Mary Vernon, M.D. - The Doctor with the Happy Patients

Using the Atkins Diet to Treat Obesity and Diabetes

Dr. Mary Vernon
Dr. Mary Vernon

If Dr. Mary Vernon can't get you excited about eating low-carb, then no one can. She is a bariatric physician who has a family practice in Lawrence, Kansas, as well as being the Medical Director of the University of Kansas Weight Control Program, and the current president of the American Society of Bariatric Physicians. In addition, she co-wrote the book Atkins Diabetes Revolution, published in 2004.

What a pleasure it is to listen to a knowledgeable doctor educate other physicians in the use of low-carb diets to treat health problems. I had an opportunity to do this at a conference of the American Society of Bariatric Physicians in Nashville. Dr. Vernon spoke on the topic "Carbohydrate Restriction for Type 2 Diabetes in Clinical Practice" at a Nutrition and Metabolism Society seminar connected with the conference. I share some of her talk with you, as well as parts of a phone conversation I had with her more recently.

How Dr. Vernon Learned about Low Carb Eating

Before discovering the tool of carbohydrate restriction, Dr. Vernon was frustrated with the lack of progress in her overweight and diabetic patients. She says, "I was telling them what I was supposed to be telling them, but nobody was getting any better."

At an ASBP seminar, she heard a presentation on the positive results of limiting carbohydrate on the body.

A short time later she was studying for her boards, and reading a biochemistry book about how the primary function of insulin is fat storage. It was her lightbulb moment. The pieces fell together, and it dawned on her how carb reduction could help people. Still, she was concerned about safety. She says, "I became a data-gathering nut", collecting all kinds of information about her patients' health as they changed their diets.

She then collaborated with researchers to find out how lowering carbs was affecting her patients as a group.

The results were so startling and positive, and her patients were so thrilled, that she was won over. She loved seeing the difference in people's lives, especially after her previous frustrations. She likes to tell the story of a medical student working with her who, after the first day of seeing one happy patient after another said, "I feel like I'm in an infomercial!"

Don't Focus on Weight

Interestingly for a bariatrician, Dr. Vernon feels that focusing on weight is missing the boat because weight is only a marker for an underlying problem. This problem is a difficulty processing glucose, a difficulty which begins with insulin resistance and can progress through various stages ending with diabetes. (See The Road to Diabetes) Correcting the problem results in weight loss - and guess what? The easiest correction is simply to give the body less glucose (carbohydrates).

How the Doctor Can Tell if You're Cheating

Two of the most consistent results when a person first reduces carbohydrates are a dramatic drop in triglycerides, and an increase in HDL ("good") cholesterol. These changes are so dependable that Dr. Vernon calls them the "hallmark of carbohydrate restriction", and advised the doctors at the conference that they could use these two measures to inform them as to whether their patients were indeed following a low carb diet.

It is this type of attention to detail that has led to Dr. Vernon becoming one of the foremost physicians in the field advocating carbohydrate restriction for weight loss and the treatment of diabetes and its precursors. She frequently lectures at conferences, continually educating other doctors about the latest research.

The rest of Dr. Vernon's talk was aimed at helping physicians understand how to diagnose glucose tolerance problems before they progress to diabetes, the biology of low carb diets, and the specifics of how to use low carb diets with their patients. She told them how to handle medications, presented case studies, and helped them to understand the role of diet in the progression of the diabetes process.

But I wanted to ask Dr. Vernon some of the questions that my readers ask me. Happily, I had an opportunity to talk to her by phone more recently.

Here are some of the questions I asked Dr. Vernon, and her answers.

Why do you think the myths about low carb eating persist in the face of the evidence?

It takes time to build credibility, and there are struggles. There is very little monetary support for research, except from the Veronica Atkins Foundation. It's not nearly at the level required to get the word out. And there aren't many physicians in practice who are talking about using low carb diets with their patients - so the credibility isn't there yet.

Some diabetics seem to benefit from the recommendations to eat more carbohydrate and less fat. That's mystified me, frankly - it makes no sense to me that eating sugar would help diabetes. Any ideas what causes this difference between people?

My guess is that it could depend on what they were eating before - it could be a carb cut for them. Also, just switching to healthier sources of carbohydrate can help. My experience was that in the long run, low fat/high carb diets didn't help people.

One of my goals is to help people to catch the process of diabetes way before the diagnosis of diabetes. How can we help alert people that this is an issue for them?

Controlling blood sugar is so important. By the time it is so out of control that you're diabetic, you're in a bad situation. Other markers of metabolic syndrome are very important to watch. One of the biggest is waist circumference. Men: Your belly shouldn't be ahead of your belt.

Women: If you're buying bigger clothes sizes or losing your waist, watch out.

What do you say to people who insist that we "need" carbohydrate in our diet?

If someone doesn't eat, they don't die from lack of carbohydrate. Even if a person ate no carbohydrate at all, the body would make what little it really needs from protein.

[Added by Laura: this doesn't mean we can't benefit from carbohydrate-containing foods such as low-carb vegetables and fruit - it just means that we don't need the carbohydrate itself.]

I get a lot of questions about ketosis - getting into it, staying in it, etc. Sometimes I think the whole business isn't worth it.

If it helps you follow the diet to check ketones, OK, but really...just follow the diet!

What do you say to people who can't seem to get down to the weight they want to be at? (Confession: I was asking this question partly for myself!)

You don't have to follow the fashion magazines. Get used to your own body, and help it to be as healthy as you can. Blood glucose, blood pressure, and other health markers are much more important than weight.

Tips from Dr. Vernon

  • If you're feeling shaky or dizzy in the first few days of the diet, it could be because your body is letting go of a lot of salt. Drink a cup of bouillon every four hours for 2-3 days. If this doesn't help, check with your doctor.
  • Eat at least a snack every three hours. At meals, just eat until you're comfortable, not stuffed.
  • If you are taking blood pressure or diabetes medicine, be sure to check with your doctor before cutting carbs, as there is an excellent chance that you won't need as much and may run into trouble if you're getting too much medication. The body tends to respond very quickly. Don't try to do this yourself. More About Medications and Low-Carb Diets

    More From Dr. Mary Vernon:

    Interview with Mary Vernon on the Livin' La Vida Low Carb Podcast with Jimmy Moore

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