Why can’t I lose weight in ketosis?
, medical content by Dr. Andreas Eenfeldt, MD
in Intermittent fasting, Keto, Low carb & high fat, Q&A, Weight loss 
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
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I just lost faith in this website and will no longer recommend it to my friends.
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.
Thanks again,
Read weight-loss tips two and four.
https://www.dietdoctor.com/how-to-lose-weight
I am beginning to think that the keto diet, as well as Atkins is a total sham.
We have documented all our weight-loss tips here:
https://www.dietdoctor.com/how-to-lose-weight
the headaches are getting me down. My B/P has average out to 126/84. I have not been dx with sleep disorder or sleep apnea. I would like to move to a steady 18/6 IF regime. Any advice? Thanks for listening.
I think that about does it. Oh, on average daily macronutrients: 115(fats)-15 (carbs, no net carb count)-73 (protein).
There are recipes example keto chicken burgers with tomato butter, we do not want that vegetable which is cabbage can we leave out the cabbage and use a salad instead. What would the carbs be for just the meat burgers .There are many recipes that we would rather just have a salad with and I don’t know how to count these particular recipes without all the vegetables that count as carbs we are not interested in . We do not like green or red peppers . Thank you so much for your help and this wonderful website 😍
Just be sure the salad dressing has no carb, or you can make your own.
I started the Keto diet on 01/22/19. It’s been almost 2 months and I’ve lost about 6 lbs. I included a 16:8 every day AND a 5:2 for a month now.
I’m 3 yrs out from an RNY and never reached my goal because i stalled for almost 2 yrs. i guess i was so happy for the scale to move in those 6 lbs but seeing how much everyone claims to lose on KETO and IF, it’s hard not to get disappointed at times. I’ve been in Ketosis the whole 2 months. I only eat when I’m hungry. My calories are between
800-1200. I’ve tried increasing calories to lose weight, it only made me gain. I work out 45mins/day, 4 days a week. I don’t have cheat meals or days. Any ideas what’s going on?
Any ideas?
In addition to this article, you can check out our weightloss tips here.
https://www.dietdoctor.com/how-to-lose-weight
Not through Diet Doctor but there are several free apps/websites available.
Weight loss can fluctuate and exercise can cause water retention. You can check out our top weight loss tips in this post.
https://www.dietdoctor.com/how-to-lose-weight
The losing inches but not pounds has to do with lessening inflammation. Also, keto helps build lean muscle mass so you can be increasing muscle even though the scale isn't showing weight loss. This link may be helpful for tips to achieve ketosis.
https://www.dietdoctor.com/lose-weight-by-achieving-optimal-ketosis
Here is a link to our guide on ketosis.
https://www.dietdoctor.com/low-carb/ketosis
Hi, Kay! You may not be doing anything wrong. Sometimes it just takes time and patience! Here's our troubleshooting guide that may be helpful for you. https://www.dietdoctor.com/how-to-lose-weight
You may not need to add extra fat if your meals fill you up and keep you full. Here's a good troubleshooting guide.
https://www.dietdoctor.com/how-to-lose-weight