Success is best depicted with a story: patient, 61 years and 294lbs, referred by cardiologist after failed LapBand surgery. We started phentermine and calorie-restricted, moderate-carb diet. He lost 16lbs but stalled for 18 months … despite phentermine, Contrave, Tenuate, Topamax, 5HTP-Carbidopa. Unexpectedly his ankylosing spondylitis flared and he almost went blind! "Start the ketogenic diet," I said. His vision cleared as the inflammation subsided. He lost another 76lbs in 9 months! “This is the first time in my life I'm not the biggest guy in the room,” he says. More importantly, his ankylosing spondylitis won't make him blind and crippled.