The ketogenic diet (aka keto) is at the forefront of diet trends today. It continues to be applauded for its rapid weight loss results and improvements tocognitive + physical functions. With both supporters and critics, many informative arguments circulate the internet, making it difficult to decide whether keto really is all it’s cracked up to be. Leaving me to ask and answer the question…”What’s the dealio with keto?”

What is Keto?

Keto is more than just a diet; it’s a way of eating. This means you aren’t bouncing back and forth from one diet or eating style to the next. Instead, it means that once you go keto, you stay keto. This diet choice isn’t something you can start and stop as you please because keto can greatly affect and mess with your metabolism, confuse your body, and in turn cause you to gain more weight than you had initially lost. It calls for a permanent lifestyle change.

How Does Keto Work?

The foundation of keto is very, very low carb + high fat intake. It involves drastically reducing your carbohydrate intake and replacing it with fat so your body enters into a metabolic state called ketosis (i.e., the body begins producing ketone bodies out of fat and uses them for energy instead of carbs). To enter into ketosis, a person needs to eat fewer than 20–50 grams of carbs per day. That’s less than two apples!

The body allows for this process because ketones (i.e., fatty acids that are transferred to the liver, become oxidized, and are turned into ketones to provide energy for the body) are able to cross the blood-brain barrier and provide energy for the brain when there is an absence of glucose (a component of carbohydrates).

I do have to give caution: When beginning keto you may experience the keto flu. Yes, you read that right—the keto flu. Many keto-ers have described flu-like feelings that smack them at the start of the diet. This happens as the body switches from relying on and burning carbs for energy to relying on and burning fat for energy.

Is Keto a Fast Fix?

As a nutrition coach, I have been asked a lot of questions regarding keto. Not surprising to me is the number of people who want to know if it is a fast fix. I am going to be completely blunt: I hate this question. I wouldn’t classify keto as a fast fix, but research does support that it promotes significant weight loss, At least in the beginning. There is a high desire within society for diets and nutrition programs that provide quick fixes to body issues, but this isn’t keto. Keto is a lifestyle change that you must be 100% compliant with.

In the 2019 U.S. News & World Report Best Diets rankings, keto was ranked 38 out of 41 diets profiled. This is because although it may lead to short-term weight loss, it has also been said to be difficult to follow and lacking in nutrition. It also comes with potential health risks from cutting major food groups and eating more saturated fat.

What We Don’t Know About Keto

Here’s the catch. There have been very few studies performed on humans because ketosis is a difficult metabolic state to maintain. This makes many of the health claims of keto highly anecdotal. For example, benefits surrounding brain inflammation, improvement of outcomes after brain injury, and extending lifespan have only been found in studies on mice (https://www.nature.com/articles/s41467-017-00707-0#Sec2).

Another interesting find is that there has been carefully conducted testing on overweight men, and results revealed that going keto didn’t burn more body fat than a regular dietary regimen (https://academic.oup.com/ajcn/article/104/2/324/4564649).

Finally, and most importantly, I want to point out that there has been very limited research on the long-term effects on overall health and weight maintenance. Instead, studies conducted for more than one year have placed focus on the impact of keto in pediatric neurologic disorders and compared the benefits to potential risks.

What Happens After Keto?

The fact of the matter is that keeping to a keto diet long-term is very challenging and requires a serious amount of restriction and discipline. If you have honestly given keto three months time to work for you and your body—and stayed true to adhering to the diet during this period of time—but aren’t seeing or feeling the results you had hoped for, then it is probably time to try something else.

Just be aware, you definitely don’t want to return to old dietary habits! The rapid change from keto (high-fat/low-carb) to any eating habit that is not keto can create major metabolic malfunction leading to weight gain, insulin spikes and crashes, hormonal imbalances, binges, bowel troubles, body discomfort, and an upset digestive system.

If you are able to transition off of keto slowly and with a great deal of patience, you will be able to keep the weight off (for the most part), minimize GI problems, and maintain control of your mind+body when it comes to reintroducing carbohydrates back into your diet. Just like coming off any diet, my best advice is to allow your body the time it needs to acclimate and re-adjust to any new changes so your body doesn’t wreak internal havoc on itself.