Probably the most common misconception about keto is about its purpose. It’s quite understandable that most people would think that a keto diet is used just to lose weight, after all all other diets are seen as a temporary way to reach a certain goal and not a permanent lifestyle.

But what many do not understand is that you can be in deep ketosis and actually gain weight! How is that even possible? Well, the whole idea of CICO (Calorie In, Calorie Out) as outlined by the standard definition of calories of each macro nutrient, is flawed, because apart from the caloric intake, the effect of proteins, fats and carbohydrates on our metabolism is much deeper and involves powerful hormones like insulin.

But at the end of the day, when you eat too much you’ll still gain weight.

Let’s make some examples of very different kind of ketogenic diets and how they are used.

Losing weight is by far the most common desired result by most people on a keto diet, and it’s quite easy to achieve. The vast majority of people who needs to shed a few kilograms don’t even need to calculate their macros or weigh food, just removing carbs from their diet and eating real food is enough to bring them to a healthy weight, reduce visceral fat and improve their health.

Others aren’t that lucky, and need to take the extra step of eating a well balanced keto diet with the right proportion of macro nutrients. We are mostly talking about morbidly obese people or people whose metabolism is damaged by a long period of bad diet, insulin resistant or diabetic. In those cases, the best results are obtained with a stricter diet, mostly based on meat and a few vegetables, with a smaller amount of added fats.

Can you gain weight on a keto diet? Yes, you can. The question is, do you want to gain weight or muscle mass? The number of bodybuilders or simply persons who want to add some muscle mass without adding more fat is increasing, and a ketogenic diet can really beneficial for most athletes.

Bodybuilders used to “build mass” with a generous caloric surplus in off season, but that mass was often composed of a quite large amount of fat. On a keto diet, they can instead bulk up without adding excess fat, making much easier the preparation for a contest. Of course to achieve this results they still need to have a caloric surplus, obtained by increasing the amount of fat in the diet and keeping the proteins high.

A proper ketogenic diet is ideal for athletes because it spares muscle mass, reduce inflammation and offers constant levels of energy for many hours without the need for a refuel.

There are also some therapeutic uses of a ketogenic diet, but in this case the macros used are quite different to minimize insulin production as much as possible. To manage epilepsy for example a very strict keto diet with just enough protein to not lose too much muscle mass is used, while up to 95% of the caloric intake is made of fats. Many oncologists also use a strict keto diet for their patients, with excellent results for most solid tumors [1].

The effects of a ketogenic (or even low carb) on T2 diabetes patients are nothing short of spectacular. Just removing most carbs from the diet produce a very quick remission, in most cases just after a few weeks [2]. And even for a significant mumber of T1 diabetes patients it seems that the beneficial effect of a low carb diet could be effectively used to managed their blood glucose instead of injecting insulin [3].

The number of cases of MS is increasing worldwide, especially in the developed world where in the last 40 years people were mostly eating a low carb diet with high amounts of carbohydrates. Several studies now seems to link a ketogenic diet with significant improvement in the management of MS [4].



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