The ketogenic diet: a promising approach for rapid weight loss

How the ketogenic diet works and its effects

Biological mechanisms: ketosis, use of fats as fuel

The ketogenic diet is based on a fundamental principle: inducing a metabolic state called ketosis, in which the body primarily uses fat as its energy source instead of glucose[6]. By drastically reducing carbohydrate intake (generally less than 50g per day), the body depletes its glycogen stores and turns to fat to produce ketone bodies, which then become the primary fuel for cells, including brain cells[7].

Effects on appetite and satiety

One of the notable effects of the ketogenic diet is its impact on appetite and satiety. Numerous studies have shown that high-fat, low-carbohydrate diets can reduce feelings of hunger and increase satiety [8]. This effect is thought to be related to several factors, including the stabilization of blood glucose levels, the increased energy density of food, and the secretion of satiety hormones such as peptide YY and GLP-1 [9].

Weight loss is often rapid at first.

The ketogenic diet is often associated with rapid weight loss in the first few weeks [10]. This initial weight loss is partly due to water loss, linked to the depletion of glycogen stores that retain water in the muscles and liver. However, beyond this effect, the ketogenic diet appears to promote greater fat loss than conventional low-calorie diets, thanks to increased fat metabolism and reduced appetite [11].

While these mechanisms show promise for weight loss, it is important to note that the long-term effects of the ketogenic diet remain unclear. Further studies are needed to assess the sustainability of the results and the potential side effects of prolonged adherence to this type of restrictive diet.

Makes it easier to control calorie intake

One of the main advantages of the ketogenic diet for weight loss is its ability to facilitate calorie control. Indeed, the high-fat, high-protein foods that form the basis of this diet have a greater satiating effect than carbohydrates [ 11]. This increased satiety allows people following a ketogenic diet to naturally reduce their calorie intake without constantly feeling hungry [12].

Seems effective in the short term for rapid weight loss

Numerous studies have shown that the ketogenic diet can be effective for rapid, short-term weight loss. A meta-analysis of 13 randomized controlled trials found that participants following a ketogenic diet lost significantly more weight at 12 and 24 months compared to those following a low-fat diet [4]. This short-term effectiveness can be particularly motivating for people looking to lose weight quickly.

May help reduce sugar/carb cravings

The ketogenic diet can also help reduce sugar and carbohydrate cravings, often considered a major obstacle to weight loss.[13] By strictly limiting carbohydrates, the body adapts to using fat as its primary energy source, which can decrease cravings for sugar and starchy foods. This reduction in cravings can make it easier to stick to the diet and promote sustainable weight loss.[14]

However, it’s important to note that while the ketogenic diet appears promising for short-term weight loss, its long-term effects remain unclear. Further research is needed to assess the sustainability of the results and the potential side effects of prolonged adherence to this type of restrictive diet. It is always recommended to consult a healthcare professional before starting a ketogenic diet to ensure it is suitable for your individual circumstances.

Difficult to maintain in the long term, requires many restrictions

Despite its potential benefits for weight loss, the ketogenic diet has some limitations, particularly in terms of long-term sustainability. This diet is very restrictive and can be difficult to follow over an extended period.[15] Severe carbohydrate restrictions can make social meals and eating out complicated, which may discourage some people. Furthermore, the lack of dietary variety can lead to boredom and difficulty maintaining the diet long-term.[16]

Possible “yo-yo” effect in case of stopping or deviations from the plan.

Another limitation of the ketogenic diet is the risk of the “yo-yo” effect if the diet is stopped or if deviations occur. When people end the ketogenic diet and reintroduce carbohydrates into their diet, they can quickly regain the lost weight, or even gain more [17]. This “yo-yo” effect can be discouraging and detrimental to long-term health. Therefore, it is crucial to have a transition and weight maintenance strategy after the initial weight loss phase.

Possible nutritional deficiencies, unbalanced intake

The ketogenic diet, by its very nature, can also lead to nutritional deficiencies and unbalanced intake [18]. Strict carbohydrate restriction can lead to inadequate intake of fiber, vitamins, and essential minerals. Therefore, it is important to carefully plan meals to ensure nutritional needs are met, possibly with the help of a healthcare professional. Supplementation may be necessary in some cases.

Contraindicated in certain cases (pregnancy, diabetes, kidney disease…)

Finally, it is crucial to note that the ketogenic diet is contraindicated in certain specific medical situations. Pregnant women, people with diabetes, and those suffering from kidney or liver disease, for example, should not follow this type of diet without close medical supervision.[19] It is always recommended to consult a doctor before starting a ketogenic diet to ensure it is suitable for your health condition.

