I’ve had patients lose 20, 30, or more pounds going keto. After that initial transition from burning sugar to fat (I talk more about potential challenges including the keto flu here), they have more energy, feel more mentally focused, and no longer get sidetracked by hunger and cravings that formerly stalled fat loss.
And then suddenly, without warning, they hit a plateau. The scales won’t budge. As a medical doctor who specializes in gut health, nutrition, and functional medicine, almost every patient I see eventually hits a wall. They’re doing everything “correctly,” and still, weight loss comes to a standstill. They feel stuck.
That’s when I shift into detective mode to find underlying obstacles that might hinder weight loss. Sometimes these roadblocks are obvious. Other times, they take some sleuthing.
I see these obstacles occur more often with ketogenic diets compared with other plans. And I became curious to find out why.
These patients initially have success on keto diets but hit a wall at some point and struggle to maintain that plan long term. The clue may be in the need for metabolic flexibility and variety to keep the body guessing.
In my practice, I commonly see these 10 reasons people don’t lose weight on ketogenic diets. When you pinpoint what might create obstacles, you become empowered to change course and minimize their impact. Here are the reasons and how I fix them.