The latest international connoisseur on the secrets of weight loss is an old-school doctor who isn’t afraid to call you ‘fat’.
PARIS - When he talks about weight, Pierre Dukan isn't always tender. He's the only acclaimed nutritionist author to consistently refer to his readers as "fat," and tell them they'll have to be on a diet "for life." His publisher at Flammarion called his blunt wording a "major marketing mistake" and predicted "a sure failure" if he didn't tweak his text. But the doctor stood his ground, and after selling 3 millions copies of his book worldwide, Dukan will not be softening his approach anytime soon.
"If you want to be understood by people who want to lose weight you have to be straightforward," he says. Dukan points to the "Five fruits and vegetables a day" campaign, a French state-sponsored nutrition campaign. "It cost millions of euros, but no one understood what it meant! I do the opposite: I tell my patients exactly what they can and cannot eat, without giving them a way out, and they're thankful for that."
He says calling his followers "fat" doesn't offend them. "You should hear them talk about themselves, they're much harsher then I am! ‘I'm obese", ‘I'm a monster", ‘I'm disgusting"; that's what they say, that's how they see themselves!"
It's true that these days, extra pounds don't only weigh on our hips or arteries; they also weigh on our mood: people who are overweight are increasingly affected in their personal and professional lives. A deep uneasiness that could explain why the Dukan diet, created more than 20 years ago, started catching on in a major way only the past five years.
People don't lose weight for the same reasons they used to, explains Dukan, noting that doctors in the 1960s and 1970s only sent people with extreme cases of obesity to nutritionists and dieticians.
"Then weight loss became seasonal: you would start a diet in April, before summer, to look good for the beach or fit in your wedding dress," he said. "Today, people want to lose weight for health reasons, but mostly to improve their self-image, to keep their jobs or boost their careers."
He said being chubby is no longer associated with enjoying life, being nice and open to others, but is rather "seen as a sign of weakness, lack of will power and self-control. The big CEOs got it first, followed by political heavyweights. But the phenomenon is broader, my patients' profiles have changed as a whole: now I treat almost as many men and women, all younger, in better shape and more motivated than ever."
Yes, he still actually meets with patients. For the past 40 years, he's been in the same office, in a large building in an upscale Paris neighborhood, which he shares with 8 others, including a dentist, a dermatologist, two OBGYNs and several plastic surgeons.
Though he insists that he's the same Parisian physician he always was, he has become a mini marketing phenomenon: you can now buy the Dukan brand, which includes bran loafs and prepackaged meals, at supermarkets; his book I Don't Know How to Lose Weight has been on the bestseller list since 2006; some 400 blogs or forums refer to his name, and there are more than five million dukanians and dukanettes (as they call themselves) in France alone who follow his strict anti-fat and anti-sugar diktats.
His calling dates back to the discovery of dietetics in the late 1960s, when Dukan was already practicing in Paris as a young doctor, specializing in neurology. "That field wasn't for me. I was suffering almost as much as my patients. I quickly found out that I have too much empathy to become a neurologist and that I'd be a better doctor if I helped those who enjoyed life too much rather than those who were dying."
That's when he got interested in nutrition by listening to the teachings of the field's pioneer, Professor Gilbert Dreyfus: "To be taken seriously, they were trying to get as close to exact sciences like physics, chemistry, mathematics. That's how they came up with the rule of the 1,500 calories a day and the balance between protein, carbs and lipids."
But the young Dukan was already skeptical of these rules that are "impossible to follow on a daily basis, and in the long run." But he wouldn't have invented anything if in 1969 he hadn't met the person he refers to in all of his books as "the man of my life": publisher Pierre Seghers, with whom he shared a passion for poetry, who then weighed 130 kilos and who one day asked him to help lose weight by "depriving him of anything if necessary, except meat." Dukan said yes without knowing what he was getting himself into. And it worked: Seghers, happy to be able to eat like a prehistoric carnivore, lost 5 kilos in just a week, and soon the word began to spread. In 1975, his first book's success (125,000 copies sold), helped him build a huge practice.
A very dangerous disease
He admits however that his method wasn't complete: "I built it like a rocket, stage by stage," he recalled. "First, the "all protein" sprint. People were happy, they were losing weight fast, but it didn't work: six months later, they had gained it all back. When I added Stage Two, with the vegetables, they only came back a year later, but they still came back. I sold them a dream, an empty dream. If I had been just a businessman, that would have been enough, but not as a doctor: I treated, but I didn't cure."
Dukan says being overweight is indeed a real disease, and a very dangerous one that kills more people than smoking does. Beyond cardiovascular diseases, being overweight is also responsible for some forms of cancer, diabetes and bone problems.
His approach is built around what he calls "stabilization," which other diets do not use, including the American Atkins diet. Still, his approach caught on not for reaching "stable" Stage 4, but the speed at which you lose weight during stages 1 and 2, even when eating twice as much as usual: so long as you don't touch sugar or fat.
Stage 3 is when things get tough. That's when patients are allowed to indulge occasionally. Many put on some weight, even when being careful. This means that the Dukan diet's efficiency still has not been proven. His own personal results, however, seem to be working. Over a long lunch, he ate three endive leaves dipped in a mix of water, mustard and balsamic vinegar. Questioned about his own slips, Dukan answered without irony: "I eat two apples for each meal. Yes two… I know that's a lot, but I love that. I'm excessive."
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