Ketosis Done Right—Meet Anne

woman victorious on ketogenic diet

Today we have an inspiring real world "n=1" example of how a ketogenic diet can be successfully used by a real woman to easily and happily lose weight!

I thought it would be nice to give you all a much-deserved break from my own dietary misadventures and stop to appreciate the beauty of a well-done ketogenic diet. My recent experiment with Professor Seyfried's dietary recommendations for cancer was one of extreme ketosis for the explicit purpose of cancer treatment. However, most people who decide to try a ketogenic diet do so with the goal of losing weight, and they use a more moderate plan, such as the one recommended by Drs. Phinney and Volek in their book The Art and Science of Low Carbohydrate Living or the one recommended by Dr. Ron Rosedale in his book The Rosedale Diet. It is this kind of plan I intend to try myself soon, motivated in no small part by my friend Anne, who has successfully applied ketogenic dietary theory to her own life, and who has generously agreed to share her inspirational story here with us. But first, a bit of context.

On a beautiful autumn day last October, I was sitting on a beach in picturesque Rockport, Massachusetts with two friends, babbling incessantly about some of the talks I had heard at the 2012 Ancestral Health Symposium. In particular, I was waxing poetic about Dr. Rosedale's presentation about high fat/adequate protein/low carbohydrate diets being the key not only to weight loss but also to overall health, optimal function, and longevity.

When carbohydrates are restricted and protein is limited to daily requirements, the body has no choice but to burn fat for energy—this is what people who want to lose weight actually want to do—they want to burn fat. While I personally had lots of positive experience with very low carbohydrate diets, I had reached a weight loss wall, and had never tried to limit protein before. Dr. Rosedale's logic seemed airtight and I was very intrigued—maybe protein limitation would be the key to my own weight loss challenges.

So, there I was, droning on and on about the virtues of nutritional ketosis to my friends. But did I start a ketogenic diet myself? Nope . . . at least not right away. But Anne did. Anne is the kind of person who embodies clarity and decisiveness. If she's on board with something, she launches into it. If not, she dismisses it and moves on, without any angst or regret. She's also really good with data and technology, so she's included some terrific graphics.

So, ladies and gentlemen, without further ado, I give you: Real Woman Anne.

Anne's Story

I’m approaching almost five months on a ketogenic diet. But before I talk about keto, I’ll give you some background information about me. I’m female, 46 years old, and 5 ft tall. I was not an overweight kid, but my diet as a child was processed everything. I loved Velveeta, canned ravioli, marshmallow fluff, boxed macaroni and cheese, etc. You get the picture. When I hit my 30s, my metabolism changed and I began gaining weight. My love for processed foods and chips and dip were at an all-time high. For emotional reasons I would turn to these foods to feel better, however briefly. I have been dieting off and on for the last 6 or 7 years.

The only other specific diet I have tried is Weight Watchers (WW). I have had success with WW in that I do lose weight, but I struggle to stick with it. One of the reasons I loved WW was that I was able to eat anything I wanted—I just had to count it. So I didn't have to give up my favorite carbs, I just had to moderate. Well, moderation is not my strong suit. When low, feeling fat, whatever, I would go on a happy bender of a bag of chips with dip.

I have tracked my weight since December 2006 when I was at my heaviest (153.4 lbs). On WW the lowest weight I reached was 126.4 lbs back in October of 2010, but I quickly gained weight again. My weight has yo-yoed ever since, but never again coming close to the low 126.4 weight. That is until now. One afternoon in October 2012, Georgia mentioned Dr. Rosedale’s diet to me. Something struck a chord and I started the diet just a few days later. With winter fast approaching and me almost at my heaviest weight again, something had to be done. I weighed 149 lbs; my BMI was 29.1.

So I began my keto diet October 15, 2012. Interestingly Dr. Rosedale never mentions ketosis in his book, but his diet recommendations put you into ketosis. Georgia had also mentioned Jimmy Moore's Livin' La Vida Low Carb blog so I checked that out too and learned more about keto and ketone strips. Since I was ready to diet again, and I had to strike while the desire iron was hot, I started the diet without blood ketone strips in hand. So I do not have the before numbers or know when I first reached ketosis. I followed Rosedale’s first 3 weeks pretty closely, avoiding any starchy vegetables, rice, flour, sugar, fruit, and fake sugars.

