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For doctors“Why am I not losing weight on the keto diet?”
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
Intermittent fasting for beginners
More questions and answers
Many more questions and answers:
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).
Once a month I recalculate what my calories and macros should be. As I lose, my calorie allowance comes down. Makes sense, right?
https://www.dietdoctor.com/low-carb/calories
https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher
That is not a normal side effect of keto. Please consult with your physician.
Generally speaking, protein can be 20-25% and fats 70-75%. There is some leeway there.
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
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
Is it possible that the ketogenic diet just doesn't work for some people?
I'm feeling a little despondent at this point.
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.
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...
Have you read through the tips on this guide?
https://www.dietdoctor.com/how-to-lose-weight
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
Unfortunately yes. Going off plan can take a few weeks to recover from.
That protein level is very high. Most women only need 45-60g protein per day. If exercising at a high intensity level, you may need slightly more, but too much protein can be converted to glucose and affect ketosis and cause stalls. Excessive cardio can also potentially be a problem for some people as it can raise cortisol and even blood sugar as well.
Still nothing.
Then, read I needed to check glucose, so I did, and that is in range with my GKI around 4.0. Again, perfect.
Still no weight loss, and now I'm seeing gains. My pants are getting tighter.
I had my RMR checked. I should be consuming 1442 calories a day(min), and I have been around 1500. So I know I am not overeating calories. I work out 2-3 times a week, without fail.
Then, I read I may have electrolyte imbalances, so I began taking magnesium, b1 and potassium supplements and drinking electrolyte water. Still no loss at all.
The only loss I have is trying to understand why nothing is working!!! I love the way I feel, better than ever, so I'm planning to stick to the Keto way of life. I would really love some insight on what I might be missing. I feel like I have tried everything, but I'm not getting the amazing results that so many Keto followers realize.
HELP!!
In addition to the above information, here's a link to our top 18 weight loss tips. If you don't see anything there that you can work with, you may wish to speak with your doctor. There are underlying health and hormonal issues that may affect the ability to lose weight as well.
https://www.dietdoctor.com/how-to-lose-weight
I started at 195. And lost 1.5 lbs the first 3 days. then slowly lost 1/2 lb here, 1 lb there.
I have plateaued at 185-186 for about a week.
I changed my exercise routine to later in day - believing my body was stressed from all intense exercise and not used to it. I stopped exercising 3 days in row. THIS HELPED ME LOSE .8 LBS.
But then - I plateaued again.
I don't care too much about weight loss. But I would like to lose and get back to 145 lbs. I was 207+ at my highest and 5'9.
I find this science interesting. And I am perplexed.
My next step is to get a continuous glucose monitor - Libre Freestyle - patch.
It must be cortisol or we are insulin resistant or we have "re-set" our Basal metabolic rate to a caloric number that will prevent us from losing. (check out Biggest Loser info from Dr. Stephen Phinney, Dr. Peter Attia, or Dr. Jason Fung on YouTube)
basically, our caloric rate is so low (who knows what it is or how the new one is measured) that you can do long term damage by exercising too much and being in caloric deficit....your body will believe that is the new BMR.
I think it might be cortisol. My weight / fat is all in my gut = 90%.
stress?
Good luck!
I will let you know. We could also just be impatient. lol
If you are still fasting 20-24 hours, and doing that every day, you may want to eat more frequently. Dr Fung recommends not eating OMAD every day as it can result in stalls at weights higher than people want. He recommends no more than 3 24 hour fasts a week.
https://www.dietdoctor.com/fasting-every-single-day-counterproductive
Are you on any medication? Do you know if you have high insulin? For some people, if their insulin is high, it can take some time for the blood sugar to stabilize, which will allow the insulin to drop. Once the insulin drops, the weight loss will begin. For some people, that can happen quickly but for others the insulin can remain higher longer.