Yes, there were lame attempts to discredit his diet by spreading rumors about how he died. As if one man's health and death prove anything anyway, out of the context of an entire life and genetic history. Neither Atkins or anyone else has ever claimed that low-carb would guarantee health, slimness, and longevity for everyone; so to trumpet his cause of death (whether true or not) or his dying weight is a straw man, and a particularly offensive one under the circumstances.

I'm 42 years old. For the first 18 years of my life, I ate a comparatively healthy SAD of the type Americans ate in the 1950s: plenty of meat and animal fats like lard, garden vegetables, not much soda or candy, but homemade dessert every day (which included a fair amount of vegetable oils and margarine) and lots of starches in the form of bread, potatoes, and pasta. I always considered myself a little pudgy -- always hated shirts-versus-skins in junior high, due to developing man-boobs -- though it doesn't show in pictures of my face at the time. From 18-23 or so, I went hog-wild on carbs and fast food, some days subsisting on nothing but pizza, chips, and Mountain Dew. The pudginess became definite fat. There were also large quantities of alcohol, and at one point when trying to stay awake long hours managing a pizza store, I started taking caffeine/ephedrine pills. A bad case of mono put a stop to the alcohol and the long hours for a while, and I cut out caffeine entirely, but continued to eat plenty of garbage. At about 23 years old, a chiropractor tested me for allergies (something I'm still not convinced really works) and came up with all the "white" foods: flour, potatoes, rice, etc. I didn't even know what a carb was at the time, to recognize that's what they all were, but I cut out those things and started feeling better, losing some weight and beginning to exercise (in that order). At 26, I changed jobs and cities, started drinking a lot again, and went back to more of a SAD diet, but stayed off the caffeine and worst stuff -- and gained weight. At about 30 or so, I discovered low-carb (Protein Power first, I think; I was never that fond of Atkins specifically), and started losing weight. I've been inconsistently low-carb since then, interspersing periods of low-carb and weight loss with hopeful attempts to add more carbs back into my diet (and gaining weight) or outright cheating when things aren't going well in my life. A year or so ago, I cut out gluten, which cleared up the last 10% of my headaches (low-carb got rid of the first 90%, but I'd still get one now and then for no apparent reason). I rarely drink anymore, but now I'm on a daily amphetamine for ADHD. I had my blood work done a couple years ago when I'd been consistently low-carb for a while, and my lipids were fine -- a high enough total to scare the brainwashed, but with good rations and right in the sweet spot of correlation with overall mortality, but some thyroid numbers were odd.

Now, the point of all that exposition is this: The one thing everyone knows about me now is that I eat low-carb. They don't all know about the heavy drinking in the past, or what I ate as a child, or whether I was breastfed, or how often I give in to a bag of potato chips when no one's looking. But they all know (no matter how much I explain the subtleties) that I "don't eat carbs." So, if I have a heart attack tomorrow, guess what they're all going to think. "All that fat gave him a heart attack." "He should have eaten more healthy grains." It won't matter if it was really caused by a congenital condition, or stress, or the way I lived and ate 10 or 20 years ago. They'll blame it on the diet, because that's what everyone believes about it right now, and you'll never get fired for buying IBM.

Dr. Atkins died of complications from a massive head injury after his loved ones saw him fight for his life for nearly two weeks. His work was my gateway from WAPF to Paleo, and he will forever be one of my nutrition heroes.

The most likely explanation for Dr. Atkins' weight gain, imho, is one which any nurse who has ever worked in critical care, either ER or ICU, has sadly seen too many times.

Dr. Atkins "mysterious" (not!) and very large weight gain was most likely due to a combination of massive third spacing of fluid into the area between the fascia and skin and probable abdominal compartment syndrome as well.

http://www.abdominal-compartment-syndrome.org/Photos_diagrams_multifile_use/Intra_Abdominal_Poster_lowres.pdf

Abdominal compartment syndrome is what I'd call a more localized version of widespread, total body third spacing of fluid. Patients in critical care settings, particularly those who have suffered trauma, as he did in his fall, or who have had certain kinds of surgeries, as well as many other critical medical conditions are at risk for these complications of treatment.

Patients who are treated in ERs for trauma and must be infused many liters of blood or fluids are at very, very high risk for third spacing of fluids. Likewise, those who have serious neuro trauma, as Atkins did, (think of the brain as the regulator that it is, which includes regulation of fluid balance) and those who have serious cardiac issues, such as cardiomyopathy, are also at obvious higher risk. Cardiomyopathy, in and of itself can lead to hypoperfusion of major organs...and hypoperfusion of major organs can lead to third spacing of fluids and electrolyte imbalances. Those with neurosurgeries are also at higher risk.And third spacing will also contribute to already existing hypoperfusion in this scenario.

The idea that this level of dysregulation, and ultimately, multiple organ system failure can be simply treated with "diuretics" is a very facile, uninformed idea. Part of the big problem with massive third spacing is that you have a person who is infact HYPOvolemic in the intracellular spaces and thus the person has a high heart rate, a low BP, and is often not making enough urine and is not breathing well, particularly if they have abdominal compartment syndrome. This all becomes a vicious cycle as the graphic in the provided link demonstrates. The odds of NOT surviving this, as a critically ill person, are very great.

Additionally, it is also not unusual for critical patients with substantial neuro insults and or surgeries, to suffer very rapid declines in nutritional status. They can become very malnourished in a matter of days, rather than weeks. This only adds to the issue as blood levels like albumin/protein drop which further aggravate the third spacing of fluids and fluid and electrolyte imbalances are part and parcel of the picture.

Some of the the most heartbreaking situations I have seen are family members who live far away seeing a person who dies in ICU after developing massive third spacing. Their shock and grief are made nearly unbearable by the surreal human before them, who was formerly "Jack Sprat" all his life, and now looks like a monster edition of the Pillsbury Dough Boy inflated over his entire body, to the point of near bursting.

I have seen trauma patients resusitated in the ER gain 20+ lbs in a few hours. And yes, it is fluid, not fat, of course. I have measured the abdominal girths, as well as arms, thighs, etc on many, many patients, as well as weighed them daily, who were severely third spacing fluids and fighting for their lives.And I have also stopped measuring them when multiple organs failed, they'd been on a ventilator for weeks, and loved ones made the decision to provide supportive care only, in the face of looming death. I have certainly weighed persons who in a week or two were blown up beyond recognition and were 40-50 lbs heavier in the end, due to third spaced fluids.

Neurogenic shock and cardiogenic shock, as well as hypoperfusion are no little things.

What an awful, awful way for Dr. Atkins to die.

And what an awful thing for his wife to have to go through - seeing her husband of many year turn into a discolored, massively bloated, unrecognizable distortion before her eyes, and then having to deal with all the drama spinners. How very, very sad.