The ketogenic diet, a low-carbohydrate, high-fat eating plan, has gained popularity as a weight-loss strategy. The premise of the ketogenic diet for weight loss is that if you deprive the body of glucose, the main source of energy for all cells in the body, which is obtained by eating carbohydrate foods, an alternative fuel called ketones is produced from stored fat. This article explores the reasons behind slow weight loss on a keto diet and provides tips to overcome these challenges.
Introduction to the Ketogenic Diet
The ketogenic diet, or "keto" diet, is a low-carbohydrate, high-fat eating plan. In the 19th century, the ketogenic diet was commonly used to help control diabetes. In 1920 it was introduced as an effective treatment for epilepsy in children in whom medication was ineffective. The premise of the ketogenic diet for weight loss is that if you deprive the body of glucose-the main source of energy for all cells in the body, which is obtained by eating carbohydrate foods-an alternative fuel called ketones is produced from stored fat (thus, the term “keto”-genic).
What is Ketosis?
When there are not enough carbs in the body, it goes into a stage called ketosis. During ketosis, the body becomes very efficient at burning fat and using it instead of glucose for energy. This fat-burning makes the ketogenic diet a popular choice for people looking to lose weight.
During fasting, or when very little carbohydrate is eaten, the body first pulls stored glucose from the liver and temporarily breaks down muscle to release glucose. If this continues for 3-4 days and stored glucose is fully depleted, blood levels of a hormone called insulin decrease, and the body begins to use fat as its primary fuel. The liver produces ketone bodies from fat, which can be used in the absence of glucose. When ketone bodies accumulate in the blood, this is called ketosis. Healthy individuals naturally experience mild ketosis during periods of fasting (e.g., sleeping overnight) and very strenuous exercise. Proponents of the ketogenic diet state that if the diet is carefully followed, blood levels of ketones should not reach a harmful level (known as “ketoacidosis”) as the brain will use ketones for fuel, and healthy individuals will typically produce enough insulin to prevent excessive ketones from forming.
Macronutrient Ratios in a Ketogenic Diet
There is not one “standard” ketogenic diet with a specific ratio of macronutrients (carbohydrates, protein, fat). The ketogenic diet typically reduces total carbohydrate intake to less than 50 grams a day-less than the amount found in a medium plain bagel-and can be as low as 20 grams a day. Generally, popular ketogenic resources suggest an average of 70-80% fat from total daily calories, 5-10% carbohydrate, and 10-20% protein. For a 2000-calorie diet, this translates to about 165 grams fat, 40 grams carbohydrate, and 75 grams protein. The protein amount on the ketogenic diet is kept moderate in comparison with other low-carb high-protein diets, because eating too much protein can prevent ketosis.
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Common Reasons for Slow Weight Loss on Keto
1. Not Achieving Ketosis
Usually, when a person does not lose weight on the keto diet, it is because they have not achieved ketosis. One reason for not achieving ketosis is not cutting back enough on carbs. According to a 2023 overview of previous research. carbohydrates should represent only 5-10% of a person’s calorie intake on the ketogenic diet. Specifically, most keto diets require a person to cut down to between 20 and 50 grams of carbs each day on a 2000-calorie-per-day diet. Sometimes, a person may feel as though they have drastically reduced their carb intake. However, they may still be eating enough carbs for the body to produce energy from glucose, and this may reduce the rate of fat burned in the body.
2. Hidden Carbs in Foods
Hidden carbs might be sabotaging your keto success without you even knowing it. To lose weight on the modified keto diet, your carbs must stay between 20-50 grams daily. That’s just 5-10% of your daily calories on a standard 2000-calorie diet. “Many of my clients are surprised to learn they’re consuming more carbs than they realize,” says Bakios, RD. “Common culprits include sugar-free products, keto-labeled cereals, and even some granola marketed as low-carb. Watch out for condiments too.”
