Not necessarily. It ultimately depends on you. SOme people may thrive by regularly counting calories, while others see counting calories as something “boring”. The key here, if you do not want to count calories, is to structure your plate in order to guarantee you are consuming enough fat. Just make sure that in every meal you are eating no more than a palm-full of protein, try to increase the amount of fat in your diet, and try to decrease the amount of carbohydrates.
Some people like to weigh their food when they first transition from a normal diet to a ketogenic diet, in order to have a fuller understanding of the amount of carbohydrates that they consume, although this can be used just in the beginning as a guide. But ultimately no, you do not have to weigh your food in order to be successful with a keto diet.
• Increasing muscle mass — Jeff Volek, Ph.D., is a registered dietitian specializing in how a high-fat, low-carb diet can affect health and athletic performance. He's written many scientific articles on this topic, as well as two books, and he explains that ketones have a similar structure to branched-chain amino acids that can be useful for building muscle mass. Ketones spare these amino acids, leaving higher levels of them around, which can help promote muscle mass.
•Sodium: Believe it or not, depending on your diet, you may be low on salt. When carb intake is low and insulin isn't being excreted, the kidneys absorb less sodium and potassium and excrete more as waste, leaving you feeling dizzy, fatigued and grumpy. Rather than reaching for more processed food, try seasoning your food a little more liberally with sea salt.

But what does the science say? Results are mixed. In one Spanish study of 20 obese adults, participants were put on a low-calorie keto diet and lost an average of 40 pounds over four months. Another small experiment had a similar outcome. In a six-month Experimental & Clinical Cardiology study of 83 obese adults, those on the keto diet lost an average of 33 pounds, while lowering their bad (LDL) cholesterol levels and increasing their good (HDL) cholesterol.
To be confident about being in ketosis, especially at the beginning when you're not quite sure how you should feel, it’s best to measure your ketone levels.  By monitoring your ketone levels, you can assure that you’re doing the diet correctly and make dietary adjustments based on what you measure. People also respond to diet and exercise differently, so the best way to cater the keto diet to your own biology is to measure.

During week 1 (and sometimes week 2) your body is transitioning to this whole new metabolic state, and there may be some initial side effects.  These are collectively known as the "keto flu".  The good thing is that if you don't take them for granted and think you're "superman" and that your body will be different, you can easily prevent these symptoms.

A related clinical diet for drug-resistant epilepsy is called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it’s more ketogenic than long-chain triglycerides. (13a) Another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the ketogenic diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.) (13b)
It usually takes three to four days for your body to go into ketosis because you have to use up your body's stores of glucose, i.e., sugar first, Keatley says. Any major diet change can give you some, uh, issues, and Keatley says he often sees patients who complain of IBS-like symptoms and feeling wiped out at the beginning of the diet. (The tiredness happens because you have less access to carbs, which give you quick energy, he explains.)
Your body is still growing — In one study, epileptic children experienced a reduction in symptoms and improved cognitive performance when a ketogenic diet was introduced.49 However, this may have a negative effect on the growth of their bodies in the long run, according to a study published in the journal Developmental Medicine & Child Neurology.50
In order to transition and remain in ketosis, aiming for about 30–50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to “eating keto,” you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.

Since then, it’s the same 10-15 pounds that I keep losing and gaining back. Love your mantras- I’ve written a few down in my journal and some just ring in my head like a music track- never two in a row!! Can’t outrun your fork!! The one about losing weight, looking good in the mirror, then world domination is my favorite. With keto, it gets me fantastic and very quick results and I go with a recarb meal (not recarb day) once a week. Eat a little more carbs after workouts. Now with the strips, I can see if what I’m doing post-workout keeps me in keto. I wish this article had come out a couple of months ago- I did hours of research before going keto, much of it bland, definitely no animal gifs. Thanks for all your resources- they are so eye-opening and so motivating (and funny)!! Great knowing that if I feel like I need the boost with 1-1 coaching it is available. Keep up the outstanding work!

