“Why am I not losing weight on the keto diet?”

askdrandreaseenfeld

Can I do the keto diet without having a gallbladder? Why am I so tired following the keto diet? And, why has my resting heart rate increased since starting keto?

Get the answers to these and other questions in this week’s Q&A with me:

Weight loss and why the keto diet is not working yet

I have been on the keto diet for 2½ weeks. I lost 6 pounds the first week and nothing since. I did the 14-day challenge and then used the meal planner for this week. I have not gone off plan and enjoying the food. Last week I tried skipping breakfast to see if that would do anything. I also can’t get any ketones to register not even a slight amount. I am obese, so lots of weight to lose. What am I doing wrong?

Dianne

 
Hi Dianne,

Losing 6 pounds is a decent start! It’s common that people lose quite a bit of weight in the first week, and after that it usually slows down to 1-2 pounds per week, sometimes less. This can still lead to massive weight loss in the long run.

Maybe you’re doing nothing wrong, and persistance is all you need. It can take time for people who are very insulin resistant to get into ketosis. However, it may also be that you eat more carbs than you know, and it can be helpful to share a day of foods with someone knowledgeable to see if there are some improvements to do. More intermittent fasting can also be helpful.

Here are all our best tips:
How to lose weight

Best,
Andreas Eenfeldt

Can I follow a keto diet without a gallbladder?

I have recently had my gallbladder removed. I have been advised to limit fat in my diet. Is there a supplement I can take to aid the digestion of fat on the keto way of eating.

Thank you,
Sally

 
Sally,

Anecdotally, many people do well even without a gall bladder, at least after having some time to adapt. Worst case it can result in diarrhea. Eating smaller servings of fat at the same time may be helpful.

Best,
Andreas Eenfeldt

Why am I so tired?


I have been eating low carb for six months. Weight loss stalled, and I began to measure veggies. I was eating too many, but since I lowered my veggie carbs to less than 20 grams, I have been so tired. Help, I have yet to feel the increased energy. Just recently started to get pink on my urine stick (2 days). I am taking salt and drinking lots of water. How long will it take?

Gwen

 
Hi Gwen!

It’s normal to feel tired at least for a few days or a week, as the body adapts to burning fat. Getting enough fluid and salt, for example a cup of bouillon daily or twice daily can help a lot.

Also, if you’re on medication for diabetes or high blood pressure, contact your doctor for testing. It may be that you need to reduce the doses.

If nothing helps and you keep feeling poorly, it can be beneficial to eat a bit more carbs (perhaps 50 grams per day) for a while, and let the body have more time to adapt.

If things don’t improve despite that, you may want to consult with a doctor to make sure it’s not something unrelated.

Best,
Andreas Eenfeldt

Resting heart rate increase

I am slightly alarmed as my resting heart rate has gone from 58 to 67 since starting keto four weeks ago. I have lost a few pounds which I wanted to. I’m a ‘fit’ 53-year-old woman. I do twice weekly weight training and play cardio games like tennis and badminton 4 times a week too. What has caused such a leap in my heart rate and what should I do? Is it a good or bad thing?! Very grateful for some advice as I cannot go to my doctor as I’m pretty sure they will know nothing of keto.

Thanks,
Heather

 
Hi Heather,

This is quite common and most likely not something to worry about. Learn more here.

Best,
Andreas Eenfeldt

More

Keto for beginners

Intermittent fasting for beginners

How to lose weight

More questions and answers

Many more questions and answers:

Low-carb Q&A

Read all earlier questions and answers – and ask your own! – here:

Ask Dr. Andreas Eenfeldt about LCHF, diabetes and weight loss – for members (free trial available).

