The keto diet: “I feel great”

Updated headshot for Deborah


After a visit to her doctor, Deborah found out that her cholesterol levels were not good. In addition, she was 30 lbs (14 kg) overweight and suffered from crippling knee pain. She was told to start taking a statin and to go on a low-fat diet.

As she started researching her health issues, she ended up on Diet Doctor. She read up on the subject and was soon convinced that a keto diet was the way to go. She went back to her doctor and told her that if things hadn’t improved after six months, she’d follow her doctor’s recommendations. This is what happened:

Thank you, Dr. Eenfeldt!

Six months ago, I had my annual visit with my primary care provider of twenty years. My knees hurt, and I was 30 pounds (14 kg) overweight, confirmed by my BMI. My cholesterol was 282 mg/dl, my “bad” cholesterol was high, my “good” cholesterol and triglycerides could have been better, but my calculated VLDL was OK.

For the knee pain, my PCP added “osteoarthritis” to my problem list. For the elevated cholesterol, she recommended exercise and a low-fat diet, a trope which she has sung to me for two decades.

“Fine,” I thought. “But my knee pain is the problem that is bothering me the most. It is not only limiting my ability to exercise, but it is limiting my daily activities. And you, knowing by my report that I am not ready to contemplate knee replacements, have essentially told me to ‘live with it'”.

I know that every pound of excess weight exerts four pounds (2 kg) of pressure on the knees. It seemed to me that my first-line effort to deal with my knee pain should be weight loss. About a week after I saw my doctor, I stumbled across I read the scientific studies regarding low-carb, high-fat diets on and in medical journals. I emailed my doctor and reiterated that what concerned me the most was my limited mobility due to my knee pain. I told her my plan: “I am going to try a ketogenic diet for six months and recheck my lipids at that time. If I lose weight, and my knees stop hurting, but my lipids get worse, I will take a statin.” Her response: “Well, that is an interesting approach.”

Six months into a low-carb, high-fat diet that probably doesn’t quite make it to ketogenic most of the time, I have lost 28 pounds (13 kg). My BMI is normal. I lost 6″ (15 cm) around my waist, and I have gone down four pants sizes. Most importantly, my knee pain is much, much better. I checked my lipids at a free screening offered by a local pharmacy: My total cholesterol, triglycerides, and “bad” cholesterol were all DOWN from six months ago. My “good” cholesterol was UP. I feel great and feel wholly vindicated in my “interesting approach”.

For me, a low-carb, high-fat diet has been easy to follow. I knew I couldn’t face recording carbohydrates after decades of off and on meticulous food record-keeping that calorie in-calorie out dieting entails. I studied the food charts and recommendations and condensed them into an easy-to-remember plan: 1) No sugars 2) nothing white except for meat, fish, eggs, cheese, heavy cream, and butter (OK, butter in the US is yellow, but close enough); 3) No root vegetables; 4) no legumes; 5) for fruit, only berries without sugar. I don’t like artificial sweeteners, so I do without sweetener of any kind.

Chocolate was my biggest challenge, so I learned to like Lindt 90% cocoa chocolate bars. In chocolate dessert recipes (Molten Lava Cake with whipped cream is my favorite), I combine equal amounts of Lindt 90% and Baker’s unsweetened chocolate. If I am craving chocolate or need a psychological diversion from low-carb eating, I eat a single square of Lindt 90% cocoa chocolate as a special treat.

I like coffee, it does not give me heartburn or palpitations, and I have the leisure to sleep late and drink multiple cups in the morning. So, instead of breakfast, I enjoy two or three cups of coffee with heavy cream in the morning while I check my email, social media, plan my day, do my household chores, etc. At about 10 or 11, I am hungry enough to eat, so I’ll have a “brunch” of bacon and eggs or smoked salmon or ham, and fresh mozzarella cheese with avocado and maybe some sliced tomato. By then I am tired of coffee, so for a beverage, I have water (still or sparkling) or a glass of unsweetened coconut milk. I am not hungry again until dinner, which I prepare using one of the recipes or a low-carb adaptation of one of our family favorites.

Dining out is relatively simple: I have grilled meat or fish and double vegetables instead of the offered starch plus vegetables. If the only option is burgers, I ask for one without the bun or remove the bun when the burger is served. At first, I had to ask the server to take away the table bread; now I just ignore it. I also make it a point to eat a zero-carb snack before I dine out so that the table bread is less tempting. I have never been much of an evening snack eater, but I do enjoy a glass or two of white wine in the evening. Lately, though, I enjoy that less (I have found that I feel its adverse effects much more now, and much more quickly) and will skip that in favor of sparkling water or homemade eggnog (pasteurized eggs, heavy cream, water, and no sugar or artificial sweetener).

My current dilemma is what to do now that I have achieved my goals of weight loss and decreased knee pain. I am concerned that if I get even a little bit liberal with my carbs, I will reactivate some triggers that will derail a sustained low-carb high-fat lifestyle. For now, I plan to continue eating as I have been for the past six months and reassess if my weight gets too low. That, for sure, would be a problem that would be a joy to tackle!

Thank you, Dr. Eenfeldt and team. Now would the rest of you medical practitioners and dieticians please get with the program?



Thank you for sharing, Deborah – and congratulations on your health improvements!

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