Lose Weight by Achieving Optimal Ketosis

Do you want to lose weight? Here’s number 14 of my 17 best tips. All of the published tips can be found on the How to Lose Weight page.

Before we get started, here’s a short recap of the tips so far: The first and most crucial piece of advice was to choose a low-carb diet. The next were eating when hungry, eating real food, measuring progress wisely, thinking long-term, avoiding fruit, alcohol and artificial sweeteners, review your medications, stressing less and sleeping more, eating less dairy and nut products, stocking up on vitamins and minerals and finally, exercise.

This is number fourteen:

14. Get into optimal ketosis

Warning: Not recommended for type 1 diabetics, see below.


We’ve now arrived at tip number 14. If you’re still having trouble losing weight, despite following the 13 pieces of advice listed above, it might be a good idea to bring out the heavy artillery: optimal ketosis. Many people stalling at weight plateaus while on a low carb diet have found optimal ketosis helpful. It’s what can melt the fat off once again.

So how does this work? A quick run-through: The first tip was to eat low carb. This is because a low-carb diet lowers your levels of the fat-storing hormone insulin, allowing your fat deposits to shrink and release their stored energy. This tends to cause you to want to consume less calories than you expend – without hunger – and lose weight. Several of the tips mentioned above are about fine-tuning your diet to better this effect.

How do you know you’re getting the maximum hormonal impact from your low-carb diet? You do that by achieving what’s known as “optimal ketosis”. 


Ketosis is a state at which the body has an extremely high fat-burning rate. Even the brain runs on fat, via ketone bodies. These are energy molecules in the blood (like blood sugar) which become fuel for our brains after being converted from fat by the liver.

To encourage ketone production, the amount of insulin in your bloodstream must be low. The lower your insulin, the higher your ketone production. And when you have a well-controlled, sufficiently large amount of ketones in your blood, it’s basically proof that your insulin is very low – and therefore, that you’re enjoying the maximum effect of your low-carbohydrate diet. That’s what’s called optimal ketosis.

Measuring ketones

Today, there are reasonably-priced gadgets available for measuring ketone levels at home. One needle prick of the finger, and in just a few seconds you’ll know your blood ketone level.

Blood ketones are best measured on a fasted stomach in the morning (before breakfast, that is). Here are a few pointers on how to interpret the result:

  • Below 0.5 mmol/L is not considered “ketosis”. At this level, you’re far away from maximum fat-burning.
  • Between 0.5-1.5 mmol/L is light nutritional ketosis. You’ll be getting a good effect on your weight, but not optimal.
  • Around 1.5 – 3 mmol/L is what’s called optimal ketosis and is recommended for maximum weight loss.
  • Values of over 3 mmol/L aren’t neccessary. That is, they will achieve neither better nor worse results than being at the 1.5-3 level. Higher values can also sometimes mean that you’re not getting enough food. For type 1 diabetics, it can be caused by a severe lack of insulin, see below.

Ketones in urine

Ketone levels can also be measured in a more old-fashioned way, with urine test sticks (sold prescription-free in pharmacies or on Amazon). Ketone sticks give less reliable results for several reasons, and the above recommendations can’t be straightforwardly applied to them. They are, however, much cheaper.

My personal experience

Feel free to read my accounts of a two-month personal trial:

  1. Experiment: Optimal ketosis for weight loss and increased performance
  2. Four weeks of strict LCHF and ketone monitoring
  3. Final report: Two months of strict LCHF and ketone monitoring

Although I was quite happy with my weight before these trials, they resulted in a further loss of 4.5kgs (10 pounds) and 7cm (3 inches) around my waist – without additional exercise or even the slightest resemblance of hunger.

How to achieve optimal ketosis

Many who firmly believe they are eating a strict low-carb diet are surprised when they measure their blood ketones. They may be at around only 0.2 or 0.5 – quite far off from the sweet spot! Why?

The trick here is not only to avoid all obvious sourced of carbohydrate (sweets, bread, spaghetti, rice, potatoes), but also to be careful with your protein intake. If you eat large amounts of meat, eggs and the like, the excess protein will converted into glucose in the body. Large amounts of protein can also raise your insulin levels somewhat. This compromises optimal ketosis.

