Why Are You Doing Keto? Start With Your Goal (Day 34 Live, July 2017)
In this recording
A 53-minute Facebook Live from my kitchen, recorded on day 34 of my own keto start. I had planned a short one about goals. Then people joined live and asked questions, and it ran long. It was never posted to YouTube.
- [0:01] Step one: why are you here? Weight loss, blood sugar, epilepsy, tumours and simply wanting to feel better are different reasons, and each one changes the advice.
- [2:26] Some research looks at whether lowering blood glucose slows some tumours. I said clearly that I'm not telling anyone keto cures cancer.
- [4:45] My own reason: home testing showed impaired fasting glucose, and I didn't want it turning into type 2 diabetes.
- [6:28] Hunger. Keto is the first way of eating that stopped me pacing to the fridge. The first two weeks are brutal, though, and if you're getting through keto on willpower you're probably doing it wrong.
- [7:55] I said percentages are a terrible way to think about this diet. To be keto, you restrict carbs.
- [10:47] An anniversary lunch with my girlfriend: chips and a panini, and I was back in ketosis by dinner. A diet is what you eat over time, not one meal.
- [14:09] Arguing with your doctor? Look for studies comparing very low carb with low fat, not keto studies as such.
- [16:54] Exercise: do both, but if weight loss is the goal, put diet first. Walking matters for staying alive. A heart-rate monitor, or the talk test, tells you how hard to go.
- [19:04] If you have a history of bulimia, anorexia or orthorexia, don't use exercise to punish yourself for a cheat.
- [26:27] I've been hungry my whole life. Now I'm not, and that's my favourite thing about keto.
- [28:35] My blood sugar was trending down. I made a rough projection that I'd be back to normal by mid-August or early September.
- [32:22] 236 pounds at the start, 222 that day. And the name: my girlfriend had started calling me KetoDick.
- [35:17] How I found keto: intermittent fasting, then testing my glucose to see whether fasting was working. It climbed through the fast. Reading about impaired fasting glucose led me to low carb, and low carb led me to ketosis.
- [47:44] Nobody is in steady ketosis in week one. Fat adaptation takes weeks.
- [49:57] Think in weeks: 20 g a day is 140 g a week.
Watching this in 2026
This is me before I was a channel, talking to a forum. The core of it holds up: ask why someone is doing keto before you tell them what they're doing wrong. Most arguments in keto groups are people with different goals shouting past each other. Someone controlling seizures and someone trying to fit into a dress need different advice, and I'd still open with that.
What I'd change is how loosely I handled some health claims. I quoted a figure for how often impaired fasting glucose turns into diabetes, and how fast. I didn't source it on camera, and it isn't on the evidence pages I use now, so I'm leaving it out here. If your fasting glucose is high, your doctor can tell you what your own numbers mean. A home meter and a regression line can't.
The claim worth unpacking: "the studies favour low carb over low fat"
At [14:09] I told people that controlled studies comparing very low carb with low fat found more weight loss and better adherence on low carb, and that people kept it off longer. Here is what the trials actually show:
- Short term, low carb often wins. In Foster et al., 2003, 63 adults lost more on low carb at 3 and 6 months. The difference was no longer significant at 12 months, and retention was low in both groups.
- Two years, a small edge. In DIRECT (Shai et al., 2008), 322 adults lost on average 2.9 kg on low fat, 4.4 kg on Mediterranean and 4.7 kg on low carb.
- Pooled over a year or more, the gap is small. Across 13 trials of at least 12 months (Bueno et al., 2013), very-low-carb ketogenic diets lost 0.91 kg more than low fat (95% CI −1.65 to −0.17). They also had lower triglycerides and diastolic blood pressure, and higher HDL and LDL cholesterol.
- Healthy versions of both did about the same. In DIETFITS (Gardner et al., 2018), 609 adults lost 5.3 kg on healthy low fat and 6.0 kg on healthy low carb over 12 months. The difference wasn't significant, and that low-carb arm wasn't ketogenic.
The National Lipid Association (2019) sums it up: low carb isn't superior for long-term weight loss, may give more loss in the short term, and has a variable effect on LDL. So my 2017 line, "more weight loss and kept off longer", was stronger than the evidence. The part that holds is adherence. If keto stops you being hungry, you're more likely to keep doing it, and that's what I was really describing about myself.
For blood sugar, the ADA consensus report (Evert et al., 2019) says reducing total carbohydrate has the most evidence for improving glycaemia. That's a fair basis for the conversation I was encouraging people to have with their doctor.
Then vs now
- Carbs: here I said 20 g a day, counted across the week. A year later I was telling beginners under 50 g total a day (video UygKGoP_BtA).
- The anniversary meal: I told the same panini story in video 1vyxuWlxT5M. The point stayed the same: one meal is not your diet.
Who should talk to a doctor first
If you take medication for diabetes or blood pressure, cutting carbs can change the dose you need. Your doctor needs to know before you start. The same goes for kidney disease or pregnancy. If you have a history of an eating disorder, involve your doctor or therapist before restricting anything, which is what I was getting at about not punishing yourself with exercise.
Key points
- Your reason for doing keto decides which advice applies to you. Say it when you ask.
- I started keto for impaired fasting glucose, not weight, and the hunger relief is what kept me on it.
- Low carb tends to beat low fat early on, but over a year or more the difference is small (Bueno 2013, DIETFITS).
- A diet is what you eat over weeks, not one meal.
- If weight loss is the goal, put diet first, but keep walking for your health.
Related
- Guide: types of keto · fat adaptation · keto vs low fat · exercise · medications · who should talk to a doctor · eating disorders
- Blog: talking to your doctor about keto · the DIETFITS study · what happens if you cheat · weight loss is made in the kitchen · keto forums and confirmation bias
- Videos: beginner questions by a random guy · 28 days for high fasting blood sugar · spend your carbs on vegetables · do you need to exercise?