In conclusion, while the ketogenic diet offers potential benefits for rapid weight loss, it also has limitations and precautions to consider. It is essential to be well-informed and receive appropriate medical supervision to maximize the benefits and minimize the risks associated with this type of restrictive diet. 

Plan your meals carefully, and make sure you have the right foods.

To maximize the benefits of a ketogenic diet, it is essential to plan your meals carefully and ensure you have the right foods on hand [20]. Proper preparation can make it easier to stick to the diet and avoid slip-ups. It is recommended to make a suitable shopping list, plan ketogenic snacks for when you get peckish, and prepare meals in advance if necessary. Online resources, such as specialized blogs or dedicated apps, can help you find ideas for recipes and balanced ketogenic meal plans[21].

Monitor your intake of vitamins, minerals, and fiber.

As mentioned earlier, the ketogenic diet can lead to deficiencies in certain essential nutrients. To optimize health and results, it is crucial to monitor vitamin, mineral, and fiber intake[22]. Sufficient consumption of low-carbohydrate vegetables, such as leafy greens, can help meet fiber and micronutrient needs. Targeted supplementation may also be considered after consulting a healthcare professional.

Gradually reintroduce healthy carbohydrates after the initial phase.

To avoid the yo-yo effect and maintain long-term results, it is advisable to gradually reintroduce healthy carbohydrates after the initial weight-loss phase [23]. This reintroduction should be done in a controlled manner, prioritizing complex carbohydrate sources rich in fiber, such as vegetables, low-glycemic-index fruits, and whole grains. A gradual increase in carbohydrate intake, while maintaining a moderate calorie deficit, can promote a smooth transition to a more balanced and sustainable diet.

Combine with regular physical activity.

Finally, to optimize the results of a ketogenic diet and improve overall health, it is strongly recommended to combine this diet with regular physical activity [24]. Exercise can help preserve muscle mass during weight loss, improve insulin sensitivity, and boost metabolism. A combination of resistance training and aerobic exercise, tailored to individual abilities and preferences, can enhance the beneficial effects of the ketogenic diet on body composition and cardiometabolic health.

In conclusion, to get the most out of a ketogenic diet and optimize its results, it is essential to prepare thoroughly, monitor your nutritional intake, gradually reintroduce healthy carbohydrates, and combine the diet with regular physical activity. Consulting a healthcare professional can help personalize this advice to suit individual needs and goals.

In conclusion, the ketogenic diet appears to be a promising approach for rapid weight loss. Its basic principle, which consists of inducing a state of ketosis by drastically reducing carbohydrate intake, seems to promote increased use of fat as an energy source and a decrease in appetite [24]. Scientific studies suggest that this diet may be more effective in the short term for weight loss than traditional low-fat diets [25].

However, it is crucial to consider the limitations and precautions associated with the ketogenic diet. Its restrictive nature can make it difficult to follow long-term, leading to nutritional deficiencies[19]. Therefore, it is essential to plan meals carefully, monitor micronutrient intake, and gradually reintroduce healthy carbohydrates after the initial weight loss phase.

For those who would like to explore alternatives to the ketogenic diet, there are other approaches that have also shown promising results for weight loss and improved metabolic health, such as the Mediterranean diet or intermittent fasting[26][27].

Ultimately, the choice of a diet should be personalized according to each individual’s needs, preferences, and health status. It is always recommended to consult a healthcare professional before embarking on a ketogenic diet or any other restrictive approach to receive appropriate guidance and optimize your chances of long-term success.

