“Will I have weight loss if I’m over 20 g carbs per day?”


How much insulin does it take to totally stop ketosis? Do I keep to the 20 g carbs per day? High or low levels of ketones in the blood when keto-adapted? And, how can a pizza that has over 1,000 calories be conducive to weight loss?

Get the answers in this week’s Q&A with me:

Insulin and ketosis


As a person with type 2 diabetes I have had success in losing some weight, reducing my Hba1c and ditching some of my insulin by following keto. Given that, as I understand it, insulin can “turn off” ketosis I assume that I have probably never been in ketosis as I still take 124 units slow per day.

What I would like to know is just how MUCH insulin does it take to totally stop ketosis? Presumably, healthy people following keto have a certain amount of insulin circulating in their bodies… but how much?


Hi Daren,

Interesting question. There are likely individual differences, e.g. it’s not just about the amount of insulin, it’s more about the effect of the insulin. So if you’re insulin resistant (T2D) you’d need more insulin to get the same effect as someone without insulin resistance.

With normal insulin resistance, about 0.25 units per pound of body weight might be considered normal for many people on a standard diet. To get into ketosis would then require significantly less than that, on average. But with insulin resistance, e.g. T2D, this number could be higher.

These numbers are highly individual. It’s impossible to give personalized advice about it. So everyone should consult with a healthcare professional.

Andreas Eenfeldt

I recently started the keto diet and would like to continue. Do I keep to the 20 g carbs per day?

As I select the various meals for the weekly planner, I realize that the carbs are not high. I remember watching a video from DD where you mentioned not surpassing 50 g. Is this correct? I want to continue experiencing weight loss, so what is recommended?


Hi Leah!

The effect on weight loss tends to be higher the lower you go with carbs. Below 20 net grams per day seems to be the most effective level, but below 50 can work fine too for many people, and it’s easier to do.

Andreas Eenfeldt

Ketone level for keto-adapted individuals

If a person is keto-adapted, wouldn’t you want to see fewer ketones in the blood? There seems to be to be so much emphasis on high ketone levels.


You’re right, the emphasis on high ketone levels may be exaggerated. It’s not a contest, and higher levels are not always better.

Andreas Eenfeldt

A serving of pizza has over 1,000 calories, how can that be conducive to weight loss?


I’m a 23-year-old female, (5’9 and 65ish kilos, not overweight but looking to lose fat/define muscle). I signed up for the 2-week challenge and was looking at the recipe for the pizza, which has 1,000+ calories for one serving – for 1 meal it seems like a lot. I watched the video about why counting calories aren’t the best method, and that it matters where your calories come from, and I understand, but this seems like a lot of calories for one meal, and are calories really that arbitrary?



Hi Lana!

It’s not required that you finish it. If you feel that you’d be satisfied with a smaller portion, feel free to make a smaller pizza or leave some leftovers. In the future we hope to have a feature where you can enter your size/weight etc. and get serving sizes more tailored for you.

The idea, however, is to get your weight-regulating hormones (like insulin) working so that you can lose excess weight without voluntarily having to restrict food amounts. It’s better if you’re able to eat what you feel you want, to feel satisfied, and still be able to lose excess weight.

