The ketogenic, or "keto," diet has gained considerable attention as a potential weight-loss strategy. This low-carbohydrate, high-fat eating plan has been used for centuries to treat specific medical conditions, such as controlling diabetes in the 19th century and as an effective treatment for epilepsy in children in whom medication was ineffective in 1920. 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. However, many people find themselves in a frustrating situation: they're diligently following the keto diet, carefully planning each meal, and tracking their macros, but the scale refuses to budge. It’s natural to hit a weight loss plateau on keto. It’s a hard diet to follow, especially in the long term.
What is the Keto Diet?
The keto diet is a low-carb, high-fat weight-loss diet. This extreme low-carb diet was created to force the body to use fat as fuel instead of glucose-a process called ketosis. The original keto diet involved eating 75-90% fat, 10% protein, and 5% carbs. It was developed to treat severe epilepsy in infants and children under strict medical supervision, not for everyday dieting. The keto diet you read about is a modified version of the original. Most people who follow this diet today do not achieve ketosis. But that’s okay! It’s possible to achieve weight loss with a modified keto diet, even if you’re not in ketosis.
How Does Keto Burn Fat (What is Ketosis)?
When you switch to a very low-carb diet, you’re essentially enrolling in an intensive fat-burning language immersion program. When you eat fewer calories from carbs, your body starts producing ketones-molecules that serve as an alternative energy source for your brain, heart, and muscles. This process forces your body to use body fat for energy.
When these stores are full, they are converted into fat. In this state, your body breaks down fats into molecules called ketones. Ketones serve as an alternative fuel source. Without careful planning, Dr.
Reasons Why You're Not Losing Weight on Keto
Weight loss plateaus on keto often stem from hidden carbs, excessive calorie intake, overlooked lifestyle factors like stress and sleep, and underlying health issues. Here are some potential reasons why you might not be seeing the results you expect:
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1. Hidden Carbs: The Sneaky Saboteurs
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.
Common culprits include:
- 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
“Net carbs” and “impact carbs” are familiar phrases in ketogenic diets as well as diabetic diets. They are unregulated interchangeable terms invented by food manufacturers as a marketing strategy, appearing on some food labels to claim that the product contains less “usable” carbohydrate than is listed. [6] Net carbs or impact carbs are the amount of carbohydrate that are directly absorbed by the body and contribute calories. They are calculated by subtracting the amount of indigestible carbohydrates from the total carbohydrate amount. Indigestible (unabsorbed) carbohydrates include insoluble fibers from whole grains, fruits, and vegetables; and sugar alcohols, such as mannitol, sorbitol, and xylitol commonly used in sugar-free diabetic food products. However, these calculations are not an exact or reliable science because the effect of sugar alcohols on absorption and blood sugar can vary. Some sugar alcohols may still contribute calories and raise blood sugar. The total calorie level also does not change despite the amount of net carbs, which is an important factor with weight loss.
Consider tracking your meals for a few weeks to detect repeat offenders. A registered dietitian can help you identify potential issues and overcome a weight loss plateau.
2. Calorie Overload: Too Much of a Good (Fatty) Thing
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).
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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
3. Poor Diet Quality: Nutrients Matter
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.
4. Lifestyle Factors: The Unsung Heroes
The success of a ketogenic diet doesn't exist in isolation-it's deeply intertwined with your overall lifestyle. Many people focus solely on food choices while overlooking crucial lifestyle factors that can make or break their weight loss efforts. Your daily habits and routines play a massive role in how your body responds to dietary changes. This includes hydration, sleep, stress management, exercise, daily movement, avoiding tobacco, and limiting alcohol.
5. Stress and Sleep: The Silent Saboteurs
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. This stress response can lead to weight gain and derail your progress, even if you’re maintaining strict ketosis.
Sleep quality plays an equally crucial role in weight loss through its effect on hunger hormones. Research shows that inadequate sleep disrupts the delicate balance between ghrelin (your hunger hormone) and leptin (your fullness hormone). This hormonal imbalance can intensify cravings and increase appetite, making it harder to maintain your keto eating plan.
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6. Lack of Physical Exercise: Move Your Body
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.
You don't need to train for a marathon. Even daily walks or simple strength training can help you break through weight loss plateaus.
