Why can’t I lose weight in ketosis?

askdrandreaseenfeld

Why can’t I lose weight in ketosis? What is the right way to count carbs? And why are you gaining weight on a longer fast?

Get the answers in this week’s Q&A with Dr. Andreas Eenfeldt:

Why can’t I lose weight in ketosis?

I have been eating low carb for two weeks. I have lost 7 lbs (3 kg). I am getting extremely frustrated! I am keeping my carbs at 20 g or less. A basic day for me would be deviled eggs and bacon for breakfast, black coffee. Snack of some cheese, celery, 3 oz. (85 g) of baked chicken (using olive oil), the same for supper. My keto level is moderate. Take anti-inflammatories, anti-depressants, thyroid meds (underactive) and gabapentin at night.

Beth

 
Hi Beth!

You’re getting good results. 7 pounds (3 kg) in two weeks is very normal. Keep it up and you might lose all your excess weight eventually.

To speed weight loss up even more, stop snacking (but eat enough to feel satisfied after your meals).

Here are more tips that you may find useful:

Best,
Andreas Eenfeldt

What is the right way to count carbs?

Should we be counting total carbs, or net carbs (total carbs – fiber)? There seem to be a wide variety of opinions on this, and I see on this site to count net carbs which is what I have been doing, but I notice that your new recipe person Kristie (in her Facebook group) says “total carbs only” though her recipes here have net carbs in the nutrition information.

Dr. Westman in the New Atkins for a New You has net carbs, though on his own sites he says total carbs. It is all so very confusing. When I look at your image of 20 grams of carbs in two different ways (whole food vs. bun) that has to be 20 g of net carbs on that plate because it is closer to 35 or 40 g total carbs. Please clear this up!

Thank you,
Robin

 
I think counting net carbs makes more sense. Fiber carbs is not a problem for weight loss or diabetes reversal etc.

That said, aiming for below 20 grams of total carbs is even more strict, difficult and thus also even more effective. But you could get the same result by aiming for let’s say 14 grams of net carbs, which would focus you on the most important thing. Does that make sense?

Best,
Andreas Eenfeldt

 

72-hour fast and gaining weight?

I’ve been doing keto for almost three months. I log my food and believe I’m under 20 grams/carbs. Not losing and start a water fast and started to gain. I do have ketones but my glucose is still in the 80’s mg/dl (4.4 mmol/L). Ketones were approx 0.5. Now that I’m fasting they are 1.6.

Marsha

 
Intermittent fasting is great for speeding up weight loss. However, I generally don’t recommend longer fasts than 24 hours or so, unless you really know what you’re doing or have medical supervision. Often you can get almost equally good results with shorter fasts, repeated more often, with less side effects (like loss of lean mass), e.g. 16:8 on most days.

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

Videos with Dr. Eenfeldt

More with low-carb doctors

10 Comments

  1. Tbone
    You didn't gain the weight over night, it's not coming off that way either.
  2. Debbie
    I gained weight while taking gabapentin...a lot..it is one of the side effects.. I quit taking it altogether...it took a while to get it out of my system..but now I am losing weight again.. I do intermittent fasting, keep my carbs low..20 or less. Try to eat 1 time a day but never move than 2. Do better if I eat with in a 4hour window. At least 16 hours between meals. Good luck..
  3. Jackie
    Debbie, I am also on gabapenton and put on 30 lbs and have tried everything. Do I have to stop the medication to take the weight off? Thanks, Jackie
  4. 1 comment removed
  5. Earline Smith
    I'm on 800 mg of Neurontin daily. I've lost 95 lbs.
  6. Kimberly Pugh
    I'm on Risperidone and gained 50 pounds. Do I have to stop to lose weight?
  7. Jill Ridgley
    This is to Kimberly Pugh. Can I ask you what your medication is for. I am also on Gapabention and another medication for Parkinson's disease. Is that what you take it for. Thank you so very much.
  8. Terri Morgan
    I'm very disappointed in your answer about fasting for shorter periods of time and "loss of lean mass". You obviously haven't read anything by Dr. Fung. Why would the body use muscle for fuel when there's plenty of fat available?

    I just lost faith in this website and will no longer recommend it to my friends.

    Reply: #9
  9. Terri,
    I've read pretty much everything that Dr. Fung has written and I'm a huge fan. I agree that loss of lean mass is no issue with fasting up to 24 hours, especially not when you're adapted to burning fat. Even with fasting for a few days losses may be marginal and quickly recovered.

    With longer fasts (several days or even weeks) there will always be *some* loss though. We can argue about how significant of a concern it is, and benefits could be larger, at least in selected cases.

  10. Ember
    Hi, I haven’t seen this question yet but do apologize in advance if it’s a repeat. A little bit about me, I am 5’1” and 117lbs and have a relatively healthy diet of mostly vegetarian dishes so this is quite the change! I just recently (within a week) started the Keto diet, not to loose wait but to get better mental clarity and break horrible habits like drinking soda and adding a ton of sugar to my coffee in the morning along with a weekly pizza ritual. My main concern is the portion sizing. It feels like so much food and I feel full half way through each meal. Is this something my body will get used too or should I cut the portion size and stop when I’m no longer hungry? Thank you for taking the time to read this! I look forward to your reply.
    Thanks again,
    Reply: #11
  11. Peter Biörck Team Diet Doctor
    Hi Ember!

    Read weight-loss tips two and four.

    https://www.dietdoctor.com/how-to-lose-weight

    Hi, I haven’t seen this question yet but do apologize in advance if it’s a repeat. A little bit about me, I am 5’1” and 117lbs and have a relatively healthy diet of mostly vegetarian dishes so this is quite the change! I just recently (within a week) started the Keto diet, not to loose wait but to get better mental clarity and break horrible habits like drinking soda and adding a ton of sugar to my coffee in the morning along with a weekly pizza ritual. My main concern is the portion sizing. It feels like so much food and I feel full half way through each meal. Is this something my body will get used too or should I cut the portion size and stop when I’m no longer hungry? Thank you for taking the time to read this! I look forward to your reply.
    Thanks again,

Leave a reply

Reply to comment #0 by

Older posts