Q&A

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26 comments

  1. Kathy Hickey
    I test positive with ketostix that turn purple which indicates moderate ketones, but I haven't lost a pound since I started 2 weeks ago
    Replies: #2, #10
  2. Jason
    Being in Ketosis isn’t enough if fat loss is your goal, You still need to be in a calorie deficit.
  3. Donna
    Help - my fast blood sugars are in the high 8's. I am type 2 diabetic with high insulin resistance. I want to do the OMAD way of eating and have done one week of 16/8. However my blood sugars are still high in the am fasting reading. Will OMAD help my issues and how long before I see results? I ahve been watching Dr Fung's videos on IF on youtube. Also would stevia in my tea cause me to fall out of a fast?
    Reply: #9
  4. 3 comments removed
  5. Betty Sovereign
    I started Keto at the end of July and have lost 33 pounds. My ketone sticks are only showing a trace, don't know why. I feel great and I intend to eat this way forever. One thing for those who stopped losing...
    Once a month I recalculate what my calories and macros should be. As I lose, my calorie allowance comes down. Makes sense, right?
    Reply: #8
  6. Kristin Parker Team Diet Doctor
    We don't recommend counting calories!
    https://www.dietdoctor.com/low-carb/calories
  7. Kristin Parker Team Diet Doctor
  8. Kristin Parker Team Diet Doctor
    Kathy, you can check out our top weight loss tips here - https://www.dietdoctor.com/how-to-lose-weight
  9. Marg
    I have been on the Keto diet for six weeks. I am 70 and started this diet with my husband who is classified as obese. Even though I didn’t need to lose weight I have shed 3 kgs and feel great. My inflammation has decreased in my joints and my mental accurity has increased. I feel great. My question is, although my blood pressure readings are around 110/70, my heart rate is an astounding 95-105. I can’t do intense exercise as it quickly climbs to over 170. What can I do to slow my heart rate. I don’t have any caffeine.
    Reply: #12
  10. Kristin Parker Team Diet Doctor

    I have been on the Keto diet for six weeks. I am 70 and started this diet with my husband who is classified as obese. Even though I didn’t need to lose weight I have shed 3 kgs and feel great. My inflammation has decreased in my joints and my mental accurity has increased. I feel great. My question is, although my blood pressure readings are around 110/70, my heart rate is an astounding 95-105. I can’t do intense exercise as it quickly climbs to over 170. What can I do to slow my heart rate. I don’t have any caffeine.

    That is not a normal side effect of keto. Please consult with your physician.

  11. Eugene
    hello everyone,i am eating low carb-under 20 g daily-and am keeping track of my carbs-fat -protein and total calories.i know i am under 20g of carbs also my fat is always higher than my protein but i have trouble getting the 70-25-5 ratio.i use net carbs from this website and fat and protein from calorie king.the numbers do not add up .is it really important to hit that number or as long as my carbs are low,fat is highest followed by protein.going to be ok? thanks
    Reply: #16
  12. Kate
    I’ve tried Keto 3 times and have lost some weight, but within the first 2 weeks I get a horrible headache that lasts for more than a week (the first time it lasted for 4 weeks). What am I doing to bring this on and what can I do to get rid of it????
    Reply: #18
  13. Tammy
    I am 60 years old and have been on keto for 5 weeks. My husband has been my active partner in this and has been keeping track of my macros on a daily basis. I have been within all three, 75 to 78 percent fat, 23 to 24 percent protein, carbs 3 to 4 percent. I didn't loose any weight my first three weeks, so I read about fasting and have been intermittent fasting, 16-8, to see if that would jump start any weight loss and after two weeks of being on the 16-8 daily, I still have not lost any weight. I do my ketostix every night before bed and I'm in the moderate range, so I know I'm in ketosis. This is becoming very frustrating. What am I doing that is not correct.
    Reply: #17
  14. Kristin Parker Team Diet Doctor

    hello everyone,i am eating low carb-under 20 g daily-and am keeping track of my carbs-fat -protein and total calories.i know i am under 20g of carbs also my fat is always higher than my protein but i have trouble getting the 70-25-5 ratio.i use net carbs from this website and fat and protein from calorie king.the numbers do not add up .is it really important to hit that number or as long as my carbs are low,fat is highest followed by protein.going to be ok? thanks

    Generally speaking, protein can be 20-25% and fats 70-75%. There is some leeway there.

