There are many reasons why you might want to lose weight. If you have been significantly overweight or obese for a long time, then you might have concerns about what the extra weight could be doing to your health. Obesity increases your risk of many health problems, including diabetes, non-alcoholic fatty liver disease, gallbladder disease, and some types of cancer.[1] If you have recently gained a bit of weight, then you might just want to lose some weight to fit back into your old jeans. Whatever your reason for wanting to lose weight, there are some important strategies that you should know about.


The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if little carbohydrate remains in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] Some evidence indicates that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] Potential side effects may include constipation, high cholesterol, growth slowing, acidosis, and kidney stones.[3]


Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]

The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients.[18] Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective.[9] Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug.[1] Some evidence indicates that adolescents and adults may also benefit from the diet.[9]


Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[19]

In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[55]

When your body burns its stores of fat, it can be hard on your kidneys. And starting a ketogenic diet -- or going back to a normal diet afterward -- can be tricky if you’re obese because of other health issues you’re likely to have, like diabetes, a heart condition, or high blood pressure. If you have any of these conditions, make diet changes slowly and only with the guidance of your doctor.
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[19] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[56]
Carbohydrates have been linked to this skin condition, so cutting down on them may help. And the drop in insulin that a ketogenic diet can trigger may also help stop acne breakouts. (Insulin can cause your body to make other hormones that bring on outbreaks.) Still, more research is needed to determine exactly how much effect, if any, the diet actually has on acne. 

“Tahini is an oft-forgotten option for nut and seed butters, but it sits front and center in my fridge because it delivers major creaminess to sauces and smoothies and packs a powerful flavor punch,” says Willow Jarosh MS, RD co-owner of C&J Nutrition. “Although some advise against eating the spread because of its high omega 3:6 ratio, the super high intake of omega-6s in the average American’s diet isn’t due to things like tahini—it’s mostly from not eating a variety of fats or consuming the majority of fats from fried foods and packaged snacks. As long as you’re also eating foods rich in omega-3s, your end-of-day ratio should be nothing to worry about. Plus, tahini is loaded with tons of healthy nutrients like copper, which helps maintain anti-inflammatory and antioxidant responses in the body. It also provides 6 percent of the day’s calcium in just one tablespoon.”


When your body burns its stores of fat, it can be hard on your kidneys. And starting a ketogenic diet -- or going back to a normal diet afterward -- can be tricky if you’re obese because of other health issues you’re likely to have, like diabetes, a heart condition, or high blood pressure. If you have any of these conditions, make diet changes slowly and only with the guidance of your doctor.
“Chia seeds aren’t just a pet, they’re a party in your mouth. I’m a huge fan of them because they’re chock-full of heart-healthy omega-3s, fiber, protein, and calcium. Chia seeds are easily absorbed by the body, so they’re very nourishing and satiating. Every day I add them to my breakfast smoothie or pair them with yogurt or cottage cheese along with some blueberries.” – Sarah Koszyk, MA, RD, founder of Family. Food. Fiesta.

1 Reference for 5%: Blackburn G. (1995). Effect of degree of weight loss on health benefits. Obesity Research 3: 211S-216S. Reference for 10%: NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available online: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf Cdc-pdf[PDF-1.25MB]External
The point at which unexplained weight loss becomes a medical concern is not exact. But many doctors agree that a medical evaluation is called for if you lose more than 5 percent of your weight in six months to a year, especially if you're an older adult. For example, a 5 percent weight loss in someone who is 160 pounds (72 kilograms) is 8 pounds (3.6 kilograms). In someone who is 200 pounds (90 kilograms), it's 10 pounds (4.5 kilograms).
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.

A University of Vermont study found that online weight-loss buddies help you keep the weight off. The researchers followed volunteers for 18 months. Those assigned to an Internet-based weight maintenance program sustained their weight loss better than those who met face-to-face in a support group. These are 50 easy ways to lose weight without a lick of exercise.
The ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the neurons to remain stable in the face of increased energy demand during a seizure, and may confer a neuroprotective effect.[56]

Some cultures and religions have restrictions concerning what foods are acceptable in their diet. For example, only Kosher foods are permitted by Judaism, and Halal foods by Islam. Although Buddhists are generally vegetarians, the practice varies and meat-eating may be permitted depending on the sects.[2] In Hinduism, vegetarianism is the ideal. Jains are strictly vegetarian and consumption of roots is not permitted.
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