How many calories should I eat on a keto diet?

How to avoid weight loss on a keto diet? Should you stop keto if you’re feeling worse? And how many calories should you eat?

Get the answers to these questions in this week’s Q&A with me.

Please note that these answers do not constitute medical advice, and no doctor-patient relationship is established. These answers are for general information purposes, and you should discuss any changes with your healthcare provider.

How to avoid weight loss on a keto diet?

I have type 1 diabetes and would like to try the keto diet to stabilize my blood sugar level. I can’t afford to lose weight. Any advice?

Paula
 

We have a guide specifically on how to gain weight on a keto diet. You may find some of that information useful.

We also have a guide on using low-carb diets to help with blood sugar control with type 1 diabetes.

However, the main point we need to emphasize is that nobody should take this on alone. Anyone with type 1 diabetes mellitus should work closely with their healthcare team when making a nutritional change to address their blood sugars.

It takes meticulous monitoring and medication adjustments that people with T1DM should not do on their own. With the right guidance, it can be an incredibly effective tool for blood sugar control.

Best,
Dr. Bret Scher

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Should I stop the keto diet?

I have several health issues: chronic fatigue syndrome, food sensitivities, thyroid problems, gut dysbiosis, mitochondrial problems.

I’ve been following the ketogenic diet for four months and have struggled with food reactions, and now I have pain in my shins and arms. I’m experiencing depression and anxiety, which I’ve never had before.

I cannot sleep or relax, feel tired but wired, my brain fog is coming back, I don’t want to eat, and I feel like giving up. It seems like the keto diet doesn’t suit me.

Could you please advise me on what I’m doing wrong?

Sue
 

Hi Sue.

I’m so sorry to hear you aren’t feeling well. We definitely have to acknowledge that a keto diet may not be the best choice for everyone. If someone feels worse on a keto diet beyond the “keto flu” period, it may be time to abandon it and experiment with another diet.

Also, finding a clinician familiar with low carb may help as they could advise alterations or further workup that may need to be done. You can look at our map of low-carb doctors to see if you find some to work with.

Best,
Dr. Bret Scher

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How many calories should I eat on a keto diet?

I’m a plastic surgeon who’s been living a keto lifestyle with ups and downs for two years, and I’d be very grateful if you could share your thoughts on the following.

I’ve read that a keto diet has a macro distribution of 80% fat, 15% protein, and 5% carbs.

If we assume a protein intake of 1.5 grams per kilo bodyweight, this would mean that a person weighing 176 pounds (80 kilos) would need to eat 120 grams of protein, and that’s roughly 500 calories.

So if we assume an intake of 500 calories for one’s protein macro to reach 15%, the calories from fat would be roughly 2666 calories per day.

Looking at these numbers, would you agree that for weight loss, it might be necessary to reduce one’s protein intake to avoid a daily calorie intake well above 3000 calories per day?

Best regards,
Georg
 

Hi Georg.

You make a great point! Our main message for creating a low-carb diet at Diet Doctor is:

1. Reduce carbs to your desired level
2. Ensure adequate protein (1.2-1.7 grams per kilogram of reference body weight)
3. Add fat as needed for satiety and taste

Notice that we don’t mention percentages, macros, or calories.

Our recipes undergo a different evaluation process since we have to pick the amount of fat as a starting point for making the recipe. But our overall message is that there’s no need to count calories or “eat to your macros.”

Therefore, rather than decreasing protein to reduce calories, you may instead want to reduce fat if you’re feeling overly full or not losing weight.

I hope that change in perspective helps!

Best,
Dr. Bret Scher

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More questions and answers

Many more questions and answers:

Low-carb Q&A