One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.

Hi Thea, That’s wonderful that IF has worked for you. Diets, and particularly fasting, can be very triggering for others with a history of an eating disorder. People who have been in remission can relapse. For more about what concerns and problems others have had, there is alot of information out there, and for starters I recommend this thorough article from Psychology Today: https://www.psychologytoday.com/us/blog/hunger-artist/201411/the-fast-diet-fast-route-disordered-eating

Obviously, it’s still possible to lose weight on any diet – just eat fewer calories than you burn, right? The problem with this simplistic advice is that it ignores the elephant in the room: hunger. Most people don’t like to “just eat less”, as it may result in having to go hungry forever. Sooner or later, a normal person will likely give up and eat, hence the prevalence of “yo-yo dieting”. While it should be possible to lose weight on any diet, some appear to make it easier and some to make it much harder.

Exercise also burns the body’s glycogen stores, which are essentially carbohydrates stored in the liver. This means that after a workout, you might be able to eat a little more carbs than you otherwise can permit yourself, without negative effects on insulin or fat storage. Also, don’t forget that the non-weight-related health effects of exercise are quite impressive.
Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]

In so far as insulin promotes de novo lipogenesis and suppresses lipolysis in adipocytes it DOES help keep the fat inside. But in Hyperinsulinemia / Insulin Resistance with Impaired Glucose Tolerance lipolysis may not be sufficiently reduced and fatty acids and glycerin can be spilled at the same time that Triglycerides are being formed & stored. In the liver the glycerin gets converted to glucose producing hyperglycemia.
The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients.[18] Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective.[9] Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug.[1] Some evidence indicates that adolescents and adults may also benefit from the diet.[9]
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]
Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[18] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[18]
If you have type 2 diabetes there is another diabetes drug that can result in noticeable weight loss: the “low-carb in a pill” drug Farxiga (called Forxiga in Europe). Unfortunately, this pill has an increased risk of ketoacidosis, probably especially for people on strict low-carb or keto diets, and it’s not recommended to take this drug while on a strict low-carb diet.

Cortisone as an oral drug is another common issue (e.g. prednisolone). Cortisone may cause weight gain in the long run, especially at higher doses (e.g. more than 5 mg prednisolone per day). Unfortunately, cortisone is often an essential medication for those who are prescribed it, but the dose should be adjusted frequently so you don’t take more than you need. Asthma inhalers and other local cortisone treatments, like creams or nose sprays, hardly affect weight.
When you’re eating the foods that get you there (more on that in a minute), your body can enter a state of ketosis in one to three days, she adds. During the diet, the majority of calories you consume come from fat, with a little protein and very little carbohydrates. Ketosis also happens if you eat a very low-calorie diet — think doctor-supervised, only when medically recommended diets of 600 to 800 total calories.
Some people feel better supplementing the already active T3 (sometimes prepared from pig thyroid glands), as it can give a stronger effect than the T4 hormone, but its effect is often harder to control. Most health professionals rarely prescribe or offer such T3 treatment, as it appears to lack significant advantages and may pose a risk when doses are high for an extended period of time. However, T3 replacement is popular among some functional medicine practitioners and naturopathic doctors. Regardless, the key is making sure you follow your levels and symptoms to make sure you aren’t over- or under-replacing thyroid hormones.
IF as a weight loss approach has been around in various forms for ages, but was highly popularized in 2012 by BBC broadcast journalist Dr. Michael Mosley’s TV documentary Eat Fast, Live Longer and book The Fast Diet, followed by journalist Kate Harrison’s book The 5:2 Diet based on her own experience, and subsequently by Dr. Jason Fung’s 2016 bestseller The Obesity Code. IF generated a steady positive buzz as anecdotes of its effectiveness proliferated.
The ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the neurons to remain stable in the face of increased energy demand during a seizure, and may confer a neuroprotective effect.[56]
The final possible issue behind stubborn weight issues may be the main stress hormone, cortisol. Too much cortisol will increase hunger levels, bringing along subsequent weight gain, especially around the midsection. The most common cause of elevated cortisol is chronic stress and lack of sleep (see tip #11), or cortisone medication (tip #10). It’s a good idea to try your best to do something about this.
Some people eat three times a day and occasionally snack in between (note that frequent snacking could mean that you’d benefit from adding fat to your meals, to increase satiety). However, there’s some evidence that frequent snacking isn’t wise when trying to lose weight. Some people only eat once or twice a day and never snack. Whatever works for you. Just eat when you’re hungry.
^ Jump up to: a b c d e f g h i j k l m n o p q r s Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Bergqvist AG, Blackford R, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb;50(2):304–17. doi:10.1111/j.1528-1167.2008.01765.x. PMID 18823325
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
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