Thinking about trying the keto diet to lose weight? Here’s what you need to know


This post is brought to you in partnership with Novant Health. All opinions are our own.

Forget the fat-free diet. One of the latest trending diets involves eating lots of high-fat foods and curbing carbs. Would you like to eat as much bacon, butter, eggs and lamb shanks as you want? Enter the ketogenic diet, or keto, for short. This low-carb regimen has a reputation for being effective for weight loss, but registered dietitians like Andrea Hiatt at Novant Health Weight Loss Services said it’s not a long-term, sustainable option for anyone looking to shed some pounds.

What is the keto diet?

The keto diet is a high-fat diet  built around meals that are 55% to 60% fat, around 30% to 35% protein and 5% to 10% carbohydrates from total daily calories. To give you a benchmark, for those on a 2,000-calorie-per-day limit, this would mean consuming around 110 grams of fat, 20 to 50 grams of carbohydrates and 75 grams protein. For example, here’s a typical daily routine on a keto diet: Eggs cooked with coconut oil for breakfast, salmon cooked with olive oil for lunch, and grass-feed beef cooked with avocado oil for dinner.

Hiatt, who works with those looking to lose weight, said that while this low-carb plan — some say it’s similar to the popular Atkins diet — can help people lose weight quickly, it’s also a very restrictive diet that can be hard to follow long-term.

How does it work?

The keto diet is built around severely curtailing consumption of carbs, which deprives the body of glucose, a main source of energy for all cells. The goal is to achieve a metabolic state in the body known as “ketosis.” When this happens, the body produces an alternative fuel called ketones, made from stored fat. As the body burns that fat, you start losing weight. The time it takes for individuals to reach ketosis varies by person, according to Hiatt, but in general, it takes around two to four days, sometimes even a week.

Originally, the keto diet was developed in the 1920s by doctors who wanted to treat epilepsy in children to help prevent seizures. This method is still used today and is considered an option for some children with uncontrolled epilepsy. There’s ongoing research on whether keto diets can also help patients with type 2 diabetes manage their symptoms. Some early studies have shown that the keto diet could be an effective alternative that helps patients rely less on drugs.

The keto diet has been shown to create metabolic changes in the body that are helpful for those who are overweight, such as rapid weight loss, reduction in insulin resistance and reducing blood triglyceride levels (a type of fat found in your blood).

Is it right for you?

Are you looking to lose weight and be healthier for the long run? Hiatt suggests that the best way to make a sustainable transformation is to make a lifestyle change, rather than a short-term change of diet.

“There are a lot of factors behind weight gain, which include not just what we eat, but how we think and how active we are, so I always advise my clients that you can lose weight short-term on a diet but it’s really a lifestyle change that’s going to help prevent you from regaining that weight back,” she said.

The hard part about keto

Like any eating regimen, consider the pitfalls before jumping on the keto diet bandwagon. As Hiatt pointed out, the diet is rigid and can be hard to follow-through on.

For example, drastically reducing carb-intake can be challenging and can lead to discomfort, irritability, loss of libido, nausea and even vomiting.

Hiatt also added that women who are pregnant, plan to become pregnant or plan on breastfeeding should avoid the diet. Those with gallbladder problems, kidney, liver or heart diseases should also definitely consult with their provider before starting the diet.

The bottom line?

Radically restricting the kinds of food you eat over the long run is difficult to sustain at best, Hiatt said. Moderation and plenty of exercise have a far better chance of helping you achieve your goal.

“A lot of folks come to me and say that they want to get started on a keto diet after reading stuff online, but I always recommend that you get educated by a professional to see if it’s right for you or try a more balanced diet first instead,” said Hiatt. “I joke that the first few days on the keto diet you turn into a gremlin because it’s such a drastic change for your body.”

If you’re looking to start on the path of sustainable weight loss, the advice is this: Do your research and don’t be afraid to consult a professional before delving into a plan that may not work for you. In addition, look at the big picture and set realistic goals that involve a lifestyle change, rather than a short-term diet alone.

Start the conversation and talk to a Novant Health primary care provider to take the first step towards your weight loss goals.


  1. Keto is a medical diet intended for highly specific use that somehow went mainstream. It is extreme and, as above, unsustainable. It is nearly impossible to execute as intended without medical supervision. This diet should not be attempted without input from a doctor.

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