Low Carb

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.


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 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.


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.

Low Carb Made Easy How to Lose Weight Low-Carb Recipes Low-Carb Success Stories


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. Pentro
    Couple of questions.. how do you keep a keto diet interesting so it's sustainable long term? And what's the best way to stay satisfied? Thanks
  2. Pentro
    Chris, that's an interesting approach with the carb refeed. Although I don't know if I could follow your diet every day... that would get boring fast.
  3. Chris
    First to apicius, you suppress hunger aka ur Lepten hormone with fat. After you have fully reached a steady state of ketosis you can do a refeed once a week of say 400g of carbs. This will ramp up your motabilizm again. Look it up its true.

    I keep my carb below 30g a day even below 20 if I can. Also I work out a lot and replenish my glycogen stores once a week loook up the term cyclical keto diet ckd.

    To pentro- a TRUE keto diet is boring it's meat and fats that's it. You can't even eat onions the first couple weeks cause they have suger. Unless you are looking for more of a just low carb diet, but then you won't be in full ketosis. And the fat you eat will be stored on ur body,

    Your midacondria will choose to burn either carbs or fat for energy. If you burn fat you will not store fat, if you burn carb then the fat you are also ingesting with not burn off it will be stored.

    That's why if you do not do this diet properly it can harm you. I eat 200 grams of fat a day if I ate carbs that amount of fat could be catastrophic to my heart and organs. My blood pressure and everything would rise.

    Look up recipes online for fats bombs to keep it interesting.

    Lastly remember to use unrefined virgin coconut oil. The reason is it is an MCT versus most fats that are LCT

    Medium-chain tryglyceride and long-chain.

    Medium chain is broken down instantly and sent to liver for ketones for fast energy. Does not get stored on body. Long chain triglycerides take a while to break down.

    This may sound weird but go to bodybuilding .com and look up ketogenic videos. There is an hour long video on there. Great video and they also have great recipes in keto articles.

    Good luck

  4. Pentro
    Cheers Chris I already visit bodybuilding.com daily. Great site.
  5. 3 comments removed
  6. For certain reasons...

    We encourage debate in the comments but also a polite language.

  7. Rainer
    Thanks for the great tips
  8. DrJenna
    Has anyone tried pruvit? Keto/OS is the drink and it puts you in a state of ketosis about 30 minutes after drinking it. Exogenous ketones......great tasting too.
  9. 1 comment removed
  10. Joy
    I am fairly new to LCHF and a previous sugar addict, but am learning about the diet plan and sticking to a keto strict diet. I also intermittenly fast between 12-15 hours a day. I am happy to say I don't crave sugar anymore! I've lost 17 lbs in the month I have been on it. I drink a lot of coffee and use 1 packet of Spenda Naturals, which is an erythitol/stevia blend, in a cup with 1/2 tbsp. heavy cream. Measuring ketones in urine, my level was moderate about 3 hours after my last meal. I read on another keto blog that if erythitol was the 1st ingrediant, which it is in Stevia Naturals, that it has 0 net carbs. Is this true? Can erythitol keep you from reaching optimum ketosis? What is the best time to test ketones, after eating or after a fast?
  11. endurance athlete
    Hi guys,

    After 30 days in keto (Diabetic Type 1) I have proteins in my urine (one mark) along with ketones (3 marks). However, blood glucose has never been better. My endocrinologist (highly respected) says I have too little insulin and that my muscles started to catabolize and I have to get off of this diet plan. Emphasis => blood glucose have never in 20y been this good, perfection
    Can you comment on this?

