By now you've probably heard about the benefits of the keto diet: weight loss, regulated blood sugar, and decreased inflammation. If weight loss is your number one goal, you're going to want to be diligent about exactly what you're eating on the low-carb, high-fat diet. To ensure that you're meeting your nutritional requirements, it's recommended that you track your carb, protein, and fat intake daily.
Dr. Steve Phinney, MD, PhD, chief medical officer at Virta Health, explained why some people experience weight gain on the keto diet. According to Dr. Phinney, achieving nutritional ketosis (bringing dietary carbs low enough so that the body burns mostly fat for energy), or the lack thereof, plays a critical role in whether you gain weight or lose weight.
"Unfortunately, due to inconsistent carb restriction or too much dietary protein, most people who are attempting a ketogenic diet are not actually in nutritional ketosis most of the time," Dr. Phinney told POPSUGAR. He added that, "nutritional ketosis is best achieved by eating protein in moderation, keeping total dietary carbs in the 30-50 grams per day range, and eating fat only to the point of satiety."
In order to sustain the metabolic benefits of the ketogenic diet, you must diligently abide by the carb, protein, and fat intake every day for months, Dr. Phinney explained. If you thought you could get away with following the lazy keto diet — fluctuating between carbohydrate restriction and moderate carbohydrates — you may not be satisfied with your results.
Dr. Phinney explained that a majority of people who are initially obese and achieve nutritional ketosis "are enabled to lose weight because their inborn satiety signals start working correctly without having to count calories or consciously restrict their food intake." He said the biochemistry of this is still being explored, but doctors know that it has to with unique anti-inflammatory benefits of ketosis on the liver, belly fat, and in the brain. However, if the necessary dietary changes aren't made, the body won't switch into ketosis and weight gain can occur. According to Dr. Phinney, finger-stick blood ketone tests are the most accurate way to find out if you're in and sustaining nutritional ketosis.
Dr. Phinney emphasized that that average person's weight fluctuates by four pounds day-to-day due to variations in hydration (water weight). "If someone in the first few months of nutritional ketosis is losing 1-2 pounds per week of body fat, variations in body water content may cause a weight plateau for 2-4 weeks, or even indicate weight gain for a week or two," said Dr. Phinney. While he does advise weighing yourself daily, he said the weekly average values are the most important.