 12?

Another clarification: I am NOT weight loss resistant on a low calorie low carb protocol. That’s the point. I am weight loss resistant on a low carb plan that does not carefully count calories. I’m currently losing weight at a very steady and satisfying pace but I was NOT when I did not count calories as well as carbs. For a long time I kept my calories above 1200 because I was following the “no starvation mode rule” and because frankly it suited the fact that I LOVE to eat. (No surprise there must of us here do or we wouldn’t have arrived here.)

It was not until I ignored this and stuck to adequate protein rather than minimum calories that the weight began dropping at a satisfying rate. The lower the calories go the faster the weight comes off. Period.

And last I checked folks stall on low carb plans that are higher in calories as well. So lets not use that as proof positive of a “starvation mode” in the clinically obese.

I’m not an ideal case–and anecdotal evidence means very little. But I am very suspicious of this “starvation mode” priniciple–you know you MUST eat a certain number of calories–when talking about the obese who are either experiencing or threatened with co-morbid disorders.

And why is 1000 or 1200 a magic number–where do we derive our BMR calculations? Is it the same assinine way we derive our BMI calculations? It’s an average dervied from a whole bunch of people and again, maybe some of us are obese because our BMR is way efficient and needs less fuel to operate optimally.

For some people 700 calories of quality protein and some fat might be just about right. Why consume extra calories when trying to lose weight? I don’t get it. Take in the protein and fat you need and cut out as much else as you possibly can without eating your left foot from hunger. (Yes I read Stephen King, don’t you?)

Jimmy–we are in 100% agreement about medical supervision but I think we have to require some accountability on the part of consumers who pursue weight loss without consulting a physician. It’s just good common sense.

I don’t necessarily agree that one has to be a doctor when selling nutritional advice–doctors have been giving the wrong nutritional advice for ages (and I’m married to one.) Most doctors will tell you that they get very little nutritional training while in medical school. It simply hasn’t been traditionally considered important.

And hey, YOU are not a medical professional are you? And I think what you are doing is great and part of living in a free society. Without it we may be at the mercy of the low fat kool-aid drinking moon-bats.

Where we have absolutely NO disagreement is using fraud in order to sell a product. That is unacceptable behavior.

Ech, even I’m tired of reading my own posts. So I’ll stop.

Thanks for hearing me out here, Jimmy, as I still cannot access blogspot, and nice to meet you Sherrie.

Also that Jama study is discussing SHORT TERM, there are people following kimkins for several months, people stalling on less then 500 calories a day and told to cut more. People aren’t told that they can only do kimkins for 12 weeks or less, nor are they given any type of refeeding program or targeted supplementation based on their needs or that there are risks involved. Heck people coming out of the diet are still often eating way too little.

You say there is no such thing as starvation mode yet at the same time state:

“Say a rather muscular large framed woman (like myself–I have an estimated lean mass of approximately 135 pounds)”

and

“Which is to say–I am EXTREMELY weight loss resistant”

If thats not a contradiction right there then I don’t know what is!

But the problem with Heidi’s plan is that it is NOT backed up by any medical professional of any sort and “purposely” so according to her. In other words, she could be ANYTHING she wants (like the 300+ pound woman she is) and give out diet advice without any repercussions whatsoever for sharing that with people. That is dangerous and I am not afraid to call a spade a spade when it is warranted. And it is.

People are putting their health in danger by blindly following the dictates of a con artist like Heidi Diaz which is what the entire purpose of this podcast was about. THANKS for sharing your comments as always.

We’ve emailed about this before but it is worth repeating because there is as big a knee jerk toward “very low calorie” as there is toward “very low carb”

First: I agree that many of the Kimkins dieters engaged in potentially harmful behavior. I agree that it is likely that Heidi Diaz will be convicted of fraud due to the use of fraudulent pictures and false success stories.

I also agree that it is not a wise decision to cut ALL fats indiscriminately. All fat calories are NOT equivalent and omega 3s and omega 6s have to be eaten in the proper ratios.

But the rest of your argument about the danger of very low calorie diets is rather specious.

It is questionable whether the risks of a 700 calorie a day diet outweighs the risk of visceral obesity. The idea that such a diet puts one into starvation mode is just false. The two most famous starvation studies were on mostly lean populations–when low calorie diets are tested on the obese, they do not have the same response. The extemely obese do not muscle waste, they stay in ketosis, and they have less side effects. What side effects occur (if any) are usually rather benign and temporary.