  12. Babs
    I'm on a no carbs diet, it's not easy, but have my Dr keeping an eye on me as she recommended it and I have the added complication of type 2 diabetes!
    May I ask someone who knows, can I have tea, no sugar, and a splash of skimmed milk? My only sin, apart from roughly 100 plum tomatoes 🍅 the other day!! It's ok I won't do it again 😭 I just want tea .... sob!!! PS this is a massively helpful website, thank you
  13. Gentiann
    Why skimmed milk???? It's a Low Carb HIGH Fat diet........
    Heavy cream is OK or it should be "a splash of FULL FAT milk"...
    Tomatoes contain naturally a small quantity of sugar, so one small one may not hurt but a lot is really bad.
    It seems that you are still afraid of fat......trying to do Low Carb and Low Fat is not sustainable, you'll be hungry all the time. Read what DietDoctor is saying about eating fat. Your doctor should have let you know about the importance of eating fat.
  14. Babs
    Hi Gentiann, thanks for replying! You may regret it!! I'm on a specific diet, through a company, recommended by my GP. All the food is provided, at a cost of course, and supplements are also provided! I have definitely struggled and I'm still learning! I'm not losing as fast as expected, and only just understood ketosis which is the ultimate aim! Apparently I came out of it after the tomatoe incident. I just miss tea, sounds daft, but I do, I have anxiety depression and it is one of my many crutches! I've not had sugar for over three wks and the other problem is ... I have type 2 diabetes. My daughters wedding is in July, so I'm running out of time .... One good thing, I've ordered a treadmill 😁👍🏼 Xx
  15. Gentiann
    I do not regret it.....!
    Did you read DietDoctor site at all?
    You do not need to waste money on a diet company, because the LCHF diet is quite easy to implement and does not have to be expensive.... It just requires some discipline for not buying the wrong food.
    If you have diabetes type 2 you can reverse it by following the Low Carb HIGH Fat diet strictly as many have done on this site.
    The problem with having meals delivered to you is that you are not learning how to be a long term low carb eater. Usually when people reach the desired weight and stop using this meal delivery service, they put back the weight......are you going to pay for such a service for the rest of your life?
    I hope you will try to read the diabetes section (and weight loss as well) on this site so you become well informed (it's free) and not dependant on a diet company.
    I wish you the best
  16. Gentiann
    One more thing... about the treadmill, exercise is probably going to make you just more hungry, not make you loose weight.
  17. jamie
    Have you heard of the insta-ketones? They are supposed to help kick you into fat loss / ketosis, even if you mess up and eat a little sugar or carbs. Wondering if there's anything to that...Thanks in advance!
  18. Michelle T
    I have been low carving since January. Then in February started counting because I wasn't seeing results. I keep it under 20 g carbs and fat is around 80g. I still wasn't loosing even though my k strips are ready very purple (4+). I gained two lbs and it stayed a full week. Then I said screw it and ate normally( not excessive) and included breads. Lost the two pounds the next day. What the hell?
  19. Josh
    Been low carbing since Jan 1. Lost 17 lbs so far. Combining low carb/ high fat with a 16 hour daily fast is the best thing I've done and the only thing that has ever worked. All my lchf food is consumed between noon and 8p. I go to bed at ten and actually sleep better too. My meals are typically salad for lunch with a tuna creations flavor of choice (they have a lot of flavors and are very reasonably priced). The salad is heavy on leafy greens and I do throw in half a dozen cherub tomatoes occasionally. I'll have an avocado for a snack around three or four o'clock and a good protein in the evening like a steak or tilapia. I always use fresh veggies on the side like buttery asparagus with fresh lemon juice and fresh steamed bean beans. Avoid canned vegetables! Buy frozen veggies if you have to. The cravings for carbs are mostly gone and people are noticing a difference in my appearance. I check my urine often and maintain moderate ketosis almost all of the time. Last night, I ordered a supreme pizza from pizza hut and ate only the toppings and about 8 wings and I was still in ketosis this morning and had lost two pounds. It doesn't have to be boring. If you love wings, this diet is perfect for you. Just do a reasonable amount of research on the place you're buying from. No fast food wings. Wing stop and buffalo wild wings are A-okay! They key is the 16 hours of fasting. This activates a mechanism in your body that burns fat to provide you the energy you need to find food. It's an ancient part of your makeup that goes back to when humans were mostly hunter gatherers. Hope this makes sense and helps you out! Good luck to you! - Josh
  20. Josh
    Oh! And i ONLY drink water with a lemon wedge. No magic flavored drinks, no protein shakes and no coffee. NO SODA. EVER. Not even diet soda. One last piece of advice, add some salt. It helps with satiety and relieves headaches you might get from hunger in the beginning. - Josh
  21. Ann in TX
    I have a question for anyone who is doing the LCHF eating plan. I started on Jan 30th, I lost 8 lbs in 10 days. After one cheat meal and another week of LCHF eating, I lost 4 lbs. The following weekend, things went crazy and I wasn't able to stick closely to my eating plan as I had been. I went off balance 2-12 days and gained the 2 lbs back. Got strict again on week 3, lost 4 lbs. The following week, lost 1 more lb. Total lost by end of February (4 weeks) was 15 lbs. First week in March and through today, I have not lost any further weight. My energy level is good, the inflammation in my joints is gone as well after cutting out sugars and carbs. I'm not yet to a good weight to exercise or do much walking (have lower back injury and a hip issue) but had hoped to get the other 16 lbs off this month. Here we are 10 days in, and not moving. I have two questions actually: 1) Any suggestions on getting the fat burning loss kicked in again? and 2) Through this whole process, I have had BM issues, completely different from before I started this eating plan. Where as I would go 2-3 per day before, it became once in 2 days and that was assisted by an oral laxative. Now, it's a problem because it's gone on to 3 days, and laxatives are not working. I drink mostly unsweet tea and water. Recently I discovered Diet Coke made with Splenda, which I've had a total of 2 in a week. (I cannot do other sweeteners because I'm allergic to Aspartame), and I have 1-1/2 cups coffee with Splenda and half n half in the mornings. I eat salads almost daily, so I am getting fiber. I eat a lot of fresh or frozen veggies such as squash, zucchini, asparagus, cauliflower, broccoli, avocado a couple times a week. Salad consists of iceberg lettuce, 3 cherry tomatoes and a few sliced cucumbers. A lot of chicken, either in fajita mean, or boneless skinless breasts, rotisserie shaved chicken breast, rib eye steak, pork chops. I try to eat 2 scrambled eggs with ham, or bacon, or sausage 4-5 mornings a week.
    What do I need to do to get my colon expelling waste on a daily basis again? Oh, and a third question....when counting my carbs per day, I have been doing total carbs (around 20 but sometimes a bit over), not net. How much difference in the weight loss process does it make if it's on net carbs as opposed to total? Should it always be total carbs? and I have been keeping my protein around 50ish per day, fat and sodium much higher. Calories around 1,000 per day.
    Reply: #325
  22. Josh