The secret to getting around this is usually to eat your fill with more fat. For example, if you have a bigger helping of herb butter to your steak, you might not feel like having a second steak, and instead feel satisfied after the first one.

A popular trick people use to ingest more fat is “fat coffee” (sometimes called “Magic Bullet Coffee” or MBC). It involves adding one tablespoon of butter and one tablespoon of coconut oil to your (morning) coffee, and requires a food blender for the right texture.

More fat in your food will fill you up more. This will ensure you eat less protein, and even less carbohydrate. Your insulin will drop and, hopefully, you’ll be able to reach optimal ketosis. And that’s when many a stubborn weight plateau is overcome.

If it doesn’t work

Being in optimal ketosis for a prolonged period of time (say, a month) will ensure that you experience the maximal hormonal effect from eating a low-carb diet. If this doesn’t result in noticeable weight loss, you can be certain that too many carbs are NOT part of your weight issue and not the obstacle to your weight loss. There are, in fact, other causes of obesity and being overweight. The next three tips in this series might help you.

Try it

Order a ketone meter online and start measuring. There are a few different models, take a look at this one and this one.


Watch my video interview with the American doctor Peter Attia, on a strictly ketogenic low-carbohydrate diet: Very Low Carb Performance

Read all the tips on the How to Lose Weight page.

A word of warning

If you have type 1 diabetes, you should not follow the above advice on optimal ketosis – it may be risky. If you have ketones in your blood at all, you must be sure that your blood sugar levels are normal. If they are, you’re in normal ketosis – just like the ketosis of healthy people who stick to a strict low carb diet.

High blood sugar levels coupled with high blood ketones, on the other hand, will mean that you have a pathologically low level of insulin – something non-diabetics do not suffer from. This can lead to ketoacidosis – a potentially life-threatening condition. If this happens, you’ll need to inject more insulin; if you’re at all unsure of what to do, contact a medical professional. Coveting really high blood ketones for weight control is not worth the risk for type 1 diabetics.

More about the free updates that people get.


Could Drinking Milk Shorten Your Life? 38
Gallstones and Low Carb 158
Final Report: Two Months of Strict LCHF and Ketone Monitoring 95
A Calorie Is Not a Calorie 73
Discovering Airline Diabetic Meal 109
A Calorie Is Not a Calorie – Not Even Close 36
A New Toy Measuring Blood Ketones 163
Where Are You On The Global Fat Scale? 29
Is It Possible to Recover from Hypothyroidism? 37
LCHF-Success Greetings from India 47
Sugar vs Fat on BBC: Which is Worse? 125
No More Than Seven Months? 35


Top Comment

  1. Ralph, Cleethorpes, UK
    Yes PC (10) that is simplistic. Good luck with that ;-)
    Read more →
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All Comments

  1. Teresa
    Elaine please start drinking 2-3 litres of water every day! And you are absolutely correct to get rid of all artificial sweeteners. Not only are they poison but they disrupt insulin and blood sugar levels. Urine keto test strips are available at pharmacies for less than $10 for one container. You also need to start even a minimal exercise plan. Walking 20 minutes per day is a great start.
    Reply: #153
  2. Elaine
    hehe don't worry i'm too disabled to have a social life or be employed, i'm free to eat whenever i want to... get most of my calories from fat tho, coz i'm broke
  3. Elaine
    Hi hon, i can't fit that much water in my stomach but will drink as much as i can... and as far as exercise goes, if i could, i would

    i am still going to use stevia but am giving up artificial sweeteners

    Reply: #154
  4. Zepp
    Its with water as for calories.. one get tirsty if one need water.. let your bodylie signaling decide how much to eat and drink!

    The trick is to know ones own signalinging and what its mean!

    Eat when hungry.. drink when tirsty!

  5. Elaine
    i guess i have to go off the keto diet, my candida problem has come back with a vengence, which is what ruined my health in the first place, i have fought for 30 years to get that health back, and being on keto has made the candida come back and worse....

    i just found out tonight that yeast feeds even BETTER on ketones than it does on sugar

    i give up, every diet i try, every healing modality i try only makes me worse, i'm 52 years old, i will just wait impatiently for death

    Reply: #156
  6. Zepp
    I dont think soo.. becuse if they real eat ketones.. they have to get in to your blood stream.. and if they realy do this.. then you are not sitting here and writing!

