Why do some long-term ketoers still have excess body fat?

obesity
fat
weightloss
(Nick) #1

Hi folks,

I realise this is a sensitive subject. Please know I am not trying to be judgemental here - I am still overweight myself.

However, I’ve noticed that some people who have been eating a low-carb/ketogenic diet for a long time (say, 12+ months) seem to have stopped losing weight and hit a plateau where they still have significant amounts of body fat (e.g., 25% or more for men). This goes against my understanding of the diet and my expectation that they would continue losing weight until they’re comfortably under 20% body fat.

Now, perhaps I’ve just misjudged the situation and they are still burning off the fat, albeit slowly. But I can think of at least one well-known, long-term ketoer (I am not going to name names) who is still overweight and has been for years.

I’m really curious why people like this remain overweight. Some potential reasons spring to mind:

  • Their metabolism is still damaged.
  • They haven’t been performing resistance exercise, and their body has insufficient mitochondria to burn fat efficiently (I’ve seen Ted Naiman talk about this on his Twitter feed).
  • We’ve all got it wrong and the keto diet doesn’t work.
  • They’re sneaking cookies when nobody’s looking.
  • They consume so much dietary fat that there’s never any need to dip into the body’s fat stores.
  • Weight loss is not a priority for them – they’re eating a ketogenic diet for the other health benefits.

What do you think?

#2

I think it’s a combination of the first and last one you listed. Some people still have a high basal insulin level because it takes a loooong time to heal adipose IR. There are also gut hormones that affect appetite. Increased appetite will mean that your satiety point is higher and you’d have to resort to willpower and restriction to lose more weight short term. This can backfire just like my many yoyo diets before keto. And so learning to be grateful that you have fixed an unknown number of physical ailments makes you care less about a specific ideal goal weight.
I’ve also come to terms with not hating adipose tissue. Adipose tissue is a metabolic and hormonal organ of the body, just like my liver or pancreas. I do not hate my liver and pancreas, so why should I hate my fat? It does wonderful things for me when it’s healthy.

(Danielle) #3

I love this. Like SOOO much.

(Dustin Cade) #4

I started keto a few months after I turned 37, I’m now 38 and figure I’ll be where I want to be by the time I turn 40… No huge rush, though being human the timeline is hard to deal with sometimes…

#5

Depending on where they started, 12 months may not be really all that long of time for loosing all the weight and fixing all the potential problems.

Related to the second part of that, they may have more problems than just what keto can fix. A ketogenic diet is a very strong tool for fixing a lot of problems that affect health and bodyfat%, but it is not a magic fix-all. The diet could have improved their situation significantly to the point where they are now a lot better than they were before, but other things could keep them at a higher weight/body fat % point than considered typically optimal (or, for some, keep them at average, or wherever). So, diet could have caused high insulin before and caused a wreck. Chronic stress could cause high cortisol levels (which will cause high insulin levels as well) and could be what keeps them where they are now. There are ways for diet to help with cortisol levels too, but that’s not necessarily the best tool for addressing that particular problem.

That’s just an example, but you get the idea. Keto is a big help and fixes a lot, but that doesn’t mean it fixes everything.

That’s also just speculation. I somewhat wonder myself about this from time to time or why it doesn’t work for some people as well as others. The better answer may require a case by case look, and may not be clear.

(Adam Kirby) #6

Not only that but he’s gained tons of weight back which I can’t understand.

(Kenneth Coleman) #7

I find that the longer I am in the Keto lifestyle the less I car about my weight. It used to be a consuming worry. Now I’m even taking my shirt off in the sun (in private, lets not push it). Perhaps that’s it. After a while you are just healthy and no longer care about the weight, so you eat and enjoy the tasty treats. Although some public figure still has some fat to lose, and didn’t have that much to start with. It’s tough for people to look up to that public figure that hasn’t seemed to make much outward improvement. But I bet his life is exponentially better

#8

This might not be popular here but he eschews calories and always has. He’s proof that calories matter as are others who have gained or not lost while in ketosis.

#9

For as long as I’ve been interested in health and diet it’s been from an evolutionary perspective, and I think about this - questions along the lines of your question - all the time. I think your list makes sense (though I would expand the “sneaking cookies” portion to include the incredible psychological and physiological complexity of obesity and hunger signaling) but I would add genetics. Not genetics as in “I’m predestined to be fat because my mother is fat” but as in all of us having very different responses to food and to hormones based on our genes.

