Ketogenic Diets Are B.S. for Weight Loss — Here's Why
The ketogenic diet advocates eating more fats and proteins in place of carbs, inducing a metabolic process called ketosis.
Most research done on keto supports its use in treating neurological conditions; there's little evidence behind its long-term effects on health and weight maintenance.
Keto's restrictiveness makes it difficult to maintain in the long run, meaning any pounds lost will likely come back.
Nutritionists instead advocate following a Mediterranean-style eating plan to lose weight.
Celebrities like Halle Berry and Kourtney Kardashian swear by it, it ranked within the top 10 most Googled diets in 2017, and it's a clear Pinterest-favorite plan. It's called the ketogenic diet, which aims to induce ketosis, a metabolic process in which we use fat for energy instead of the body's preferred source, sugar.
Fans of the low-calorie, high-fat diet tout having more energy, lower appetite, and pretty immediate weight loss — all while chowing down on bacon, heavy cream, and butter.
But when I first heard that the next weight-loss "trend" was the ketogenic diet, I laughed out loud. "Absolutely not — no way! That's IMPOSSIBLE!" I was caught saying one year ago.
That's because my intro to this seemingly new plan was when I worked in a hospital, where ketogenic diets were specifically used as a medical nutrition therapy for pediatric patients with seizure disorders, for whom medication was no longer effective. In other words: It was used as an absolute last resort for families who felt otherwise hopeless in the face of a neurological disease, and under strict medical supervision.
Indeed, there's plenty of research to support ketogenic diets in the treatment of some devastating neurological conditions. But can it really help the average Joe or Joanne lose weight? Well, yes, in theory — especially ultra low-calorie versions. But is it suitable for long-term, sustainable weight loss and improved health? The jury's still out on that.
How the Keto Diet Works
In regimented keto diets, only 10% of total calories per day (about a measly 20 grams!) come from carbs, 20% from protein, and a whopping 70% from fats. Since our bodies preferentially use carbs for energy, cutting them means we have to use something else to keep organs functioning. Our bodies then turn to the glucose stored in our muscles as glycogen for fuel.
What else happens when we break down muscle glycogen? We lose water weight! Our muscles store about 3 grams of water for every gram of glycogen, meaning we can lose quite a bit of weight right away when we tap into glycogen stores for fuel. That's why someone who loses weight in "just one week!" from a low-carb plan is likely losing water weight, not necessarily real weight that stays off over time.
What's more, studies that have examined the efficacy of the ketogenic diet for weight loss have a few questionable similarities. First, they use the keto diet in conjunction with an extremely low-calorie plan (under 1,000 per day!), which makes it difficult to determine what caused the actual weight loss. Second, they all question the long-term impact on your heart of eating mostly saturated fat, not to mention how hard (and boring) it is to eat mainly coconut oil and butter for months on end.
The Keto Diet's Undeserving Rise to Fame
So why is social media blowing up with all things #keto, all the time? Well, most of us eat too many carbs to begin with. About half of our calories should come from carbs, according to the USDA Dietary Guidelines for Americans. That's about 250 grams per day for a 2,000 calorie diet. When you consider all of the grain-based foods and sneaky sources of added sugar, it's easy eat a lot more than the recommended amount.
Contrary to what social media hashtags would have you believe, there's not much to suggest that it will improve athletic performance. Keto also ranked dead-last (down with another joy-stealer, the Whole 30 Diet) on the U.S. News and World Report's Best Diets list. The lack of research on long-term outcomes, hard-to-follow regimen, and potential health hazards all alarmed the panel of experts.
Science simply doesn't support the notion that keto diets keep weight off in the long run, unlike the evidence-backed Mediterranean-style plans. Ketogenic eating may actually increase your risk for kidney and liver problems, plus osteoporosis.
Why the Keto Diet Will Probably Backfire on You
Since carb-filled foods contain the highest amount of water and dietary fiber, it's crucial to consider both the immediate side effects (constipation) and future ones (increased risk of GI cancers and decreased immune function) of cutting them out.
Besides constipation, crabbiness, and making it difficult for others to make plans with you, keto may lead to other health concerns too. Since research has yet to follow participants for more than a year, it's difficult to say with certainty that other problems (like an increase in LDL "bad" cholesterol) won't arise as well.
But the real reason why keto plans fail most of us is that they're not sustainable for the long term. Holidays, vacations, work functions … there's likely at least one scenario in which you'll find yourself eating higher-carb foods. And the same reasons why we see immediate weight loss on carb-restricted diets is the same reason why we see immediate weight gain after adding a seemingly harmless sandwich back into the mix: The water weight comes back instantly with glycogen storage.
The Bottom Line
Any diet that's as extreme as keto — to the point where it's often implemented under the supervision of an entire medical team — won't translate into everyday life. And when it backfires (as it always does), the shame and feelings of inadequacy hit us even harder when we've put so much darn work into it.
It's for that last reason alone that I don't recommend the keto diet. It can be so downright discouraging when we "fall off the wagon" that it seems completely pointless to eat healthier at all.
Keto diets rely on an extreme technique to (temporarily) move the scale down a few pounds, and basically eliminates all joy associated with eating real food and living life. Since restriction for life is downright impossible: Cut back on ultra-processed, high-carb foods like sugary beverages and tons of refined grains, and fill up on more nutritious carb choices, like veggies, fruit, legumes, low-fat dairy, and 100% whole grains to maximize long-term weight loss, health, and happiness.
Want to see what that looks like? Check out this seven-day, 1800-calorie meal plan developed to help you lose weight safely and sustainably.
Understandably, readers had a lot to say in response to this piece. You can learn more about Jackie's reasoning and see her replies to the top comments in support of keto here.
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