    Becuse if you got candida in your blood you got sepsis and is on a stretcher or on an ambulance getting to nerest emergency intake!

    You having ketosis transitation side effects!

  7. Elaine
    this site doesn't show comments when i click on them, but i'm glad you don't think soooooooooo, wooopity dooooo, you don't think sooooooo

    that doesn't change that i'm sitting here with the worst yeast infection that i have had in 30 years, not to mention oral thrush which i have NEVER had before...

    and all if this with almost zero carbs in my diet

    so i'm glad you don't think soooooo but it really doesn't matter what you think does it?

  8. Elaine
    also here's an article on candida in the blood stream, if you look on the second page and how it can happen part of the list is having a bad immune system and being extremely ill.... that's me


    why wouldn't i be sitting here?? i DID spend a lot of years bed ridden, is that what you mean?

    you think systemic candida is impossible for some reason without being in the emergency room? i have spent hundreds upon hundreds of nights in the emergency room

    and the reason is because systemic candida DESTROYED MY HEALTH

    and now i'm sitting here listening to you say 'i don't think sooooooooo'

  9. Elaine
    excuse my angry response, i'm very upset right now, because YET AGAIN i tried to help myself and i made myself worse.... how to get sicker and sicker over 30 years of your life? just keep trying to get better

    please accept my apology

    Reply: #160
  10. Ralph
    What do you typically eat please Elaine?
  11. Elaine
    depends on what time of my life you are talking about, for the last few years i'm been a whole foods low fat vegan, anything processed makes me super ill.... but it got to the point where this perfect diet made me even more ill, but i won't get into that

    on the keto diet what do i eat? mostly coconut oil and butter, 80% fat... i put them in coffee and cocoa at night... i eat one meal a day, some zucchini or green beans and some meat, and the meat usually makes me ill, i'm sitting here puking and puking because i had a meat ball and my body is rejecting it.... even tho it's organic grass fed beef

    Reply: #162
  12. Ralph
    Is it possible that you have some residual problems due to B12 deficiency? Do you have B12 injections (if you have been B12 deficient, you may have affected your digestive system, and lack intrinsic factor).
    Your diet does seem very restricted, and coconut oil is expensive. I usually have creamed coconut, or desiccated; cream, nuts and olive oil are also cheaper.
    Cocoa is a processed food, and the caffeine also in coffee raises insulin.
    Atkins used to advise eating a variety of food, warning against developing intolerances by avoid eating the same food within 4 days.
  13. Elaine
    Hi Ralph, thanks for the reply... coconut oil isn't expensive here... and i don't have a gallbladder... i haven't been eating the same thing on the keto diet for the last 6 weeks, but my diet has been getting stricter and stricter as i was not losing weight, and getting sicker and sicker...

    when i was a vegan my doctor gave me B12 injections

    i drink decaf coffee and the cocoa is certified organic with only 1g of carbs per tablespoon and the only ingredient is cocoa

    it will be very difficult for you to diagnose what's wrong with me, as i have been diagnosed with CFS, fibro, chronic pain syndrome, IBS, anemia, you name it, my doctor thinks i have lupus, my last doctor thought i had MS, and i refuse to be tested because it's the doctors who make me sick in the first place, and i don't want to put my body thru any more of their treatments

    i'm just discouraged

    i really like the keto diet, it got rid of horrrrrrrible hunger pains i suffered with almost constantly, even if i ate until my stomach hurt

    but i can't risk letting candida overtake my body again and leave me bed ridden for years

  14. Ralph
    Quite right Elaine; you know yourself best.
    Have you tried looking at Zoe Harcombe's diet, the GAPS diet, or the Perfect Health Diet? The can all be used for healthy, ketogenic eating, though I would keep it low Gi/low insulin producing foods too.
  15. Elaine
    thank you so much, i think i will buy the perfect health diet when i have the money, it's primal not keto right?

    frankly, i think i have lupus, which has no known cause of any kind and i pretty much know what caused it, a life of horrible abuse.