    Stop counting calories! You wouldn't have to even worry about counting carbs if you just monitor your foods and be conscious about what you eat. LCHF will mean more calories but they are calories your body will instantly burn off. Intermittent fasting will also fire up your ketosis. Please read my other two posts right above yours. It works. I promise! Just remember, no bread, pasta or dairy. Lots of water. When counting carbs, deduct the dietary fiber from the total carbs and you'll get the net carbs. Net carbs are what you want to count. You may not be getting enough carbs if going by total carbs. Good luck - Josh

  23. Gentiann
    magnesium tablets help with irregular BM but do not take too much or you may end up with diarrhea
  24. Toni
    Hi guys...love diet doctor and so many of my friends are giving it a go too.
    Question - i have been limiting my carbs to 15gm a day and mid morning my bloods were 1.8. Then I tested after dinner eating steak n 2 tbs sour cream and only got .4. ...i am only eating 100gm protein per day..i also do crossfit and lift heavy. (Just incase that makes a difference).
    When testing after eating is it normal for ketones to reduce? I will test again in the morning before my buttery scrambleded eggs.
  25. Kelly Valentine
    I have lost 16 pounds in the past 5 weeks on LCHF diet, plus intermittent fasting daily. I gave up grains completely and have noticed I suddenly have vivid dreams at night and also many skin rashes have disappeared. I am a 47 year old female and I was 65 pounds overweight, so I still have a long way to go. In the past 10 days, my weight loss has substantially slowed down. I just took a urine ketone test with results at 4.0, which is supposed to be high. I wonder if I should test for diabetes? Any thoughts on this? Also, I am eating avocodos, fish, nuts, bacon, tamari, lots of vegetables and different meats - moderate dairy and cheese. It took 9 days to lose 1.5 pounds. I feel this is a bit slow considering how overweight I am and that my diet has changed dramatically. I only went completely off wheat in the last two weeks. Prior to that, I ate 1 ezekial muffin a day and was achieving faster results. Any thoughts or suggestions?
  26. Sandra
    QUESTION: my boyfriend and I are on keto diet since the end of February. This is our 3rd. Week. But I'm so worry for my boyfriend because he is feeling pain in his liver area. The pain started during the second week. He says that he doesn't feel hungry and the pain starts everyday 2 hours after he takes breakfast. Is this part of the keto flu?
    Thanks on advance for your help.
  27. Angie
    Hello guys need reassurance please!!

    I started lchf a month ago and IF just 10 days back. I've been fasting for 17-18 hrs zero food and liquid intake (religious reasons)! I usually break my fast with 2 glasses of water with apple cider vinegar at 7pm then a keto/lchf dinner online recipe (usually some protein, low carb veggies in some heavy cream sauce r sour cream and cheese mix.. I don't over eat) around 8pm then by 10 or 11pm I take a bullet proof coffee adding a lil whip cream, heavy cream, vanilla extract, butter and coffee! By midnight or 1am I'm not really hungry but I need to eat before I sleep so I don't starve I usually do 3 boiled eggs, with a spoon of store bought mayo, a lil mustard and 2 small cucmber pickles. Sometimes I also munch on a few pepperonis and beef salami (Hebrew national brand) slices while I prepare the eggs!
    My Keto urine test is usually on the light to dark purple side. I also drink a few glasses of water to catch up! Can someone please advice if I'm on the right track to loosing weight? I'm definitely under 25grams of carbs! Should I cut down on fats to lose more I haven't really lost any weight maybe a half inch on my waist! I'm 4'11 and 135lbs that 150cm and around 62kgs. Want to loose 12-15 lbs! I use to log my daily intake to make sure I hit my macros always below the carb and fat and might be a lil over in protein some days! Am I on the right track or should I start extended fasts to switch things up? Thanks

  28. Fran
    i need help....

    My blood ketone levels are 0.9 in the morning and in the middle of the day 0.7. How long should it take to reach optimal ketosis? I tend to keep my carbs intake close to 0g a day.


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