Keto Doesn’t Work For Me So What Do I Do Now?

You’ve tried keto and failed and it’s left you wondering “now what?” I decided to write about this topic because I see it come up pretty regularly in a number of online groups I follow. People try going low carb and then they claim keto doesn’t work, and now they’re switching to paleo. The problem I think is that there’s a lot of keto “information” online but some of it is complete nonsense in my opinion. Unfortunately, most people overlook the health benefits of a low-carb lifestyle and only pursue keto for weight loss. Weight loss isn’t linear and many quickly give up on their effort because they believe keto stopped working. Diet culture has taught us to expect failure and it doesn’t take long for someone to fully believe keto doesn’t seem to be working. If you believe keto failed and now you’re wondering what to do keep reading. Making keto work for you is about more than just food.

Scrolling through Pinterest for keto recipes I wonder if people will ever poop again because there’s so much cheese. So much cheese. If your version of keto consists of mug cakes made with a “keto sweetener” and bricks of cheese I hate to be the bearer of bad news but that diet isn’t going to work for anyone. You may believe that keto stopped working simply because you were focused on macros more than food quality. Bricks of cheese and mug cakes definitely won’t work if you’re following keto for weight loss. A well-formulated ketogenic diet is about more than just the macros. For decades we’ve been told that it’s all about calories and little attention has been paid to the quality of those calories. Keto has fallen to the same fate. People believe that as long as it fits the macros then “It’s all good.” That simply isn’t true and that’s why many are left believing keto failed.

Should You Jump Straight Into Keto For Weight Loss?

Some coaches will tell you yes but I’d tell you no. People experience a carb flu when they go from SAD (Standard American Diet) to paleo. Why increase the level of suck by going even lower carb if you don’t have to? I know people who claim that they tried keto for a day but they couldn’t make it. If you want to go keto you have to build the metabolic machinery first. You have to remind your body how to switch from carbs as a primary fuel source to remembering how to burn stored body fat for fuel. This is an instance where many people fail. It’s not a failure on your part, you simply don’t know what you don’t know. We can’t say keto stopped working before it was given a full chance to get going.

Keto Failed According To Your Urine Test Strips?

This is a question that will need some explaining. Sure your body can produce ketones after a night of sleeping without food but is your body using them? There are people who recommend ketone test strips for urine. People pee on the strip and see ketones and they get wildly excited that they’re in ketosis. Not so fast. If you’re peeing out ketones it’s more than likely that your body isn’t using them. It’s good to know that your body is in fact making ketones but urine test strips don’t tell you much about the body’s use of them. With consistent low carbohydrate eating, you should see ketones in urine decrease and/or disappear altogether.

When ketones disappear from urine test strips some people are led to believe that keto stopped working. They think that their no longer in ketosis and that keto simply doesn’t work for them. Honestly that’s most likely 100% false. Before you believe that keto failed get a reliable blood ketone measurement. If you want to know what your blood ketone levels are you have to test your blood.

Can You Pass The Fat Burning Test?

Before you align your macros with a ketogenic template make sure your body is using stored body fat for fuel. What are the signs and targets?

• Has your hunger signal switched from Hangry to a gentle reminder that maybe you should eat?
• Is your energy level consistent throughout the day?
• Can you effortlessly get by on 2 or 3 meals a day without snacks or feeling hungry in between meals?
• Have  you completely eliminated sugars and grains from your diet (including honey & maple syrup), eating less than 150 grams of carbohydrates per day or less?
• You have completely removed vegetable oils from your diet. (corn, soy, canola, cottonseed, sunflower, & safflower oil)
• You have been comfortably eating a variety of nutrient dense foods in a macro combination of high fat, moderate protein, and low carb intake.
• You are getting in regular aerobic workouts at a heart rate of 180-age and incorporating lots of general everyday movement.
• You are conducting brief high intensity workouts with full body functional movements a few times a week along with occasional sprints.
• You have excellent sleep habits.
• Are you managing stress well. (Increased daily movement, regular breaks during the day, disciplined use of technology, social time with friends, personal time for you, relaxing bedtime rituals, and consistent bed and wake times.)
• You handle frequent 12-14 hour overnight fasting periods that can extend to 16 hours (8 pm -> noon the next day) with stable energy and mood.
• You can skip lunch, or simply have a light snack and carry on productively until dinner without hunger pangs or loss of mental focus.
• You are free from strong sugar cravings, high-carbohydrate treats, afternoon sleepiness, post-meal sleepiness, or early evening burnout when you come home from work.
• You rarely notice your mood or concentration levels are affected by food.
• You rarely experience significant hunger, say 2x/week or less.

If you said no to most of these then I’d definitely say you’re not ready for keto. Adopting a new lifestyle change should be an enjoyable experience. Set yourself up for success by becoming fat adapted before you pursue a keto diet for weight loss or other health goals.