7. Hormonal Imbalances and Medical Conditions: The Underlying Issues
Several medical conditions can significantly impact your weight loss journey on keto:
- Hypothyroidism, which slows overall metabolism
- Insulin resistance, making fat loss more difficult
- Chronic inflammation, which can lead to a weight loss plateau
Your hormones have a close relationship with weight loss. These powerful chemical messengers influence how your body burns fat, even when you're following your keto plan perfectly. They influence everything from how hungry you feel to how easily your body burns fat.
Some medications can impact your weight loss efforts. Common examples include certain steroids, diabetes medications, antipsychotics, and some antidepressants.
How to Break Through the Keto Weight Loss Plateau
Successful weight loss on keto requires proper nutrition, regular exercise, stress management, and figuring out what works best for your unique body. Here are some strategies to help you overcome that plateau:
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.
Precise 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.
Incorporate Lifestyle Changes
Managing lifestyle factors can significantly boost your results. Incorporate regular exercise into your routine: even a 30-minute daily walk can make a difference. For stress management, consider calming practices like yoga or meditation, which can help regulate cortisol levels that affect weight loss.
Creating a consistent sleep schedule, limiting screen time before bed, and maintaining a cool, dark bedroom environment can improve your sleep quality. These lifestyle adjustments, while simple, can enhance your body’s ability to maintain ketosis and support your weight loss goals.
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. A healthy, balanced plate might include 4-6 ounces of lean protein, like chicken or fish, paired with ½ cup of brown rice, and the other half of the plate filled with vegetables, such as a salad or green beans.
By focusing on adding lower-calorie, volume-dense, nutrient-packed foods-especially plant-based options-you can fill your plate with more food and still feel full, thanks to the higher volume. Additionally, plant-based foods provide beneficial phytochemicals that offer protective benefits to your body.
Keto Alternatives: When to Try Something Different?
While the ketogenic diet can be effective (particularly in the short term), it's not the only path to sustainable weight loss. Diets that eliminate food groups that our bodies rely on can lead to an unhealthy obsession with food. Often, people fail to enjoy a balanced diet and feel a physical strain from fighting cravings or the urges to “cheat” on their diet.
So, if you have been trying the keto diet for a while, and it doesn’t seem to work anymore, it’s perfectly fine! There are other ways for you to reach and maintain a healthy weight.
Here are some reasons why you may consider a different path to weight loss:
- When not losing weight on keto is affecting your mental health
- If you’re concerned that the intense keto food rules may trigger an eating disorder, disordered eating, or constant thoughts of food (”food noise”).
- If cutting carbs triggers binge eating episodes or intense food cravings
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”
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.
As a Registered Dietitian with years of experience in weight loss counseling, many clients succeed by learning to enjoy food in a balanced, sustainable way. Focus on incorporating foods that fit their lifestyle and provide all macronutrients in evidence-based proportions, emphasizing the importance of adequate micronutrients.
The best diet is one that you can maintain long-term while meeting your nutritional needs. A registered dietitian can help you navigate this process.
Foods to Add Back to Your Plate After the Keto Diet
Here are 10 healthy foods to begin eating again on your keto maintenance plan:
- Strawberries: Now you can eat enough to make it an actual snack.
- Carrots: This vitamin A-rich finger food is great for dipping into hummus.
- Black Bean Soup: Top with diced avocado for a boost of heart-healthy fat.
- Edamame: Edamame is also an excellent source of fiber, protein, and iron, and the legumes also contain vitamin C.
- Kiwi: One vitamin C-packed kiwi contains just 10.5 g of carbohydrates, making kiwi a perfect snack to nosh on post-keto.
- Butternut Squash: In fact, half a cup of baked butternut squash - rich in eyesight-friendly vitamin A - supplies 11 g carbohydrates.
- Watermelon: A super hydrating fruit (it’s mostly water).
- Lentils: Post-keto, it’s worth incorporating them into your meals again, since they’re packed with fiber.
- Oatmeal: Now it’s time to bring back the real deal. Top with a dollop of nut butter or sliced nuts and blueberries.
- Sweet Potatoes: Some of the last things you should add back into your post-keto diet are carb-rich whole-grain bread, brown rice, and potatoes, including sweet potatoes, because it’s easy to pack in a lot of carbs at once with these foods