Here are some common hidden carbs:
- Sugar substitutes like maltitol can affect blood sugar despite being marketed as keto-friendly
- “Keto-friendly” processed foods may contain fillers and starches
- Certain vegetables that seem low-carb but add up in larger portions
- Dairy products, especially flavored varieties
- Nuts and seeds, which can be easy to overeat
3. Excessive Protein Intake
Many low carb diets allow for a moderate amount of protein. Some people mistakenly think a low carb, high protein diet is a keto diet. However, this type of diet is unlikely to cause ketosis because the body can break down excess proteins into amino acids and convert them to types of sugar. A person on the keto diet will get most of their calories from fat, which should represent about 55-60% of their calorie intake. This fat intake leaves little room for protein. If protein makes up more than 35% of a person’s diet, they may not go into ketosis.
4. Overconsumption of Keto-Friendly Foods
On the keto diet, several types of carbohydrates are acceptable, including nuts and dairy. These foods are typically high fat, nutrient-dense foods that make a great addition to a keto diet. However, they also contain carbohydrates. Eating too many of these foods will keep a person from achieving and maintaining ketosis.
Read also: Keto Calorie Counting: A Detailed Guide
5. Sugar Alcohols
Sugar alcohols are typically a good option for people following the keto diet. They provide sweetness without increasing net carbs in the body. However, not all sugar alcohols are alike. For example, although maltitol is technically a low glycemic index (GI) sugar, it can still affect a person’s blood sugar levels. Consuming too much maltitol may prevent a person from entering ketosis.
6. Excessive Calorie Intake
To lose weight, a person needs to burn more calories than they consume. People who consume too many calories may gain weight, even if they are in a state of ketosis. It is, therefore, important that people keep track of the number of calories that they consume. Sticking to a balanced meal plan can help a person work toward their ideal weight.
7. Snacking and Alcohol Consumption
Continual snacking can increase a person’s calorie intake. This can mean a person consumes more calories than they are burning off, resulting in weight gain. Many alcoholic drinks, such as wine or beer, are high in carbohydrates. Hard alcohols, such as gin and vodka, contain less sugars, meaning they are lower in carbohydrates. However, alcoholic drinks contain many calories. As such, even these options can prevent weight loss.
8. Lack of Exercise
Exercise is an important part of staying healthy. Exercise also stimulates the body’s metabolism and burns calories. Exercise may be especially important on a keto diet, as the high fat foods a person eats contain many calories. Burning calories through exercise can help a person reach their desired weight.
9. Stress and Sleep Quality
A high-stress lifestyle can also stop a person from losing weight on the keto diet. As one 2022 article notes, psychological stress can cause changes in hormone levels, such as cortisol, which can lead to weight gain or difficulty losing weight. Chronic stress may also cause people to crave comfort foods, which can add extra calories to the diet. Stress and poor sleep can quietly undermine your keto diet efforts, even when you’re diligently tracking macros. When stress levels remain elevated, your body produces excess cortisol, a hormone that not only triggers cravings but also promotes fat storage.
Read also: Magnesium Supplements for Keto
10. Underlying Medical Conditions
In some cases, an underlying medical condition can cause weight gain or prevent weight loss. Alternatively, a medication that a person takes for the underlying condition may be causing increased appetite as a side effect. Some conditions that can contribute to weight gain include: some endocrine conditions, such as: hypothyroidismpolycystic ovary syndromeCushing’s syndromemental health conditions, such as depressionchronic stress. A person should contact a doctor if they are unable to lose weight despite adhering to a strict diet and exercise plan. The doctor may carry out tests to determine what is preventing weight loss. Treating the underlying condition may resolve the issue.
11. Poor Diet Quality
While hitting your macro ratios is important, your body needs a full spectrum of nutrients to thrive and achieve healthy weight loss. Nutrient deficiencies can slow your progress. “Poor gut health can prevent you from losing weight, even in ketosis. The keto diet eliminates many vegetables, legumes, and fruits-foods that offer protective benefits to your gut through fiber, vitamins, and minerals,” says Bakios, RD. “These high-carbohydrate foods also provide more volume for fewer calories, which can help with feelings of fullness when trying to lose weight.”
