Ketogenic Sleevers

Some folks asked me about this a while back, and I keep forgetting to write about it. So, this is my personal opinion and my personal experience. This isn't advice, necessarily, just an observation. I am mostly contemplating out loud. I also know quite a few of you also eat the same way with a sleeve.

I was wondering if anyone else followed a high-fat low-carb sleeve diet? I thought it might be interesting to start a discussion about it.

I'd be interested in following because I haven't decided exactly. I currently am 11 weeks post op and I'm in ketosis. So far that's mostly because carbs are pointless to my diet, and I need every calorie to get in my protein goals.

But, I'm also a Type I diabetic and interested in continuing to take the amount of insulin I take now (6 units or so per day). I've already talked to my NUT about not reintroducing carbs and she's on board and looking forward to seeing how it goes.

Right now I do not eat particularly high fat. I have my macros set at 20% carbs, 40% protein and 40% fat. I do eat full fat cheeses/dairy and I don't pick my meat cuts based on their leanness (chicken thighs, ribeye, etc).

I target 600-700 calories right now and I do find that adding any truly high fat foods (nuts, mayo, cream cheese, sour cream, etc) eats into my calories quickly.

I actually don't add extra fat, but I don't avoid it either. I probably am a bit lower in fat than the average person on a ketogenic diet, but I also have fat to lose and (some) imply it's easier to do eating less fat. I also think in the keto movement there's a tendency to overeat "treats" under the guise of eating more fat, sadly.

You can actually stay in ketosis during most weight loss, even on higher carb diets. I usually am in ketosis (according to blood tests) up to 65g of carbs or so, and I'd suggest some people who were less obese and insulin resistant than me would even stay in ketosis around 100 or thereabouts. It's highly individual, though.

I figured that most people doing "high fat" wouldn't seem actually high fat to the average keto diet "user". I have friends who add mayo to their mayo and 6lbs of cream cheese to their cheddar. I don't get how you lose weight doing that.

If you're fasting and skinny you actually benefit from adding fat, since if you are lower body fat you need the extra energy. Fat doesn't stop autophagy, whereas protein and leucine (found in dairy) can disrupt it. You also can lose a LOT of weight eating that way if you are obese, because ketosis naturally suppresses hunger (for that matter so do fat and protein). I probably lost my first 200 pounds eating around 2000 calories a day on average. Of course, I was 750 or so. These days I hover around 800-1000 depending and still lose.

Very high protein (150g or more) and very high fat would result in less weight loss likely, since the protein stimulates a stronger insulin response. Having said that, though, it would be very difficult to gain weight eating very low/no carbohydrate and very high fat, since there isn't really much to trigger energy storage.

Calories in/calories out doesn't reflect the fact that most obesity is hormonal at base primarily and not just about consuming excess food. It's a complex hormonal dysregulation. 300 calories of wheat will cause more insulin and fat storage than 300 calories of beef, for instance.

The benefit of low carb and sleeve or bypass surgery (or the DS for that matter) is it makes the surgery's metabolic changes 2x as efficient.

This is a fantastic explanation!

I plan on being ketogenic since that's the only way I've lost weight before the sleeve. I'm 6 days post-op so only on liquids for the next 2.5 weeks, but keto is the plan! So far my post-op diet has consisted only of nettle tea and bone broth with a scoop of protein powder.

I do low carb, high protein, so I'm not exactly ketogenic, per se. However, I do use lots of keto recipes, in order to introduce variety into my diet. There are some interesting recipes for pizza crust, bread, and lots of other items that fall into the ketogenic diet.

I eat low carb - sometimes high fat, sometimes not.

Gwen, how does athletic stuff go on a low carb diet? Do you find it's any different?