1. Masood, W., & Uppaluri, K.R. (2019). Ketogenic Diet
2. World Health Organization. (2020). Obesity and overweight
3. Paoli, A. (2014). [Ketogenic diet for obesity: friend or foe?]International journal of environmental research and public health, 11(2), 2092-2107.
4. Bueno, NB, de Melo, ISV, de Oliveira, SL, & da Rocha Ataide, T. (2013). [Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomized controlled trials]. British Journal of Nutrition, 110(7), 1178-1187.
5. Kossoff, EH, Cervenka, MC, Henry, BJ, Haney, CA, & Turner, Z. (2013). [A decade of the modified
6. Atkins diet (2003–2013): results, insights, and future directions. Epilepsy & Behavior, 29(3), 437-442.
7. Westman, E.C., Mavropoulos, J., Yancy, W.S., & Volek, J.S. (2003). [A review of low-carbohydrate ketogenic diets] Current Atherosclerosis Reports, 5(6), 476-483.
8. Phinney, S.D. (2004). [Ketogenic diets and physical performance]. Nutrition & metabolism, 1(1), 1-7.
9. Gibson, AA, Seimon, RV, Lee, CM, Ayre, J., Franklin, J., Markovic, TP, … & Sainsbury, A. (2015). [Do ketogenic diets really suppress appetite? A systematic review and meta‐analysis. Obesity reviews, 16(1), 64-76.
10. Paoli, A., Bosco, G., Camporesi, E.M., & Mangar, D. (2015). [Ketosis, ketogenic diet and food intake control: a complex relationship]. Frontiers in psychology, 6, 27.
11. Gomez-Arbelaez, D., Bellido, D., Castro, AI, Ordoñez-Mayan, L., Carreira, J., Galban, C., … & Casanueva, F.
12. F. (2017). [Body composition changes after very-low-calorie ketogenic diet in obesity evaluated by 3 standardized methods]. The Journal of Clinical Endocrinology & Metabolism, 102(2), 488-498.
13. Johnstone, AM, Horgan, GW, Murison, SD, Bremner, DM, & Lobley, GE (2008). [Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men eating ad libitum]. The American journal of clinical nutrition, 87(1), 44-55.
14. McClernon, FJ, Yancy, WS, Eberstein, JA, Atkins, RC, & Westman, EC (2007). [The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms]]Obesity, 15(1), 182-182.
15. Wolever, TM, Gibbs, AL, Mehling, C., Chiasson, JL, Josse, RG, Leiter, LA, … & Ryan, EA (2008). [The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein]. The American journal of clinical nutrition, 87(1), 114-125.
16. Brinkworth, G.D., Noakes, M., Buckley, J.D., Keogh, J.B., & Clifton, P.M. (2009). [Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo]. The American journal of clinical nutrition, 90(1), 23-32.
17. Stern, L., Iqbal, N., Seshadri, P., Chicano, KL, Daily, DA, McGrory, J., … & Samaha, FF (2004). [The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial] Annals of internal medicine, 140(10), 778-785.
18. Greenberg, I., Stampfer, M.J., Schwarzfuchs, D., & Shai, I. (2009). [Adherence and success in long-term weight loss diets: the dietary intervention randomized controlled trial (DIRECT)]. Journal of the American College of Nutrition, 28(2), 159-168.
19. Sumithran, P., & Proietto, J. (2013). [The defense of body weight: a physiological basis for weight regain after weight loss]. Clinical Science, 124(4), 231-241.
20. Freedman, M.R., King, J., & Kennedy, E. (2001). [Popular diets: a scientific review]. Obesity research, 9(S1), 1S-40S.
21. Kossoff, E. H., & Dorward, J. L. (2008). [The modified Atkins diet]. Epilepsy, 49, 37-41.
22. Sondike, S.B., Copperman, N., & Jacobson, M.S. (2003). [Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factors in overweight adolescents]. The Journal of Pediatrics, 142(3), 253-258.
23. Gupta, L., Khandelwal, D., Kalra, S., Gupta, P., Dutta, D., & Aggarwal, S. (2017). [Ketogenic diet in endocrine disorders: Current perspectives] Journal of postgraduate medicine, 63(4), 242.
24. Zupec-Kania, B.A., & Spellman, E. (2008). [An overview of the ketogenic diet for pediatric epilepsy](https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1528-1167.2008.01821.x). Nutrition in Clinical Practice, 23(6), 589-596.
25. Paoli, A., Rubini, A., Volek, JS, & Grimaldi, KA (2013). [Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets]. European journal of clinical nutrition, 67(8), 789-796.
26. Volek, J. S., Sharman, M. J., & Forsythe, C. E. (2005). [Modification of lipoproteins by very low-carbohydrate diets] The Journal of Nutrition, 135(6), 1339-1342.
27. Bueno, NB, de Melo, ISV, de Oliveira, SL, & da Rocha Ataide, T. (2013). [Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomized controlled trials] British Journal of Nutrition, 110(7), 1178-1187
28. Estruch, R., Ros, E., Salas-Salvadó, J., Covas, MI, Corella, D., Arós, F., … & Martínez-González, MA (2018). [Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts]. New England Journal of Medicine, 378(25), e34.
29. de Cabo, R., & Mattson, M.P. (2019). [Effects of intermittent fasting on health, aging, and disease] New England Journal of Medicine, 381(26), 2541-2551.