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Damian Dyńka, Łukasz Rodzeń, Mateusz Rodzeń | Nutrients | (2025)
Primary Link Pubmed DOI Openalex Full text (OA)

Abstract

With the prevalence of obesity and overweight increasing at an alarming rate, more and more researchers are focused on identifying effective weight loss strategies. The ketogenic diet (KD), used as a treatment in epilepsy management for over 100 years, is additionally gaining popularity as a weight loss method. Although its efficacy in weight loss is well documented, the areas where it may be beneficial to other dietary approaches need to be carefully examined. The objective of this paper is to identify the potential benefits of the KD over alternative dietary weight loss strategies based on a comprehensive literature review. It has been shown that the KD may be more bioenergetically efficient than other dietary strategies, inter alia owing to its effect on curtailing hunger, improving satiety and decreasing appetite (influence on hunger and satiety hormones and the sensation of hunger), inducing faster initial weight loss (associated with lower glycogen levels and reduced water retention), and controlling glycaemia and insulinemia (directly attributable to the low-carbohydrate nature of KD and indirectly to the other areas described). These effects are accompanied by improved insulin sensitivity, reduced inflammation (through ketone bodies and avoidance of pro-inflammatory sugars), reduced need for pharmacological obesity control (the diet’s mechanisms are similar to those of medication but without the side effects), and positive impacts on psychological factors and food addiction. Based on the authors’ review of the latest research, it is reasonable to conclude that, due to these many additional health benefits, the KD may be advantageous to other diet-based weight loss strategies. This important hypothesis deserves further exploration, which could be achieved by including outcome measures other than weight loss in future clinical trials, especially when comparing different diets of equal caloric value.

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William Fan
10 months ago
William Fan's 2025 91 Day Weight Loss Challenge

Week 7: Losing water weight post surgery

  • Weight (7d avg): 188.8.2lbs/85.6kg, from peak -10.9lbs/-4.9kg

  • RHR (7d avg): 56.6bpm

  • Calories In (7d avg): 1014kcal

  • Exercise (7d avg): 267kcal

  • Net Deficit (total): -6300kcal

  • 3k run: 19:12 min

Notes:

This week started the day after my sleep apnea surgery. Because of the palate and tonsil reduction, eating solid foods was quite painful, especially after the first 2 or 3 days after the anaesthesia wore off. Eating was so painful, that I began to feel nauseous simply thinking about eating. In turn, this meant I could only take in a little over 1000 calories a day. My exercise also decreased, the small amount of cardio barely offsetting the general lack of movement from the days I stayed in bed. However, the did weight did fall off during this time period, dropping 3.7lbs (1.7kg) in a week.

But I knew this wasn't all fat I was dropping. More likely the reduction in food likely meant I was dropping water weight as I was both salt and carbohydrate depleted. The body stores carbohydrates as fuel in the form of glycogen and as stated in this article from the American Journal of Clinical Nutrition:

Glycogen is stored in the liver, muscles, and fat cells in hydrated form (three to four parts water)

That means while in a calorie deficit, especially when carbohydrates are limited, your body depletes its glycogen stores and the water it holds; one of the reasons ketogenic diets see such immediate weight loss within the first two weeks of dieting.

Ketogenic diet users can expect to lose up to 4.5 kg of body weight in the first 2 weeks or even sooner. For the most part, this is due to reduced water retention in the body, which in turn is mainly attributable to low carbohydrate supply, which is intrinsic to this particular diet....It is generally assumed that 1 g of glycogen is associated with at least 3 g of water (2.7 to 4 g). Assuming a 1:3 ratio, a loss of 500 g of glycogen will be accompanied by a loss of approximately 1500 g of water. Thus, the combined effect will be 2 kg of lost body weight. In addition, insulin is known to affect sodium retention in the kidneys, so a reduction in insulin concentration (as observed with the KD) will reduce sodium retention, which in turn leads to increased water excretion by the kidneys

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