  15. Kristin Parker Team Diet Doctor

    I am 60 years old and have been on keto for 5 weeks. My husband has been my active partner in this and has been keeping track of my macros on a daily basis. I have been within all three, 75 to 78 percent fat, 23 to 24 percent protein, carbs 3 to 4 percent. I didn't loose any weight my first three weeks, so I read about fasting and have been intermittent fasting, 16-8, to see if that would jump start any weight loss and after two weeks of being on the 16-8 daily, I still have not lost any weight. I do my ketostix every night before bed and I'm in the moderate range, so I know I'm in ketosis. This is becoming very frustrating. What am I doing that is not correct.

    I know how frustrating it is to be following the plan but not seeing success. You can check out our troubleshooting tips here to find something that may inadvertently be tripping you up - https://www.dietdoctor.com/how-to-lose-weight

  16. Kristin Parker Team Diet Doctor

    I’ve tried Keto 3 times and have lost some weight, but within the first 2 weeks I get a horrible headache that lasts for more than a week (the first time it lasted for 4 weeks). What am I doing to bring this on and what can I do to get rid of it????

    It sounds like it may be an electrolyte imbalance/keto flu. You can read more about that here, and how to help alleviate it.
    https://www.dietdoctor.com/low-carb/keto/flu-side-effects

  17. Rachel
    I've been using the keto meal planner for 2 1/2 weeks now, keeping around 20g carbs per day, have been in moderate ketosis since day two, but have not lost any weight. I have already read through all the tips on https://www.dietdoctor.com/how-to-lose-weight - no help from this. I feel quite tired all the time (yes I'm ensuring I am getting adequate magnesium,potassium and sodium), and find myself craving vegetables - my diet before this was mainly vegetables/salad and meat, with a little bit of fruit (usually apples), with some cheese (limited to hard cheese as I'm mildly lactose intolerant), and very limited grains due to having a wheat allergy (and gluten/wheat free products are expensive so I didn't often buy them) and my usual calorie intake was around 1500 calories per day (any more than this and I gain weight). I've been careful to plan my meals to keep roughly around this calorie intake (yes I know you reccommend not counting calories, BUT you and Dr. Eric Westman also say on this website that calorific intake DOES count), and I've had all my hormones tested prior to starting keto, and all are fine. I am at least 15kg overweight, so it's not like I don't have plenty to lose!
    Is it possible that the ketogenic diet just doesn't work for some people?
    Replies: #22, #23
  18. Rachel
    p.s.on the keto meal plan I haven't usually been feeling hungry. My husband has been doing keto with me, eating exactly the same meals, and has lost 5kg already.
  19. Rachel
    Oh, and my body meaurements also remain unchanged.

    I'm feeling a little despondent at this point.

  20. Vicky
    Hi Rachel...think of this as a lifestyle change not a diet. It took me 18 months to lose 10kg - Im 60. I was suffering from PTSD and until I got my stress/cortisol in check, by taking up e-mountain biking every day, the weight stuck.. I was following a low carb diet and mentioned the slow loss to my Endocronologist. He said to me 'think how bad you'd be if you weren't doing it'. He had a point. You feel better in yourself with this diet, even without much weight loss. Stick with it - for me it has been a marathon not a sprint. Have you examined what you are drinking??
    Reply: #24
  21. Kristin Parker Team Diet Doctor
    Rachel, I'm sorry you're not seeing the progress you had hoped for. It can be frustrating. Sometimes when we have other issues at play (stress, as mentioned, health issues, etc), it can take a little longer to see the changes we hope for.
  22. Rachel
    Thanks for the encouragement Vicky. My cortisol levels were fine at last check-up, though the kids have been a bit trying this last week or so (tired from starting back at school and kinder for the year), so perhaps worth checking my levels again, even though I don't feel particularly stressed.
    My water consumption hasn't been as good this week as last (approx 1.5L per day compared to 2-3L) as the weather/temperature has been erratic (easier to drink more on the hot days), but still adequate water really. I also drink 1-2 cups of coffee maximum daily, with a splash of coconut milk (the brand I use for coffee is very watered down so very low in carbs and calories anyway), and sometimes herbal tea (no milk). I rarely drunk alcohol in the past and haven't had any since well before starting keto. I don't have any other types of drinks - mainly as I don't want the kids having anything but water or milk! Lol
    I'm only 37, and have normal hormone levels for someone my age, even testosterone at the higher end of normal which should help with weight loss.... sadly nothing seems to work.
    I've never liked "diets", which is why keto appealed to me, being more of a lifestyle meal plan, but I feel like I'm getting less nutrients as I used to eat a much bigger variety of fresh produce.
    Reply: #29
  23. Lisagirl
    I love Keto but have read some troubling news from the European Society for Cardiology. A German study conducted over 10 years with more than 24000 participants showed low carb diets had a marked in crease in cardiovascular diseases, stroke and cancer. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Low-carb...
    This worries me, any response to this?
    Reply: #26
  24. Kristin Parker Team Diet Doctor

