Hear me out. I’ve been keto since March with weight loss as my originating goal. Since then after reading lots of books/blogs/websites, watching YouTube videos and listening to hundreds if not thousands of hours of podcasts I now know keto is about metabolic healing first and weight loss is a positive side effect. Has it though gotten lost in the shuffle as a long term goal? Many people still talk about it a lot but it often feels too far down the list, getting lost in the trees of test result numbers. This is why it concerns me. I’m a registered nurse working in a hospital on a medicine ward. No one ever thinks or plans to be in the hospital for long periods of time but it does happen. I’m here to tell you that continuing to carry extra weight is detrimental for most people when they are in hospital. When you are weak from an illness or accident however great your other biomarkers are those extra pounds may be a problem. Getting out of bed, mobility, turning and positioning, skin integrity and elimination are just a few things that are impacted by extra weight leading to longer recovery times. I suppose this seems very specific and again most people don’t expect anything to ever happen necessitating a hospital stay. I guess I’m just saying that finding optimal body composition, while possibly not the primary goal should still figure in the keto journey.
Weight loss as a goal getting lost?
I think weight loss is still a primary goal but it is no longer fashionable to say so. In addition I think it can be comforting to focus on other health goals when weight loss is slow or stalled. This can keep one’s head in the game, enabling one to KCKO until all health biomarkers are reached including weight. I like to think in terms of size over weight, personally - since I’m doing a muscle building program, but agree that it’s very important.
It’s an interesting perspective to say that it’s not fashionable and I had sort of thought along that line as well, people are still concerned about it but just not talking about it. And of course when hitting a plateau or stalled most people will focus on what they are changing rather than what they aren’t.
This is a good reminder. Weight loss isn’t only about vanity. If weight gain is a symptom of metabolic disorder, and I think we agree it is for the most part, then treating the symptom is perfectly valid as long as it part of treating the whole. Don’t loose the trees for the forest!
I wonder in a way if we aren’t going too far the other way in being less concerned about weight in an attempt to minimize the obsession and maximize other health markers?
I so agree. Since when did losing weight become a thing we are not supposed to strive for??
People love to say “Your body is healing” and other stuff with no quantifiable data because it gives people the good feelz.
I’m in this for weight loss personally and I love the way I feel on keto, but sometimes data is good and the warm fuzzies are taken too far. imho, of course 
I totally agree. I am losing weight to lose belly fat and lower my triglycerides. So losing weight is making me healthier.
I dunno. I’m focused on the weight loss, job one. The health benefits are good, too. If I were stalled, I’d be pursuing ways of breaking the stall. If I were at maintenance, I’d be more concerned about my body healing and so on.
Everyone comes to this with different goals. It’s okay to shift your goals. So long as you’re evaluating your goals and understanding why you’re shifting.
I believe that this is the Jimmy Moore effect. Like Richard says (and I think that most will agree), achieving better metabolic health is of paramount importance. Unfortunately, I do agree with you in that I have seen a whole lot of excuse making for not having or achieving a “permanent” weight loss goal by saying that simple metabolic health is more important. If you start out with a goal to have $1 Million in your bank account, and then later say that it is now more important to have current recreation time, then that is one’s own decision. I see the majority of keto dieters find their “settling point” in the overweight range, and skinny-fat, and adopt this stance. In the end, everybody needs to rely on their own "Why? for motivation.
I came to keto with a real need to lose weight. It was enough that it was becoming debilitating. That wasn’t all I needed to do but it was something important that needed to happen. Lots of other things happened, for sure. But the weight did come off, and it continues to slowly move towards my non-so-far-off goal. I’ve never eaten so little sugar in my life and low carb is becoming my “norm”.
Eating good, no meds, getting decent exercise (actual work, not gym time) and feeling way more alive than I have in well over a decade. I’m not the “fat guy” anymore.
Actually, a hospital stay in 2015 planted the seeds that maybe all wasn’t quite so well with my health. It was a badly broken leg that required surgery with hardware, they weren’t looking to diagnose prediabetes but could have. I saw the numbers. No one really wanted to talk about it, and to be honest, I didn’t either. After all, I ate “healthy”. It took until 2017 and an additional 25 pound weight gain, major family upheaval, and a death in the family before I finally faced the music and figured out that if I didn’t do something different than I’d been doing, I wasn’t going to be around a whole lot longer.
So for me, weight loss was big. It wasn’t the only thing but it was big. Now that I’ve lost a bunch (like about half of a whole 'nother person), the perspective has changed a little, as it should.
Being healthy is of course paramount. But weight loss is a top three priority to me: forestalling and/or reversing neuropathy, losing weight and improved self image all go hand-in-hand to me.
That said, I had an extremely successful week of fasting and Keto last week and an absolutely horrible day of carb failure today. It’s not always a rosy path. So now begins another 48-hour challenge.