Among humans there’s a very wide variety of starch-breakdown enzymes and therefore very different glucose and insulin responses to eating carbs. When you think of the complexity of hunger signaling, hormonal responses to food, etc, I think you can assume that even just that one genetic variation means a totally different “ideal” diet for different people.

And some of us are REALLY good at storing fat - maybe not just because we’re metabolically deranged but because actually we won the genetic lottery - at least relative to the circumstances of most of our history, since that would have made us some of the only people to survive a famine and have children afterwards.

Those are just two small examples and I think there are infinitely more (some that we know about and probably many more that we don’t even have the tools to measure or understand at this point).

Keto seems to me an incredible tool. I love how it flips conventional wisdom on its head and I love watching how beautifully it cleans up so much of the mess created by SAD eating and standard dietary advice, and it clearly lines up with so much that we understand about human physiology - but personally I don’t think it’s the end-all and be-all WOE for every human all the time, because it doesn’t seem possible to me that there is any such thing.

(Adam Kirby) #10

Maybe. Something is definitely wrong with Jimmy’s situation that’s for sure. Unfortunately as one of the predominant spokesman for low carb his massive unexplained weight gain in the last few years gives ammo to the opponents of this lifestyle.

(Arlene) #11

Thank you for bringing up this subject. I am a faithful ketoer. I love this lifestyle and will never return to my former junk food junkie way of life. I love the way I feel and the freedom to enjoy healthy, nutritious food without some kind of diet guilt. All that said, I still have excess body fat to lose, just to get to a healthy weight, and upon seeing several long-term ketogenic proponents still living in obese bodies, I am both confused and concerned. I have been very successful thus far, and I’ve only been eating this way for 6 months, so I remain hopeful that my body will continue to respond favorably to this way of eating, but I can’t help but wonder “what is the reason that these obese people remain obese”? I understand we all have different body shapes, but a significant amount of excess fat just doesn’t seem healthy.

Perhaps the “Phinney weight” comes into play here, and the keto lifestyle will allow most of us the freedom to choose the body we are content to maintain, while eating the way we want to eat.

I suspect it’s more than that, and perhaps this journey is a never-ending learning experience. At the very least, eating this way appears to have the greatest potential for helping the majority of people achieve their best health.

(Nick) #12

Thanks for your reply. I hadn’t heard of the term “Phinney weight” before, but after a quick Google I found a definition on this forum!

I’m in a similar position to you: I’ve been steadily losing weight since switching to a low-carb diet four months ago, and I keep hoping that it continues for some time. Part of the reason I’ve been thinking about the kinds of people I mentioned in my original post is that I’m worried (only a little) that the same could still happen to me.

I suppose I was lucky that I hadn’t had any noticeable health problems as a result of my obesity, so appearance and the number on my bathroom scale has been more of a focus for me than somebody recovering from, say, type 2 diabetes.

(KetoCowboy) #13

I don’t know what to make of his situation (because metabolisms are unique, and his is uniquely “deranged”–to use the language of 2KetoDudes).

But I do know that the 2nd thing vegans seem to learn is to worship Dr. McDougall.

The FIRST thing they learn seems to be to point at Jimmy as proof that keto doesn’t work.

(Arlene) #14

Exactly! Almost daily, I have to remind myself to keep calm and keto on, as so many have said on this forum. I also have to remind myself to keep my focus on my own life. I have not walked in another’s shoes. I do not know their struggles, and it’s not my place to make any assumptions about their life decisions.

Like you, my motivation is to achieve a healthy weight, and I want to be as healthy as I can for as long as I am alive. I am convinced eating this way is the way humans are meant to eat, so I will continue to do so.

Keep calm and keto on! Best of luck to you in achieving the weight that is right for you.

(KetoCowboy) #15

Given that most of the keto crowd understands keto is a lifelong commitment (not a crash diet), I’m surprised this attitude isn’t more common. Props to you.

#16

This is not going to attempt to sound scientific but here is my observation based on myself mostly. Keto fixes a lot of issues 99%, but other issues it may only fix 50-60%. It moves all the indicators in the right direction but not necessarily at a rapid pace, especially as time goes on. I feel better and look better every day (been keto 6 months) but in terms of drastic improvements in physique there hasn’t been the same progress recently that I enjoyed early on.

