Lose weight by achieving optimal ketosis

Do you want to lose weight? Here’s number 16 of my 18 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, eating only when hungry, measuring progress wisely, being persistent, avoiding fruit, beer and artificial sweeteners, review your medications, stressing less and sleeping more, eating less dairy and nut products, stocking up on vitamins and minerals, using intermittent fasting and finally, exercising smart.

This is number sixteen:

16. Get into optimal ketosis

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

confused

We’ve now arrived at tip number 16. If you’re still having trouble losing weight, despite following the 15 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.

Video course

How to Eat LCHF Video Course

Do you know exactly how to eat a low-carb and high fat diet (LCHF)? This is required for ketosis. If not the easiest way is watching this high quality 11-minute video course on how to eat LCHF, and the most important things to think about.

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Maximum effect from an LCHF diet

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

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, the most popular one is probably the Precision Xtra ketone meter. Unfortunately these meters are all quite expensive to use, as the test strips can cost about $5 per test.

Here’s a complete package with everything you need to check your blood ketone levels.

More

Learn much more about ketogenic diets here:

A Ketogenic Diet for Beginners

What Is Ketosis?

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.

357 Comments

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. Marianne
    I just started my Keto Diet (not even a week in) and I must admit I am really not hungry at all. Of course I have ample stores of fat to fuel my body ;). I probably have around 100 pounds to lose but I am taking in day at a time. Many thanks for all the recipes and great videos on the site I am leaning so much!

    I do have one question though : I have a condition called Hemachromatosis (i.e. too much iron) will all the meat and great green veggies we eat on keto increase my iron? Most real and healthy foods are rich in iron like red meat, broccoli, kale and nuts.

    Thanks

    Reply: #366
  2. Judy F.
    I am on the Keto diet for just over a month now and have lost 20 lbs . My question is about my blood ketones I sit at around 0.3
    How can I raise them my macros are
    18 gr net carbs
    110 Gr fats
    90 gr protein
    I have gone over on my protein a couple of days by a teensy bit ,but not my fats .my carbs I never go over. Any suggestions would be appreciated
    Thanks Judy
    Reply: #353
  3. Peter Biörck Team Diet Doctor
    Hi Judy!

    Increase your fat intake a little bit (you could try a cup of tea with a tablespoon of coconut fat twice a day) and eat little less carbs...and see if your numbers goes up.

    If this doesn't work then try to increase your fat intake even more and eat even fewer carbs.

    If you after that still have problem then you could try to reduce the protein intake.

  4. Lori
    I've been on the keto diet for three months I have a monitor I've been in Keto's for majority of the time I have only lost 2 lb I have lost some inches I have been very frustrated to not see my scale not go down I have had A hysterectomy and Mike gallbladder removed I am 58 years old female is this a factor for not losing my weight ?
  5. Bre
    I have been eating keto for 6 days. 20 or less carbs per day. Around 1700 calories. I tested my urine today and it was 4. I was a bit alarmed as I’m reading this is also known as “starvation ketosis”. Should I be increasing my carbs? I’ve been feeling weak and dizzy.
  6. mira
    Scale has been seesawing up and down by a half pound for almost two weeks. (FYI: This is the same weight as I was when I stopped losing weight on every other diet I tried before Keto.) I have been doing intermittent fasting for a week or so. I am usually at a moderate ketone level, but as soon as I eat a meal or have a fat bomb, my ketone level drops down to small or sometimes trace ketones. Why?
  7. Doreen Edmundson
    Re: constipation, if you are drinking regular tea, that contains a lot of tannic acid, which is VERY constipating!
    Try switching to herbal teas. That should make a big difference!
  8. Drag CA
    My Ketone level is over 5. Mostly 8.
    Is that dangerous state, or I can proceed with my diet?

    I am not diabetic!

  9. 1 comment removed
  10. Rachel
    I can’t trust anyone’s advice about what my mitochondrion do or don’t do if they can’t even spell mitochondria. Bro. Really?
  11. Matt
    Your idea of measuring blood ketones as a tool is flawed. Many people are in optimal ketosis at .3-1. It’s not about how many ketones are in your blood as genetics, ketone uptake, fat adaptation etc can result in lower readings. For weight loss it’s about the lipolysis affect, so effectively .0 and 4 are the only readings you need to worry about.
  12. Samantha
    Hi there

    I hope someone can help me.
    I feel at a plateu and I don't Know what to do about it.

    In December 2017 I weighed 185 and started diet doctor January 15th 2 week challenge I lost 8lbs!

    I calculated my macros for my weight to be 108 fat 90 protein 20 carbs. I lost a total of 25lbs. I weighed 160lbs end of April.

    The month of May my weight really fluctuated up and down but I did not lose any more weight. I fluctuate between 160 and 162lbs. I reduced my macros and I'm wondering if this the problem. I got a ketone meter to read my levels and I am 1.3dl which is good but not optimal.

    What can I do?
    I'm not giving up and I'm very happy to lose 25lbs so far and many inches but I don't like this stall/ plateau.

    Please help me!!!

  13. Amy
    Hi i am doing the hcg diet. I did it before and lost 60 lbs in 3 12 months
    Now I am doing it again. In not allowed fats period but I use my oil. I'm only allowed 3 ozs.meat a 2twice a day and 1 leafy veggie 2wice a day and 2 apples or strawberries twice a day. I'm never hungry and my question is how do I get my ketosis to go higher. Is the 2 apples stalling me ?
  14. parast
    I am eating 900 cal with 20g carbs 49 gr protein and 76 gram fat! this carb is total carb or net carb?
  15. Noel
    My diabetes (2) is totally controlled. Dropped to normal first day. Lost 10kg over six months but very little since. Have no gallbladder, could this be a reason.
    Eat 5-10g carbs p/day. Coffee with cream 2-3 pday. Two eggs. Some cheese. Smallish meat or fish plus veg. Raspberries and cream. Sparkling water with lemon. Stevia sweetener.
    Am trying, digestive enzymes, pre/probiotic combo, magnesium, vit d, multi vit,fish oil
    Just bought a ketone monitor 0.1. (This a.m. Glucose 6.2)
    Any suggestions on how to lose more. Weigh 100 kg, height 5'8". Age 73. Aquaerobics twice weekly, a bit sendentary. Kathy (Noel)
  16. Nicole Moore
    Most likely it will increase your iron stores.
  17. Kelly
    I've been Keto for a month. I have kept my carb intake to 20g/day, don't eat too much protein, and haven't cheated. I'm tracking my Ketones via blood test and I'm ranging 1.7-0.6mmol/L, averaging 1.0mmol/L. Why aren't I achieving optimal levels? I only have one reading within the optimal zone. Please help!
  18. marianne
    Hi There ! I realllly need help ...

    I am not sure i am measuring well my blood ketone
    I saw on multiple site that in order to properly measure blood ketone you should :
    take your blood sugar and divide it by your blood ketone
    For instance my blood sugar is 4.7
    Blood ketone level is 0.4
    Then i am at 1.88 so in the range

    Am i right or the only level that matters is the only ketone level which is 0.4?

    Thanks a lot it is a bit confusing when you are a beginner

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