‘Dangerous’ keto diet might be best for long-term weight loss

Abby Haglage
The ketogenic diet emphasizes fats over carbohydrates. (Photo: Getty Images)
The ketogenic diet emphasizes fats over carbohydrates. (Photo: Getty Images)

A growing interest in the ketogenic diet has garnered a considerable amount of criticism from the dietary world. The high-fat, low-carb diet works by forcing the body to burn fat — instead of carbohydrates — for fuel. It can, and does, lead to intense weight loss. But many nutritionists worry the transformation comes at too high of a cost.

On a recent list of 2018’s best diets released by U.S. News and World Report, the “keto diet” came in last (tied with the Dukan diet). Experts called it “dangerous,” brushing it off as something that “couldn’t be taken seriously.”

But this month, the Journal of the American Medical Association (JAMA) is pushing back, publishing a reported piece that shows how the diet — when followed carefully — can be a game changer for a variety of health conditions. It’s a fitting conclusion, given that alleviating health concerns is how the diet originated.

Introduced in the 1920s, the keto diet was initially presented as a treatment for epilepsy, a way to curb seizures in both adults and children. In 2017, however, the diet entered the pop culture lexicon, with celebrities like Kim Kardashian and Tim Tebow latching onto its weight-loss benefits and touting it in interviews.

In the wake of its newfound fame, experts began demonizing the diet as “too extreme,” a “dietician’s nightmare,” and a setup for failure. But this month, a new editorial in the JAMA is reframing the conversation once more, suggesting that the keto diet could be a game-changer in the journey to stem chronic illnesses caused by obesity, which affects one in three adults in America today.

The JAMA report details a meta-analysis of 13 different studies, which found that those who stick to the diet not only succeed in losing more weight than people on traditional low-fat diets but manage to keep the weight off longer. Experts told the journal that this efficacy rate is likely due to one of the hallmarks of the diet: a significant decrease in feelings of hunger.

David S. Ludwig, MD, a professor at Harvard Medical School, has studied the diet’s ability to keep weight off in the long term and likens that aspect to the ketogenic diet’s secret weapon. “If this apparent metabolic benefit persists, it could play an important role in improving the success of long-term weight-loss maintenance,” he told JAMA.

At the moment, Ludwig is in the midst of crafting a three-year trial on the phenomenon, in which he’ll bring overweight and obese adults to a center in Massachusetts to spend three months having their eating monitored as they follow the ketogenic diet and other similar diets.

But beyond simple weight loss, experts are interested in the diet’s potential to treat obesity-related conditions, such as type 2 diabetes, heart disease, and cancer — all of which are among the leading causes of preventable death in the United States. One such researcher is Steven Heymsfield, MD, a professor at Louisiana State University’s Pennington Biomedical Research Center who also heads up the Obesity Society.

Heymsfield touted the diet’s “heart-healthy” benefits, which could help reduce the need for pharmacological treatments. “It seems to help people not only lose weight but reduce their requirement for [diabetes] medications … which is an endpoint for diabetes management,” Heymsfield told the JAMA. “Those are all the good things that happen over the relatively short term — six months perhaps to a year.”

While the developments and the ongoing studies are an exciting indication of the ketogenic diet’s success, multiple JAMA experts stressed the importance of fully understanding the diet before taking it on. One of them, Rick Hecht, MD, is a research director at the University of California, San Francisco. “I don’t think everyone should be carbohydrate restricting to the level of a ketogenic diet just because they want to lose weight,” Hecht told JAMA. “We need to understand better the predictors of who’s going to benefit from this diet.”

So although the diet may not be a safe one to take on without understanding all of its tenets, it’s not something that people looking to lose weight should immediately dismiss. “People who need to lose weight and who don’t have [type 2 diabetes or epileptic seizures] may also benefit from a ketogenic diet, but responses are variable,” Heymsfield tells Yahoo Lifestyle. “The risks related to ketogenic diets in otherwise healthy adults who are overweight or obese are relatively low, so it might be worth trying this type of diet to see if it fits your lifestyle and leads to satisfying weight loss and maintenance.”

Ludwig, who also spoke to Yahoo Lifestyle about the general population trying out the keto diet, was similarly open — but cautious. “A ketogenic diet shows promise beyond seizure control, including for weight loss and control of type 2 diabetes. However, research in these areas is preliminary,” says Ludwig. “Anyone interested in pursuing a ketogenic diet, especially for diabetes control, should do so with expert oversight.”

So whether the keto diet lives on in celebrity interviews or not, at least in the medical world, it’s safe to say that, for now, the high-fat, low-carb regimen is here to stay.

Read more from Yahoo Lifestyle:

Follow us on Instagram, Facebook, and Twitter for nonstop inspiration delivered fresh to your feed, every day.