Why is this, well two things come to mind. First, keto improves insulin resistance in the liver but the other half of the insulin resistance equation is getting your lean mass more insulin sensitive. Translation: exercise, especially HIIT from what I’ve read. Secondly, keto is an excellent way to lower insulin levels and increase sensitivity but it only scratches the surface compared to fasting. I’m trying to shift my mindset towards: keto is great but keto is just a way to set yourself up for successful long fasts (however long you think is needed for you of course). My interest in trying fasting is what lead me to keto, this may be the case for a lot of people but I’m not sure. The issue with fasting for me now isn’t hunger so much as the routine I have of eating delicious keto food everyday. Sure fasting might be the missing link but a buttery ribeye with some grilled veggies is more exciting than a glass of water.

You might find this link interesting also, the person you were presumably talking about did address this very topic:

http://livinlavidalowcarb.com/blog/why-do-so-many-low-carb-representatives-tend-to-be-on-the-heavier-side/9169

(Crow T. Robot) #17

Good topic, and one that I’ve been thinking about starting myself.

I think it’s pretty clear that most of those coming from severe obesity still struggle with high basal insulin levels, even if their glucose is under control, so I guess you could say this is a key factor. I would also say that “sneaking cookies” could be a problem and no one would know unless the person fessed up.

Personally, I think the biggest factor got left out: homeostasis. The body can be “hacked” for a period of time, but eventually figures out what you are up to and adjusts to keep from changing. Weight loss slows and sometimes stops. At that point, you’ve got to change things up. Now I don’t mean going high-carb – I don’t believe that a healthy approach – but I think this is where resistance training, ZC, and fasting can be effective.

To quote Dr. Fung, all diets work for awhile for weight loss and then become less effective. He recommends LCHF, but I believe he knows from experience that fasting is often necessary even for ketonians in order to continue losing at a certain point.

Actually, without knowing exactly what he’s eating, it doesn’t prove anything. You are assuming that he’s being very strict, and no one knows that. Seems to me that he loses weight just fine when he puts his mind to it and he’s happy to report that, but then there will be these times when he “goes dark” on that topic and the next time we see him, he’s back to his previous weight or more. I’m not judging, we all have our challenges, but it might be better if he were more forthcoming with his, because it just looks like keto isn’t working in his case.

(Siobhan) #18

A lot of reasons, but even if you do everything right if you have insulin resistance or other confounding factors it can take a long time to fix.

Me for example - I was 221 at 5’1" when I started. Thats over 100 lbs overweight. Now I am almost 11 months in and have lost 50+ lbs, about halfway there. I started keto at 20 years old so this is me catching it EARLY compared to people who start in their 30s, 40s, 50s or even 60s. Insulin resistance that advanced probably isnt going to reverse overnight, or even over a year.

Plus there has been month long stalls, the very common post introductory 1-2 month stall, and life happening too. I visited my boyfriend for a month, there were holidays, busy times at work, and times where I was still keto but not focusing on being perfect and focusing on living my life instead.

Because I know with keto Ill get there eventually, it becomes a lot less of a priority and I stop trying to maximise weight loss 24/7

Plus… keto is a learning process. So I had stalls and it could become a game of… okay do I need to fast here? Eat more to boost metabolism? Shake things up? Try an egg fast? Lower carbs? Lower protein? Just wait it out? Drop dairy? Drop artificial sweeteners? Something Im eating spiking insulin? Elimination diet?
That is probably true for a lot of people, and testing all those things takes a LOT of time.

So yes the keto way of eating works, but life is also a thing, you have the surity of progress or at least a healthy stall if you just want to coast a while and focus on something else, the slow progress of healing from insulin resistance and lowering basal insulin, lots of n=1, etc

I really am not interested in accusing people of sneaking cookies because they dont have perfect health or weight after a mere year. That is a very short time in terms of derangement of the metabolism. Plus they could be pretty healthy and decided weight isnt as big of a priority anymore… the list goes on.

It is extremely complicated and keto is not some quick weight loss diet, shed-the-weight-and-all-derangement-in-12-months type of thing. Its a process. Sometimes a slow one. Lots of learning and experimenting along the way.

#19

He has said that he gained significant amounts of weight in ketosis so it’s not a presumption.

(Solomom A) #20

Keto can only do so much. And it’s not as intense as water fasting. Prof. Noakes says he still takes metformin, one of the twoketodudeds does same and has a high fasting insulin. Some of us came to keto with our condition still redeemable, others came with some systems or organs beyond total restoration. And some may need several years despite all the deligence to heal. But the NSV are many for these guys. You tend to concentrate on health rather than weight with age.