Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions. Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.
In 2008 between US$33 billion and $55 billion was spent annually in the US on weight-loss products and services, including medical procedures and pharmaceuticals, with weight-loss centers taking between 6 and 12 percent of total annual expenditure. Over $1.6 billion a year was spent on weight-loss supplements. About 70 percent of Americans' dieting attempts are of a self-help nature.
This diet has introduced structure into my eating and has helped me better plan what I am having. Day 1 was rough due to the lack of caffeine even though we can have 2 cups of coffee that day but I didn’t feel hungry at all. In fact, throughout my 3 days I haven’t felt hungry at all. It was more of my craving for the fatty unhealthy food I was so use to eating before. I am on the last stretch of my 3rd day, still have my ice cream to eat. Before starting this diet I was extremely skeptical. I was worried that the amount of food or lack there of was going to leave me feeling hungry, weak and tired. I have tried other diets in the past and got results but not enough to keep my motivation. I’m not going to lie to you and say these past 3 days have been easy. It definitely took every ounce of will power and I’m looking forward to eating my 1500 calories tomorrow. I have been able to sleep better and I still have energy to take on my day as a full time working mom.
"When going out for fast food, I used to get the large-size value meal. Now, I satisfy a craving by ordering just one item: a small order of fries or a six-piece box of chicken nuggets. So far, I've shaved off 16 pounds in seven weeks, and I'm on track to being thinner than my high school self for my 10-year reunion later this year." —Miranda Jarrell, Birmingham, AL