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

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


Videos with Dr. Eenfeldt

More with low-carb doctors


  1. CharleneWepner
    The Keto Diet is The Atkins Diet. Dr Atkins was labeled a quack 30 years ago when he went against THE LOW FAT INDUSTRY & pushed LOW CARBS. The LOW FAT DIET is the reason the whole country is now so over weight!! DR ATKINS HAS BEEN VINDICATED!!! Hope he’s smiling up in heaven. 💕👍😀
  2. Michelle
    I agree 100%!
  3. Patty
    Good on you for pointing that out, Charlene Wepner. I don't know why they call it the Keto diet now when it really is Atkins...and he should get the credit for it.... even if it's posthumously. I personally don't diet... I just eat healthy most of the time and my weight is normal.
  4. RedCoat Gal
    Atkins and Keto are the same during induction.
    However, it's after 'induction' where there are differences.
    Atkins gradually adds carbs and tends to be higher in protein, whereas with Keto your fat remains high, proteins are moderate, and carbs remain (for many of us) under 20g.
    Atkins Phase 4/Maintenance averages 30-50g of carbs daily (minimum of 20g must come from leafy greens).
    I've been Keto since April 2nd per my dr's orders and have lost 50 lbs (so far), am off high blood pressure meds and insulin... The rest of my life I'll need to stay under 25g of carbs a day, but I'm ok with that.
    I personally notice a spike in my blood sugar and experience headaches if I go above 30g/day.
    So while Dr Atkins does need to be recognized as knowing what he's talking about, it's in the later phases where there are differences.
  5. Kelly Washburn
    I was having great results when I started Keto with your 14 day challenge. After a month I started to plateau with the loss but was still feeling great. 2 weeks ago I was in an accident suffered a broken ankle that required 2 screws. I'm concerned because I can't walk or exercise of gaining weight. I'm watching my intake but would really like some guidance on how to lose with limited mobility
    Replies: #6, #9
  6. Steve
    Do intermittent fasting in combination with keto diet.
  7. Anthony R Locke
    Atkins is high protein and low carbs. Keto diet is low protein and even lower carbs. Atkins is NOT the same as Keto. The diets have NOTHING in common.
    Reply: #17
  8. Anthony R Locke
  9. Kristin Parker Team Diet Doctor
    Kelly, with Keto, it's not about exercising to burn off what you ate; it's about keeping carbs low enough so that you begin burning fat for fuel instead of glucose. That and lowered blood sugar and insulin allow you to lose fat as you burn it. Best of luck with your recovery.
  10. 2 comments removed
  11. Hollie price
    Get on this way of eating as soon as you can. It’s legit and it works! Loving it, as I’m down 50 lbs in 137 days and so is my husband.
  12. Janice
    Dr John Yudkin pioneered low carb eating in the 1960s and 70s in his books This slimming business and Pure white and deadly . He didn't push high fat but recommended eating proper food e.g. butter, cheese etc and suggested keeping under 50 carbs a day, reducing the number of carbs if necessary . He pointed the insulin /obesity link and he was a Professor of Nutrition in London so no lightweight. His writing is witty and well-informed and I see the excellent Diet Doctor as his logical heir. Thank you for carrying on the good work!
  13. Robyn
    Hi everyone - I've been doing great on Keto for a few months and lost 12 kgs (26 pounds). My husband, who is seriously overweight has been doing some research and he has been looking at the 'blue zones' and people who live a long life (Seventh Day Adventist study), China Study. He is convinced that the science behind having high carbs, low fat, vegetarian is the way we should be eating. I have watched some of the documentaries "Forks over Knives" and read some of the literature. The high carb, low fat, vege way of eating is meant to be good for longevity and all round good health. They knock keto a lot and say things like "find me someone who lived a long life following a keto diet". So, I'm feeling really compromised at the moment, I have been trying to prepare legumes, beans, low fat, vege food for him and of course I'm eating it too - but I have put on 3 kgs in two weeks!! I am determined to get back onto Keto but I would really appreciate some advice or research which I can show my hubby - I have watched all the films and documentaries on Diet Doctor - these are good, but are there any longitudinal studies which I can refer him too? Thanks - sorry about the long message. Robyn
    Reply: #15
  14. carol
    I would like to see more liver recipes, dont seem to be able to ask questions anywhere
  15. Anni
    To say they have NOTHING in common is quite interesting considering both require your body to be in ketosis to lose fat.
  16. Jean
    For Robyn: Anecdotal evidence. My dear mother lived a very full and healthy life until she was 94. She faithfully followed the advice of an English Doctor, Dr. Richard Mackarness, who wrote a book entitled "Eat Fat and Grow Slim". She also understood the principles of LCHF as outlined by one "Banting" many years ago, in England. She maintained a healthy weight of around 50 kilos (on her small frame) until her death. This proves only one thing: that LCHF doesn't make you sick! Best wishes, Jean
  17. Kate
    Dear team - I am not sure where I should post this question, apologies in advance if this is the wrong place.
    I was diagnosed as having postmenopausal breast cancer Dec 18. Grade 2 HER negative, ER8 positive for oestrogen. Mastectomy followed Jan 19.
    I am seeing a dietitian via NHS who is advocating a Mediterranean diet particularly low in fat, high in fruit/vegetables, based around starchy carbs. Indeed they say particularly consuming less dietary fat may significantly improve my survival rate.
    I find this conflicting advice confusing and would be grateful for your thoughts, as well as any pointers to studies/evidence to the contrary please especially around breast cancer.

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