Keto Diet for Weight Management

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Duke weight management specialists provide medical supervision and lifestyle counseling to people with chronic conditions including obesity, diabetes, and heart disease, who want to lose weight using the keto diet. In addition to weight loss, published research shows that the very low-carbohydrate, low-sugar diet is an effective method for reducing hunger, increasing muscle mass, and reversing medical conditions to the point where medication, such as insulin, may no longer be needed.

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Understanding the Keto Diet and How It Works

The low carbohydrate ketogenic diet, or keto diet, includes mainly proteins and fats. It limits carbohydrates (carbs) to a small portion of your daily calories (roughly 5% to 10%).

How the Keto Diet Works
When you consume mainly protein and fat, the main fuel source for your body is fat (fatty acids and ketones). If even a small amount of carbs is consumed, your body burns these carbs before burning fat. When carbs are no longer the main part of your diet, your body starts burning fat for energy automatically. This fat-burning process is called nutritional ketosis and involves the production of an energy molecule called ketones. Studies show the increase in ketones appears to suppress your appetite so you feel less hungry and feel full sooner. As you eat less, you begin to lose weight.

Sample Foods You Can Eat
The foods you can eat on a keto diet are readily available in grocery stores and restaurants. Accepted foods include beef, chicken, pork, bacon, fish, eggs, salad greens, and fiber-rich vegetables. Oils and artificial sweeteners are also allowed.

Sample Foods to Avoid
Simple and complex carbohydrate foods are not allowed. They include all types of sugar (white, brown, honey, and molasses), milk-based products (including yogurt and cheese), fruit juice, fruit, grains (including white flour and whole grains), foods made with flour (bread, pasta, and crackers), and starchy vegetables, such as carrots, slow-cooked beans, corns, peas, and potatoes.

Our Locations

Keto Diet management is offered at two Duke Health locations in Durham.

Expected Weight Loss
People who follow the keto diet with medical guidance can expect to lose about one to two pounds per week. No exercise is required on this diet.

Health Benefits
Duke research shows the keto diet can help reverse diabetes and lower blood pressure. A stricter version of the diet has been used to successfully treat epilepsy, fatty liver disease, polycystic ovary disease (PCOS), heartburn, and irritable bowel syndrome.

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Initial and Follow-Up Visits

Initial Consultation
The initial consultation takes about 45 minutes. your doctor will perform a physical and take a comprehensive medical history. If you take insulin, your doctor will talk about tapering the dose as the diet will quickly lower blood sugar levels. Lab work will be performed to screen for medications and conditions that cause weight gain. The visit will end with a tailored plan and detailed instructions to help you get started on the keto diet.

Reducing Keto Adaption Symptoms
During your first visit, your doctor will also explain the possibility that you will feel headaches or fatigue during the first few days. This is sometimes referred to as “keto flu” or keto adaption. Your doctor will offer advice on how to avoid these problems as your body adapts to the new diet.

Home Monitoring Is Encouraged
If you are on medications for diabetes or hypertension, it is important to keep a close watch on your blood sugar levels and blood pressure. It is very likely that some or all medications will be reduced or eliminated as these conditions improve.

Follow-Up Visits
Follow-up visits take place about every one to two months. They provide an opportunity to discuss progress and roadblocks, ask questions about your energy levels, and ensure you are getting adequate nutrition. Your doctor will provide ongoing education to address constipation, muscle cramps, or hair loss if they occur. They will also recommend food substitutions if you are struggling to follow the diet. On average, it takes people about six to 12 months to learn to follow the diet successfully and get off their medications.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

This page was medically reviewed on 03/24/2022 by