A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed; 24% occasionally prescribed the diet as a last resort; 24% had only prescribed the diet in a few rare cases; and 16% had never prescribed the diet. There are several possible explanations for this gap between evidence and clinical practice.[33] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[30]
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.[18] 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.[3]
Now that you’ve read through the reviews and testimonials; you’ll realize that a few people actually report losing 10 pounds! Most people report losing weight in the 4-7 pound range. However, if they continue to lose weight on the 4 days off, they could feasibly reach the 10 pounds in a week goal. The short answer to the question “Can you really lose 10 pounds in a week?” is yes. But, as you probably guessed, there’s more.
The 2003 research indicated that exercise is a top weapon against visceral fat, backed up by a 2011 study which found that aerobic exercise is basically a magic bullet. Aerobic exercise is known to most people as cardio — activities such as running and cycling, as opposed to resistance training (where you lift heavy stuff around). While participants in the study worked fairly hard (jogging 20km per week at a high intensity), the researchers said lower-intensity but longer workouts should have similar benefits.
While some report that they look forward to doing the diet again — "I wasn't hungry... just lacking energy," one user wrote — others preferred to find a diet that kept them feeling more full. Mom of three @sweatherly816 also gave it a shot. "I wanted to see how much I could lose, and I wanted to get a jump start on a healthier me," she said. "I lost 7lbs 3oz in the three days, which I was pretty proud of." She found it difficult — "It is a hard challenge, you have to drink plenty of water to stay full" — but ultimately was pleased with her results.
As a self-described “nutrition nerd,” I couldn’t help but analyze the first three days of menus provided using my nutrient analysis software. You’ll see the daily totals at the bottom of each day, and while I can’t describe the intake as “good”, “ideal” or “healthy,” the data was slightly better than I expected. (Or perhaps, I really wasn’t sure what to expect from this very odd combination of foods!)
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.[18] 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.[3]
To get the most benefit from the Keto diet, you should stay physically active. You might need to take it easier during the early ketosis period, especially if you feel fatigued or lightheaded. Walking, running, doing aerobics, weightlifting, training with kettlebells or whatever workout you prefer will boost your energy further. You can find books and online resources on how to adapt Keto meals or snacks for athletic training.

Boredom is dangerous and so easily leads to weight gain. While free time gets perceived as relaxing, it actually makes me feel anxious, which can lead to bad eating habits. My busiest days are the ones when I tend to focus less on my food and more on what I need to get done. That's why I always try to fill my schedule with things that make me feel productive—so I don’t find myself rummaging through the pantry for a lack of something to do.
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