‘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 30-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?


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

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,


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.

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?


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.

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.


Hi Heather,

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

Andreas Eenfeldt


Keto for beginners

Intermittent fasting for beginners

How to lose weight

More questions and answers

Many more questions and answers:

Low-carb Q&A


Videos with Dr. Eenfeldt

More with low-carb doctors

Older posts