    right now i no longer believe in healing... i have been on the verge of giving up for a while now, doing last ditch things to do with fasting... i went on a water fast but only lasted 8 days, but i stopped waking up with my hands seized in pain

    i just don't know what to eat tomorrow, i don't know what to do

  16. Ralph
    Fasting should only be attempted intermittently. We eat to provide nutrients that we need; cutting back too far will not provide the necessary building blocks to keep you healthy.
    Dr. Ron Rosedale for example acknowledges the longevity benefits of caloric restriction, and says these benefits can be realised by eating fat instead of having to experience the starvation. However, even he recognises the need to consume nutritional minimums of protein for instance. Consider what micro-nutrients are being provided by the food you eat.
    Lupus is an autoimmune disease that some believe results from chronic inflammation.
    Phase 1 of the Harcombe Diet is 5 days, specifically to counter issues including candida. Notwithstanding that, your symptoms may be so severe that you need to consider that medication may be necessary first. The GAPS diet also has a strict phase that is designed to redress the balance of gut flora.
    Good luck!
  17. Elizabeth
    How do you know the weight that you are losing is actually fat loss? I really don't care about weight loss, only permanent fat loss. I do know that a lot of the initial weight lost on a LC diet is water and maybe some muscle. How about on a prolonged keto diet?
  18. Steve
    Hi Elizabeth, I've been in Keto six months, day after tomorrow. In that length of time, the bathroom scales have shown 44 pounds of weight loss. I am much heavier underwater now than I weighed underwater 6 months ago. I am stronger and feel better. I am more emotionally stable. I do seem to aspirate water far more easily now, but I have no great trouble staying hydrated.....just have to drink a little more water. I do fluctuate in weight both up and down due to water, but simple reasoning will tell you that no part of my 44 pounds over the last 6 months has been due to water. If it was a gradual water loss, I'd be pretty darn dehydrated by now. What I have lost of water, I've replaced by drinking water.

    Looking at my muscular definition in the mirror, I can now plainly see an attractive form. If you are worried about losing muscle mass, it might be good for you to study how ketosis causes weight loss, as well as what is needed to maintain muscle mass. You certainly CAN lose muscle mass on ketosis if you don't eat any proteins, and/or don't do any exercises. But that isn't the fault of ketosis.

    One other thing I noticed. I used to have a problem with slow healing, and occasionally sores around my cuticles. However, after about 1.5 to 2 months on a ketogenic diet, I heal faster, and my cuticles are now perfectly formed. This is leading me to suspect what has been generally taught to people indicating that all of the vitamins and minerals are somehow in the carbs. I highly doubt this now from this experience.

    The only way you will personally know that you are losing pure fat on a ketogenic diet is to try it and look in the mirror. The old saying is that "skinny" people look good with clothes on. "Fit" people look good regardless. I can tell you that I definitely have not lost any muscles on Ketosis these last 6 months. And what I am finding about the variety of foods that are good ketogenic foods.....I don't have any desire now to ever stop.

  19. Lisa
    This message is for Elaine,

    Hi, I'm 49 years old, I had a hyterectomy 2 years ago, still have my ovaries, one Fallopian tube. I know TMI. My mom has fibromyalgis, I've been told I have it, because I've had a lot of the symtoms. I've had migraines my entire life, the fun kind where you lose vision and feeling down one side of your body. I have had a constaint yeast infection on my skin ever since I can remember. I have never really felt well. A year ago I started with insomnia, feelings of overwhelming ness. My response to stress caused me physical pain. I've been in all diets, I could quote them by heart. I've had the most success with Atkins, but have never lost all the weight. A few months ago I started the Doctors diet, and then began looking closer at Keto. I am taking some suppliments, the ones I can say that have had the biggest effect are, vitamin c, magnesium,
    Ultimate flora, and B complex, 7keto dhea(I wouldn't recommend without a doctors advise)
    Since I have been following the diet, I haven't had a migraine, the yeast on my skin has cleared, I'm actually getting 4 hours, sometimes 5 hours sleep.
    The improvements have been really slow and you have to pay attention, because all of a sudden you realize you do not feel like crap all the time. Also, I drink Keto, or Fat bomb coffee everyday and I also do "oil pulling" with coconut oil, first time I have woken up without any white on my tongue, with your condition, you would know how big that is. I know I'm rambling, but I just wanted to let you know, although not the same, you are not alone, hope this helps!