A Ketogenic Diet And Blood Sugar

If you’re taking medication to control blood sugar you must work with a physician who will work with you. A gal I helped noticed that her blood sugar levels kept dropping when she went paleo but her doctor told her to keep taking all of her meds. The result was that her kids had to call an ambulance because her blood sugar levels were too low and she passed out. She’s since changed doctors and cut her prescription meds from 8 to 4 but it’s imperative that you find a doctor who is supportive. Many doctors will tell you that you need to keep eating carbs because you’re taking blood sugar lowering meds and in the sense that you’d end up passed out on the floor, that’s true. However, that doesn’t reduce your medication dose and/or eliminate the medication all together.

If you’re going to do keto for a month or just for a special occasion then working with a doctor is going to be a lot of hassle for nothing. My advice is that if you’re going to do it, then plan on doing it indefinitely.

Where can you find a doctor who will work with you? The Paleo Physicians Network is a great place to search for a physician in your area who understands low carbohydrate eating. Most functional medicine docs are also on board with this eating style. The other alternative is to simply ask.

The Non-Obvious Reasons Why Keto Didn’t Work?

Your Exercise Routine

Your Sleep & Stress Levels

When the body is stressed it goes into fight or flight mode by activating the sympathetic nervous system. That in turn causes the body to release cortisol. Your body perceives a threat and it still thinks you are a hunter-gatherer who needs to outsmart a bear. Cortisol signals the body to release glucose from storage and make it available in the bloodstream so that you have the necessary energy to beat the bear. When glucose is abundantly available, whether, from internal or external sources, it’s going to make getting into ketosis a challenge. You can follow the cleanest version of keto for weight loss but if you don’t pay any attention to sleep, stress, and exercise it can lead you to believe keto stopped working. Your belief that keto failed can have little to do with your diet and more to do with cortisol.

How well do you sleep at night?

Did you know that your quality of sleep and overall health are tightly connected? Did you know that a good night’s sleep is just as important as exercise when it comes to body composition goals?

Study: A restricted-sleep schedule built to resemble an American work week made study participants feel less full after a fatty meal and altered their lipid metabolism. One night of recovery sleep helped, but didn’t completely erase the effects of sleep restriction.

Study: Partial sleep deprivation during only a single night induces insulin resistance in multiple metabolic pathways in healthy subjects. 

Study: Losing 30 minutes of sleep per day may promote weight gain and adversely affect blood sugar control

If you don’t sleep well and/or regularly skip sleep for other things you feel are more important you may want to reconsider. For new moms, I completely get it. No one tells you that you’re not going to sleep for the next 2 years all they say is “when are you having a baby?” Unfortunately there’s not much you can do other than to share the evening duties with someone else. I’m married to a paramedic and I will vouch that his sleep schedule is horrible. I’d like to overhaul emergency medicine; if it’s not an actual emergency let the EMS crew rest. He’ll get calls in the middle of the night simply because a physician is too impatient to wait until the morning. Just because they are available around the clock doesn’t mean they should face long term health consequences for it. Right?

If you’re in a profession like this share the science about sleep deprivation and health consequences.

You Ate Too Much Fat

People tend to determine the level of their dietary success based on how much they weigh. Unfortunately, that’s a poor indicator of overall health. This is why I don’t own a scale. Some people get carried away with eating fat when they’re following a ketogenic diet. While it’s true that initially eating more fat can help your body become fat-adapted there’s a breaking point. How is your body supposed to burn your body fat when you’re constantly eating massive amounts of fat? It’s not. It’s going to burn what you’re eating instead of what’s stored. If you’re following keto for weight loss and you believe keto stopped working the fix could really be as simple as adjusting your macros. Also, you want to make sure you’re eating fat, avoid all vegetable oil, because it hinders fat burning, and it can promote insulin resistance.

Is Keto Right For Everyone?

Do I think that people should obsess over their macros daily? No. That borders on another type of diet culture eating disorder. Your ultimate goal should be metabolic flexibility. That is, you should be able to burn whatever fuel source is available. Before you throw in the towel with the belief that keto failed, use what you now know and give it another effort. The science shows the keto diet has positive benefits for your immune system and a number of other bodily systems.

Dr. Nasha Winters says that everyone gets cancer, it’s just a matter of when. In her book The Metabolic Approach to Cancer she advocates that a ketogenic diet can delay the onset of cancer.

Ultimately I think becoming fat adapted is attainable and I think that we should use it as often as we can. Our hunter-gatherer ancestors had no idea what a calorie or a macro was so they didn’t obsess over either. I’m guessing that when they came across a berry patch in the summer they didn’t have any guilt about eating an entire bush of berries. The sugar they consumed help them put on fat for the winter which is when they’d need it the most.

When a person can easily incorporate intermittent fasting into their life and activate autophagy the science definitely supports the health benefits. (Autophagy is when your cells are allowed to clean house and repair themselves.) Then there are various approaches to carb cycling on a ketogenic diet. These of course depend on the person, their level of insulin sensitivity, activity levels, and goals.

Originally posted on September 26, 2019 @ 13:17

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