As a T2DM with HTN and in my 8th week of keto, getting better numbers for my BS and BP are primary, because it means I can reduce my medication for both diseases. Weight loss is important too, and I do track it and know I have further work to do in that regard, but right now, it is not my primary goal.
Weight loss was my primary goal for starting this last August. I was obese. I wanted to be overweight by Christmas and then my goal was to be normal by my anniversary in May. I stalled out 3-5 pounds shy of my goal and stayed there until yesterday (and today), where I was 168. Technically I’m normal (BMI that is…). Now, my goal is just to sustain the weight loss and build strength (although I want to see how low it will go).
The reason I wanted to lose weight though, was to not get T2 and to lower my blood pressure. The remainder of the benefits (basically feeling much better and having more energy) are jsut that, benefits, but not my motivation.
The fact that it’s about fat loss combined with functional healing - not weight loss per se for everybody - is also a fact that needs to be stated and re-stated. Two 6’ tall men who weigh 225 can have enormously different innards and body fat levels.
For the obese and morbidly obese, a well formulated ketogenic way of eating’s significant physical weight change is a reachable goal, and deserves to be plentifully reiterated.
For the not technically overweight (as in 50+ y.o. females sporting 30% body fat) and the non-overfat, who restore lean mass through a well formulated LCHF/ketogenic way of eating - the scale may not change at all - and it may even INCREASE to reflect more lean mass. This, also, is much deserving of community education and public health attention!!!
Regardless, sustainable fat loss is about sustainable metabolic healing and functional health, as far as I can tell. Stephen Phinney MD and Jeff Volek PhD Reg. Dietician emphasize these nuances in The Art & Science Of Low Carbohydrate Living. 
My goals changed as I learned more about the science behind keto.
I started out with my goal to lose 30 lbs, overweight but not terribly obese.
I knew my health would improve when the weight came off but I had no idea how much it would improve in other areas. At almost 60 years old that is very important to me. I don’t want to spend my retirement years broken down, on a bunch of meds or T2D.
The last time I had surgery the surgical nurse came out to the waiting room where I was sitting and waiting for my name to be called. She had my paperwork on a clipboard and pointed to the section for medications and said “I forgot to fill it out”. I smiled and said I don’t take any meds. Her eyebrows went up, she checked my birthdate and then grinned and said “good for you!” and off she went.
As for encouraging others whose weight loss has stalled… I am all for that if it keeps them motivated until the scale is kinder to them.
If becoming fat is a symptom of a diseased state, then fat loss is a result of becoming healthier. In my opinion this should be the foundation for fixing our population wide (or wide population) problem.
We’ve been telling people, especially female people, for decades that they should be as small as possible. It has not worked to improve health outcomes for them.
Weight loss per se, is pointless, fat loss is great, but if you’re getting lighter by spending all your time on a treadmill and not eating anything, there is no improvement.
Completely about weight/fat loss for me. It was getting harder to move. I didn’t like the way I looked or felt.
K
I think weight loss, while important, is a difficult goal. Say you set your goal to lose 50 pounds in a year. What happens if you don’t meet that goal?
Personally, it took me about 1.5 years to lose 30 pounds, and then another year or so to lose another 20, and that’s after starting intermittent fasting and fasting a handful of 4.5-5.5 day fasts and many 3 day fasts. And then I had shoulder surgery and gained weight and lost muscle (you have to sleep sitting up, you’re taking drugs, can’t exercise, can’t lift more than a coffee cup for many months…). I had a DEXA scan done because my weight gain was distressing. In one year (starting about 6 months after shoulder surgery), I gained about 4 pounds of muscle and lost 6 pounds of fat, so the scale went down 2 pounds. In a YEAR, and that’s keto+IF.
Because of that, I realize now that I have to go back to doing longer-term fasts (was only doing 36 hour fasts). This week, I’m fasting 4.5 days.
For me, and I think Jimmy Moore also, my metabolism is so messed up that it’s quite difficult to lose weight. Even eating basically meat and vegetables and fasting 36 hours twice a week and 22 hours once a week, doing HIIT, and Body by Science (intense weight lifting), my weight loss has slowed to point where it’s difficult to make a “goal”. If I had to make a goal, it might be something like “lose 5 pounds in 6 months” and that might not be reasonable, even though I’m just over “obese”.
Some of us are just hitting a wall where weight loss is still a goal but is so slow as to be not the main goal. Because it can’t be the main goal. I’m basically maxed out in the amount of exercise I can do, the amount of fasting I can do, the low carb diet I can. Even doing everything I can do (I can’t do any more), I’m losing weight at a minuscule pace. So, weight loss can’t be my main goal.
@ctviggen thanks for that perspective, I appreciate your feedback! I think most people want better health as a primary goal and maybe it’s just because we always used weight as the indicator for health now that we’ve got all these other tests to use it’s less important