KETO Diet?

Just curious if any surgeons are incorporating a Keto diet as part of their protocol? Has anyone been prescribed a Keto diet post op?

My NUT was pretty clueless, so I made my own diet protocol based on OH and research. I eat "Keto-ish." High protein, low carb, and I don't pay attention to fat. :)

My NUT was also clueless. I asked her for some targets, like no more than this many carbs, get at least this much protein, etc and she looked at me with a dumbfounded expression. She told me that I shouldn't be eating more than 300 calories. I said, Thanks, have a nice day and came home and between here and my surgeon started a low carb, high protein diet. I was told by my surgeon to not worry about fats (except to go for more healthy versions when possible). When I make a Keto recipe, I usually dial down the fat.

I figure if it works for all you good people, then it should work for me and I'd make adjustments as needed.

300 calories? Wow. That seems low... even for us :P

It sounds like most programs prescribe "low carb, low fat, high protein" but not actual keto - this is the case for my surgeon as well. A lot of us (including me) are choosing to eat keto for the rapid weight loss. I was successful with keto multiple times before WLS, but always gained the weight back when I started getting diet fatigue. Nutritionists are definitely still discussing low fat with WLS patients, which is just silly.

The only place where I have seen such diets (low carb, high fat) prescribed is for non-WLS gastrectomies, where they are trying to keep the calories as high as possible to minimize weight loss while controlling dumping. In the WLS world, it's mostly something that people pick up on their own off the net.

My surgeon advocates balanced macro, but will support it if someone wants to do low carb or keto. Which is one reason I went to her instead of one of the big names in town. I physically cannot do ketosis so I can't do ultra low carb or keto, it makes me incredibly ill. I didn't want to have to be fighting against everyone at the center with what I have to do to stay healthy.

It's my understanding the large groups/big names in town preach low-carb but not necessarily keto.

This is in no way meant to be argumentative but I am very curious what you mean when you say "I physically cannot do ketosis..." and when you say low carb makes you incredibly ill. I have never heard anyone say this so I would like to try to understand how it makes you feel and maybe understand what could cause that. Purely a research type of query, I am not trying to sell anyone on a diet.

Sure. I probably didn't word it great, either. It's not that my body won't go into ketosis, it just makes me very ill when I do.

I get an extreme version of what people refer to as the "carb flu" but it doesn't go away. The longest I've been able to maintain ketosis has been almost 3 weeks, and I felt as bad on the last day as I did on the first. It is a debilitating fatigue, dizziness, brain fog, etc. During this time I also had multiple glucose readings under 50.

I'm not diabetic, and my hypoglycemia has never been reactive. But I historically have run some very low blood sugars and the only thing that would properly bring them up was a large carb load, after which I did not have a huge drop as would be expected in reactive hypoglycemia. I have suspected something like a hyper-insulin situation as is theorized in Syndrome X, but it hasn't developed (yet, at least) into Type 2 Diabetes as would be expected.

My blood sugars have become more normal and more stable as I've gotten into middle age, so I had given some thought to whether this extreme reaction to ketosis was still in play. But the liquid phase post-op for 2 weeks solidified it for me. I was in ketosis for most of it due to my intake being almost exclusively protein shakes, and was incredibly ill until I managed to get my carb intake up over 60g/day which was close to when I was able to start soft foods. So I shoot for 80-100g of carbs a day, which is still lower than the average diet, but nowhere near low enough to put me in ketosis.

Wow, that is VERY interesting. So it sounds like ketosis and hypoglycemia collide and your body tanks. Not suggesting you try this but I wonder if a blood sugar stabilizer like cinnamon in a large dose would help. Its a very curious problem, but its clear at points in your life you have had other blood sugar stabilization issues. I also wonder if you were getting enough fats during that time because that should have kept your blood sugar in the 70-80's (thats a guess basically I mean above dropping to such a low level as you experienced).

Its an interesting issue. This must have been a tough journey for you. Are you losing weight at a regular pace with 80-100g of carbs? I wonder with your low blood sugar issue if you eating 80-100g or carbs is like someone without your problem eating 10-30?

Thanks for the info, gives me something to think about.