    I love Keto but have read some troubling news from the European Society for Cardiology. A German study conducted over 10 years with more than 24000 participants showed low carb diets had a marked in crease in cardiovascular diseases, stroke and cancer. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Low-carb...
    This worries me, any response to this?

    I can't locate that press release on their website anymore. Without knowing more about the study and methodology, it's not possible to comment further. We do have several articles on our website that address the topic in general.
    https://www.dietdoctor.com/all-over-media-low-carb-diets-could-shorte...
    https://www.dietdoctor.com/dr-malhotra-on-bbc-news-claim-that-low-car...

  25. Sandy
    I have started keto and followed the advise on tips regarding weight loss tips and has not helped. I began in May 2018 and my weight hasn’t changed since October 2018. I am 5’5” and 164. (My weight Went up 5 pounds and is not moving.) I have increased exercise over the last 2 weeks. I have implemented 16:8 intermittent fasting for about 2 months or more. I have stopped hypertension diuretics about 2 months ago as well as cholesterol meds. I don’t think this would result in weight gain anymore. My waist measurement has gone up 1”. I was eating 2 keto recipes a day which I am thinking in retrospect may be too many calories since I only need to lose about 10-15 lbs more. Help!!! I am going in the wrong direction!!
    Reply: #28
  26. Kristin Parker Team Diet Doctor

    I have started keto and followed the advise on tips regarding weight loss tips and has not helped. I began in May 2018 and my weight hasn’t changed since October 2018. I am 5’5” and 164. (My weight Went up 5 pounds and is not moving.) I have increased exercise over the last 2 weeks. I have implemented 16:8 intermittent fasting for about 2 months or more. I have stopped hypertension diuretics about 2 months ago as well as cholesterol meds. I don’t think this would result in weight gain anymore. My waist measurement has gone up 1”. I was eating 2 keto recipes a day which I am thinking in retrospect may be too many calories since I only need to lose about 10-15 lbs more. Help!!! I am going in the wrong direction!!

    Have you read through the tips on this guide?
    https://www.dietdoctor.com/how-to-lose-weight

  27. Vicky
    Hi again, Rachel, You are being too hard on yourself and have only been doing this for 2 ½ weeks – it’s a lifestyle change, not a quick, overnight fix!
    Forget about the 15kg – lower your expectations - just aim to lose 1kg – when you have done that – do it again – it will add up over time. Be patient – don’t give up – experiment - think where you could be in 6 months time or 1 year’s time or on your 40th birthday! There are great health benefits besides weight loss.
    I have never been in ketosis and am losing my weight (slowly) on 50-75g of carbs a day. A UK study I recently read, gave an AVERAGE weight loss on a low carb program over 1 year as 7kg (15lbs) – personally, I prefer a slow, sustainable approach.
    All the information you need is on this site. You just have to find the pieces of the jigsaw that are most relevant to YOU and build your own picture. Read Jason Fungs ‘The Obesity Code’. Watch Jason’s and Andreas’s videos. Try 16.8 Intermittent fasting – fancy words for skipping breakfast! Also no snacks. Lunch and dinner – thats it.
    I know you are only 37 but this is a useful post - http://www.dietdoctor.com/top-tips-lose-weight-low-carb-women-40
    Finally, keep going ! Tweak your diet until you get the right results. Forget the scales and buy a belt! THIS WORKS! x

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