Most experience increased health and vitality almost immediately due to an improvement in their obesity induced hyperinsulemia and general hormonal imbalances.

When the 700 calories are from protein and fat (you cannot go fat FREE no matter how hard you try if you are also eating protein) the biggest risk you have is some mineral deficiencies (particularly vitamin K) and an imbalance in potassium and magnesium from the diuresis that occurs on low carb diets in general. (This is likely what most of the “heart problems” people report are related to–most such arrhythmias are benign and corrected with potassium and magnesium supplements.)

It is true that one should probably consult their doctor if they decide to go low calorie–and to ask him or her about appropriate supplementation. And it is also true that not all doctors would approve. But, as we well know, not all doctors approve of low carb diets, either.

When we are talking about folks with a body fat percentage above 32% in women and 25% in men, they don’t NEED calories. I cringe when I hear dangerously obese people being told they “need to eat more” when they stall in weight loss.
If you are carrying around abdominal obesity you do not ever need to eat more, unless you are skimping on protein.

Also–think about it–what is body fat THERE for if not to be used as fuel? Certain things our body does not manufacture on its own and that is why supplementation is necessary. But you can live quite nicely off your own body fat as you know.

BMR is very difficult to evaluate and there is no one size fits all way to calculate it–some folks might do extremely well on 700 calories a day.

There IS a dip in metabolism when one cuts calories, as there also is when one loses weight. But this dip in no way equals the caloric deficit that caused it. The dip in metabolism self-corrects as higher calorie diet prevails. (Which it usually does since most people don’t do well going hungry for long.)

Say a rather muscular large framed woman (like myself–I have an estimated lean mass of approximately 135 pounds) decides that losing fast is desirable for health reasons (while it is not true in my case, for argument let’s say a hormonal imbalance or an encroaching risk of type II or combination type II type I diabetes).

At four calories a gram I only need 540 calories for adequate protein.

While I appreciate the zeal for exposing Diaz’s fraud–I think a lot of really adorable baby is going out with some filthy bathwater.

Which is to say–I am EXTREMELY weight loss resistant (my family is of robust health and built to last extremely harsh climates!) and the only thing that has brought me success is low calorie and low carbohydrate. I rotate through higher and lower calorie days only because, hey, I’m a foodie and I like to eat. But if I could stay on the lower end of the spectrum until goal I’d do it.

My religious background encourages fasting and I have also conducted extended fasts with nothing but positive health effects. Again–there is a reason I have this fat layer. I’m built to last. Most of us who struggle with weight are.

If you can eat 1800 calories a day and lose fast enough to keep yourself motivated that is GREAT. But a low calorie approach done thoughtfully and with medical guidance has not been proven conclusively to be a bad thing. On the contrary (see JAMA quote below) side effects are benign and improvement in obesity related health conditions are radical.

If anything it seems to be equivalent with other diets out there in that it is successful as long as it lasts. It is hard to achieve long term success but that is true for ALL approaches.

From JAMA 1993:

“Current VLCDs [very low calorie diets] are generally safe when used under proper medical supervision in moderately and severely obese patients (body mass index [weight in kilograms divided by height in meters squared] > 30) and are usually effective in promoting significant short-term weight loss, with concomitant improvement in obesity-related conditions. Long-term maintenance of weight lost with VLCDs is not very satisfactory and is no better than with other forms of obesity treatment. Incorporation of behavioral therapy and physical activity in VLCD treatment programs seems to improve maintenance.”

Fast weight loss can be–as you have experienced yourself–HIGHLY motivating. If someone may need to go VLC to get that why scare them away from it?

The risks of obesity are largely understated and the risks of low calorie approaches for those in the danger zone are tiny by comparison–said risks are usually the result of an already imbalanced system righting itself. What’s a little thinning hair or few skipped periods compared to a life time of Type II?

It certainly makes it undeniable that the voice of ‘Kimmer’ in the interview is the same as the voice of Heidi Diaz from the KTLA expose. It also explains her panic and deception in the surprise phone call you made.

This will be a good resource to link to in trying to explain this craziness.