12. Consuming too many fat calories
While the keto diet is designed to help you burn fat, the fundamental principle of weight loss applies-you still need a calorie deficit. Depending on your fat intake, you may be consuming too many calories (yes, that includes healthy fats). Common high-calorie pitfalls on a keto diet include: Large portions of fatty meats and animal protein Liberal use of cooking oils and butter Excessive snacking on nuts and seeds Multiple servings of packaged “keto-friendly” desserts.
Strategies to Overcome a Keto Weight Loss Plateau
1. Ensure You're in Ketosis
Home testing can be a helpful way for people to ensure that they are entering ketosis. A person not losing weight on the keto diet may benefit from purchasing a home testing kit. These kits contain test strips that check for ketones in the urine. A positive result indicates that the body is in ketosis. Another option is to use a small machine called a ketone breath analyzer that detects ketones in the breath. People can use this information to make dietary changes to help them achieve their weight loss goals.
2. Track Your Macronutrient Intake
To help reach your intake goals, consider tracking your macronutrients through an app like MyFitnessPal. This can help you learn how many servings of carbs you’re allowed to have in a day depending on your calorie needs.
3. Monitor Calorie Consumption
It is, therefore, important that people keep track of the number of calories that they consume. Sticking to a balanced meal plan can help a person work toward their ideal weight. Creating a calorie deficit is still essential for weight loss. Consuming too many calories from high-fat, low-carb foods can hinder your progress. Tracking helps ensure you’re not unknowingly overeating.
4. Focus on Whole, Unprocessed Foods
To optimize your nutrient intake while losing weight on the keto diet, stick to unprocessed, whole foods. For example, full-fat dairy products, eggs, fish, pastured meats, poultry and healthy fats like avocado and olive oil are all great choices. Be sure to add non-starchy vegetables like greens, broccoli, peppers and mushrooms to dishes to add nutrients and fiber.
5. Manage Stress and Improve Sleep
Creating a consistent sleep schedule, limiting screen time before bed, and maintaining a cool, dark bedroom environment can improve your sleep quality. Consider calming practices like yoga or meditation, which can help regulate cortisol levels that affect weight loss.
6. Incorporate Regular Exercise
Incorporate regular exercise into your routine: even a 30-minute daily walk can make a difference. Regular exercise can be your secret weapon on keto, even if it doesn’t burn hundreds of calories. Think of movement as your body’s tune-up; it helps your metabolism burn fat more effectively, maintains muscle mass, and makes your cells more sensitive to insulin.
7. Consult a Registered Dietitian
The most effective first step in optimizing your keto journey is consulting with a registered dietitian who specializes in keto diets. These experts can assess your unique needs, medical history, and lifestyle factors to create a personalized plan that works for you. A registered dietitian can help you personalize the macronutrient ratio for your goals and lifestyle.
8. Precision in Food Tracking
Once you have professional guidance, focus on precision, at least in the short term. Track your macros using reliable apps, measure portions carefully, and log everything from cooking oils to seasonings.
9. Lifestyle Changes
Managing lifestyle factors can significantly boost your results. These lifestyle adjustments, while simple, can enhance your body’s ability to maintain ketosis and support your weight loss goals.
10. Hormonal Imbalances and Medical Conditions
If you suspect an underlying condition, work with a healthcare provider to address these issues along with your dietary changes.
11. Focus on Whole Foods and Mindful Eating
While the Keto diet can be effective in reducing excess sugar and encouraging more mindful eating, a more sustainable approach to consistent weight loss is having a balanced plate at each meal.
Alternatives to the Keto Diet
1. Intermittent Fasting
You could consider experimenting with intermittent fasting, which involves consuming daily calories within a limited time frame while fasting for the rest. Note: Intermittent fasting is not for everyone. Please consult your healthcare provider before you start any diet involving fasting. By cycling between periods of eating and fasting, your body enters “mild ketosis” during the fasting phase. “Unlike the keto diet, which requires strict food restrictions, intermittent fasting lets you enjoy a variety of nutrient-dense foods, such as fruits, vegetables, whole grains and legumes, during eating windows,” Dr. Ring explains.
2. Mediterranean Diet
A more balanced weight loss approach may be the Mediterranean diet. It’s based on balanced meals and offers sustained weight loss in the long term.