The ketogenic, or "keto," diet — which first became popular in the 1920s as a treatment for epilepsy and diabetes— limits carbohydrates to no more than 50 grams a day, which is the rough equivalent of a plain bagel or a cup of white rice. By comparison, dietary guidelines from the US Department of Agriculture recommend from 225 to 325 grams of carbs a day.
A lot of changes are happening in your body and you’re going to feel it! The first five to seven days can be pretty rough, but your body is getting over its dependency on sugar. During this time of transition it is essential that you supplement electrolytes. Your body is flushing out lots of water, and with that goes electrolytes. The Keto Flu can be greatly reduced if you add sodium, potassium and magnesium to your diet. Check out our supplements page for a list of electrolyte supplements we recommend. Stay on course and you’ll start feeling better in no time!
Clinical improvement was observed in Alzheimer’s patients fed a ketogenic diet, and this was marked by improved mitochondrial function. (14a) In fact, a European Journal of Clinical Nutrition study pointed to emerging data that suggested the therapeutic use of ketogenic diets for multiple neurological disorders beyond epilepsy and Alzheimer’s, including headaches, neurotrauma, Parkinson’s disease, sleep disorders, brain cancer, autism and multiple sclerosis. (14b)
• Cancer: Early experimental research suggests that the keto diet may have anti-tumor effects, likely because it reduces overall calorie intake (and circulating glucose) for tumor growth. In one 2014 review of animal research, a ketogenic diet was found to be successful at reducing tumor growth, colon cancer, gastric cancer and brain cancer. More research on humans with larger sample sizes is needed, but it's definitely food for thought.
The removal of many grains and fruits with such a large emphasis on fats can bring about its own set of side effects. “If not done properly — with most of your carbohydrates coming from fiber-rich vegetables — you may not be getting enough fiber, which can lead to constipation,” says Chris Mohr, PhD, RD, a sports dietitian based in Louisville, Kentucky, and co-owner of MohrResults.com. (5)
Alcohol also tends to interrupt ketosis, since your liver will burn it preferentially before anything else. Your body treats alcohol like a toxin and like a fuel source, so your body will use it before it uses foods or the calories stored in your fat cells. While it won’t necessarily “knock you out” of ketosis, it does pause it until the alcohol is cleared from your system.
[i] Hussein M Dashti, MD PhD FICS FACS, Thazhumpal C Mathew, MSc PhD FRCPath, Talib Hussein, MB ChB, Sami K Asfar, MB ChB MD FRCSEd FACS, Abdulla Behbahani, MB ChB FRCS FACSI PhD FICS FACS, Mousa A Khoursheed, MB ChB FRCS FICS, Hilal M Al-Sayer, MD PhD FICS FACS, Yousef Y Bo-Abbas, MD FRCPC, and Naji S Al-Zaid, BSc PhD. "Long-term effects of a ketogenic diet in obese patients"
Your lean body mass is your total body weight minus your fat. For example, if you currently weigh 180 lbs (81.65 kg) and your body fat is at 30%, your lean body mass is 126 lbs (57.16 kg). In order to obtain the amount of protein you need to eat daily, you need to multiply 126 per 0.6 to 1.2, and you’ll get a range of 76 to 151 g protein/day. 75.6 g would be the minimum amount you need in order to maintain your bodily functions and muscle mass.
Unfortunately, there’s no long-term data on ketogenic diets versus other diets. In a 2015 Italian study, those on a ketosis diet lost 26 pounds in three months. About half of the participants stayed on the diet for a year but lost little additional weight in the next nine months. People in a 2014 Spanish study who followed a very-low-calorie ketogenic diet lost an average of 44 pounds in a year—but a third of them dropped out, possibly because it was too hard to maintain.
Other experts say the long-term accumulation of ketones could be harmful. “Those ketones are emergency fuel sources, and we’re not meant to run on them long-term,” says Kristen Kizer, a registered dietitian at Houston Methodist Hospital. “Ketones are negatively-charged molecules, which means they’re acidic. When you build up ketone bodies in your system, you’re building up acid. One of the ways your body buffers acid is by pulling calcium from your bones.” Kizer also notes that the diet isn't very balanced and involves a very high intake of animal products, which generally do not protect against cancer, diabetes, or other diseases.
The keto diet is currently being used as a safe and effective addition to the treatment of several types of cancer and can help slow tumor growth. As an example, we’d like to point to a promising study showed the intracerebral growth of the CT-2A & U87-MG tumors (related to malignant brain cancer) is significantly decreased by about 65% and 35% (27).
Thanks for the very informative article. This was the push I needed to at least try it. Starting next weekend, my partner and I will be trying keto for 30 days. I’m all for small changes, in theory, but what I sometimes discover is that sweeping changes can have their place, too, if they produce positive results. Often, what will work for me is trying a big change, and even if I then throw out 80% of it, at least the remaining 20% sticks. By contrast, any backsliding from a small change can often mean just throwing it out entirely.

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