    Reply: #170
  20. Elaine
    Hello Lisa.... thank you so much for your response.... the keto diet seemed to make the yeast crazy looking for food from my body, like they were zombie yeast that attacked me instead of dying. i know that keto is the best diet for me, i think i maybe should have eased myself in, instead of going cold turkey....

    i wish i had a good report like you, that it made my rash go away, but it instead made it blow up... but it did help the pain in my body, and the constant gnawing hunger.... that's how i know it's right for me...

    thanks for reaching out!!!

  21. Ahmed
    I have been told that I am Diabetic two years ago. For the last several months I have been following on the LCHF and I saw good effect on my Glucose level about 5-7 avarrage 6 even one hour after eating a meal. However the frequency of urinating went up. Secondly in the morning is still high compare to the level at bed time. Generaly 5-6 at bed time but 7-8 in the morning.

    Any adivice

    Reply: #172
  22. Zepp
    Its cald Dawn Phenomenon, and its a part of your cirkadian cycle, nothing to do about but to be healtyer.


    Its probably linked to Cortisol awakening response?


    Everybody do have a slight higher glucose level ín the dawn, its becuse you shall wake up full of energy.

    The problem för diabetics is that it can be prolonged.

    The thing to do is to take the dog for a swift walk early in the morning!

    Urination is probably by ketosis, less insulin levels and/or mayby to little salts?

    Insulin stimulate the kidney to reasorb more salts, water comes whit it by osmos.

    If one pee a lot one lose to much salts.

  23. Sha
    Hi Elaine. Im sorry for what you've gone through all these years. I am a Candida sufferer too. The crisis that you are going through when you are on low carb and restricted sugars diet is what is called HEALING CRISIS or DIE OFF SYMPTOMS when the yeast are dying and starving from not havong sugary or starvhy food. Maybe you could read about that on your own.
  24. Elaine
    it's not die off, i have had 20 years of candida die off and know what that's about

    it doesn't DIE now, it turns virulent and eats my flesh, if you can direct me where to read about THAT .... that would be some info i could use

  25. ahmed
    Thank you Zepp, your reply was very helpful.

    I hardly salt is that contributing to more frequent urination.
    Also since I started the LCHF because there is enough fiber in the food I take I am not going to toilet as I used to do.

    Someone before suggest that I drink a wine before sleep to keep the Liver busy so to reduce any increase in the glucose level of he moring. Unfortunately I do not drink Alcohol any other suggestion.


    Reply: #176
  26. Zepp
    It could be and thats one comon beginners side effect.. salt defiency.

    One can feel a slight head ake and dissiness, its low blood presure.

    Its easy to check, take a pinch of salt in a glass of water, drink it.

    Another side effect is constpation.. becuse you dont eat that much that goes right thru.

    But it is good to be regular, if you did go ever day befor, every second day as a mean is aproproprate, or ad more fibers.

  27. Channing Drew
    I am told to get on a ketogenetic diet to help reverse my diabetic neuropathy. I am a type 2 diabetic male 145# 5'-9 with excellent blood sugar control with an 4.9 A1c. I do not need to loose any weight while on this diet, i plan on eating 45g carbs and 120g protein. How can I make this work. Please let me know, thank you.
    Reply: #178
  28. Zepp
  29. Nef90
    Hi. I am 24 and if I am honest with myself I am obese. I am 112kgs and 167cm tall. I am starting my ketogenic diet tomorrow and am feeling anxious. I see there are a lot of health benefits and I am super excited to be finally treating my body right after years of yoyo diets and other fads. I am just wondering what I can expect for reasonable weight loss? I know everyone is different. I have always been active however so will continue this, I gym 5 days a week. Three cardio and 2 resistance session. I guess all I am wanting to know is will I loose weight fast it will it be graudal?
    Reply: #182
  30. Mary Jo
    Can ketone on your breath ever be mistaken for alcohol consumption? A diabetic friend was pulled over for a DUI when he had not been drinking and the breathalyzer test indicated a failed test. Does this ever happen?
    Reply: #181
  31. Zepp
    Yeas it does.. all the time.. even on rapid weightloss with VLCD!
  32. Zepp
    First you will feel tired and have difficult to excersise.. its glucose shortige.

    Dont overdo it if you got that feeling, it take som time to be adapted.

    Dont expect anything, focus on your healt and eating real food then it comes buý it self.

    One pound a week is very fast.. often one lose some water in the beginning.



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