The Man Who Ate Everything - Jeffrey Steingarten [53]
Day Twenty-one. No change. What a relief! I had feared the consequences of unbridled Chinatown feasting even though everything I ate was Montignac-approved (or would have been if Montignac were not so French provincial).
I telephone Louis Aronne, M.D., director of the Comprehensive Weight Control Program at New York Hospital–Cornell University Medical Center, to ask about insulin resistance and obesity. He is not a fan of the Montignac Method, which he characterizes as “Atkins revisited,” a reference to a once-popular high-fat, high-protein diet considered unhealthy because, unlike the Montignac Method, it eliminated carbohydrates entirely and led to metabolic imbalances. But he concedes that some people do poorly on the high-carbohydrate diet recommended by the American nutrition establishment. A substantial minority of the population does suffer from insulin resistance, he tells me; their excess insulin causes an enzyme called lipoprotein lipase to appear on the surface of their fat cells, and this brings additional fat into the cells. As Montignac says, a low-carbohydrate diet does seem to suppress insulin secretion, making it harder to store fat. But Aronne worries that, even if adherents to the Montignac Method lose weight initially, their bodies may soon find ways around it.
And Aronne tells me something new: he suspects that insulin resistance may be one cause of high total cholesterol and triglycerides and low HDLs (good cholesterol). If I am insulin resistant, then my blood test next week may show an improvement in my cholesterol and triglycerides despite the amount of saturated fat I have been eating.
Aronne believes that drugs are the real future of obesity treatment. “Before now obesity has been seen as either a behavioral problem or a moral failing,” he says. “But now, for the first time, we are entering a period of rational medical therapy.”
Day Twenty-two. Progress again. One scale says 165 and the other 165.5. I celebrate with a lunch of scrambled eggs, a half pound of bacon, Reblochon cheese made in France from raw milk and smuggled into the United States, and decaffeinated coffee. And more Chinese food for dinner.
People tell me that I look thinner. It’s probably my new haircut.
Day Twenty-five. My scales have gone haywire! They are a pound and a half apart! I spend half an hour stepping first on one, then on the other, then on the floor. I move the scales around the bathroom, and they change their minds, slightly. Then I try standing on them in different ways, my heels close together or wide apart. I was penny-wise and pound-foolish to go electronic.
I telephone two leading French nutritionists, Marian Apfelbaum, M.D., and Jacques Fricker, M.D., both of the Hôpital Bichat in Paris. Neither is impressed with the Montignac phenomenon. Fricker concedes that foods rich in fiber and those with a low glycemic index assuage our hunger more effectively than others, but he says that without some high-glycemic starches in our diet, any weight lost is more likely to come from lean muscle mass than fat reserves.
Apfelbaum has been quoted as saying that losing weight permanently is more difficult than being cured of cancer. If people temporarily lose weight with the Montignac method, he tells me, it is not because the diet is particularly clever but because it is a diet. That is, it focuses our attention on what we eat. I ask him whether lowering one’s insulin level by eliminating most carbohydrates will automatically prevent weight gain. His answer is no. For centuries before Europeans arrived, Eskimos had subsisted on fish and sea mammals—all fat and protein and virtually no carbohydrates. Yet in their native state, Eskimos were fatty and obese.
But Apfelbaum is pleased that after thirty years in which hundreds of fad diets were imported