I ordered my blood ketone strips and tester and began testing my ketones on November 6, 2012. At three weeks on keto, my ketones were at 5.4, blood glucose 73 (testing always occurred first thing in the morning before breakfast). That was the highest ketone measurement I ever had, and my ketones quickly came down to 2.8 in a couple of days. I ranged from a high of 5.4 to a low of 0.3 blood ketones while I was testing. I ran out of expensive ketone strips on January 4, 2013. Since things were going great—I was losing weight, I was satisfied and not hungry for many hours—I no longer cared about my ketones. Or at least not enough to keep spending the money.

ketogenic diet macronutrient ratio

I have written down my food, protein, fat, carbs, and calories each day and tracked my weight. Upon review I see the first 3 weeks I was really trying to not eat many saturated fats, a recommendation from Dr. Rosedale. I vaguely remember being tired for the first few days on keto but hung in there. My target protein has been 66 grams/day and I try to keep the carbs down to 50 grams or less/day. I have days when I do go over on one or the other, but for the most part I've been pretty steady. Over these 5 months, I have averaged 1,160 calories, 42 g of carbs, 82 g of fat, and 73 g of protein a day.

Anne's weight loss history

As of today March 11, 2013, I weigh 121.4 lbs, a loss of 27.6 lbs in less than 5 months. My BMI is 23.6. I’ve gone from a size 12 to a size 8; a few pairs of pants are a size 6. My initial goal is to reach 120 lbs. I’m just 1.4 lbs away, but I’m not going to stop there. I’m thinking once I reach the 120 goal, I’ll go for a goal of 115 lbs and see how I feel at that weight. I still have more fat on me than I’d like. I’ve never dieted without an intense desire to reach the end of the diet before. Nutritional ketosis is so different for me. I’m happy on this diet. I don’t have the cravings for any of those foods that have been my comfort and my downfall. My low level depression is gone. I have energy. I’m not hungry. I don’t covet the foods other people are eating. I find this diet just amazing. I never thought any of this would be possible. My impatience is only around my intense curiosity of what this old body could look like again.

Anne's weight loss graph

As for exercise, I have been much more active in the past. With a current hip problem, my activity level has slowed to a crawl. I do a little biking (10-15 min/day and a little Pilates (5-10 min/day). Two years ago when I reached 126 pounds, I was playing tennis 3-4 times a week, biking, and hiking.I have found that I can have ½ of an apple, berries with heavy cream or sugar free chocolate as my treats in the evening with no ill effects. It hasn't made me crave more sweets or carbs. Life is good. Of course, what I don’t know is the sustainability of this weight loss. What will maintenance look like once I've reached my weight goal? How many more carbs and protein can I have without triggering the old cravings or gaining weight? I’m going for blood tests tomorrow to make sure my cholesterol isn't sky high. I eat a lot of saturated fats now and hope I’m not hurting myself. Stay tuned, I’ll keep Georgia apprised.

UPDATE: March 2013

Anne tells me she has continued to lose weight, and is now at 118 lbs, which is 8 pounds lighter than she was able to achieve with Weight Watchers plus exercise two years ago. She has surpassed her original goal of 120 lbs and has set her sights on 115.

She had labs drawn in March of 2011 (while eating a standard diet, not during her Weight Watchers diet) and again in March of 2013, while on a ketogenic diet. I have excluded electrolytes, blood count, kidney and liver function tests because they were normal and unchanged.

Anne' lab results on ketogenic diet

Reflections on Anne's results

Anne's fasting blood sugar is much better on a ketogenic diet, but her lipid profile has "worsened." Anne is eating a standard ketogenic diet—high fat, moderate protein, low carb, and not exercising much these days due to a hip problem. She includes dairy and some processed foods in her diet, as the vast majority of people who eat a ketogenic diet do. Her triglycerides, while still in the normal range, have increased significantly, and her HDL has fallen. I will not venture to form a conclusion about these results except to say that they may or may not be due to a) the high fat content of a ketogenic diet, b) the process of fat burning, c) the presence of dairy, d) low activity levels (HDL in particular).

My own (much more extreme) version of a ketogenic diet earlier this year, with little/no dairy or processed foods, and almost no exercise, produced the following lipid profile:

  • Total cholesterol: 260
  • LDL: 170
  • HDL: 70
  • Triglycerides: 99

[For my complete lab results, see my post "Keto for Cancer: Week 5."]

Her primary care doctor was very concerned about the trend in her lipid profile. She recommended she reduce her saturated fat intake, and start taking red rice yeast daily. What do you think of Anne's lab test results?

If you are interested in starting a ketogenic diet yourself, see my online guide: "Ketogenic Diets 101."

Recommended ketogenic diet resources

  • Art and Science of Low Carb Living book cover
  • The Rosedale Diet book cover
  • Keto-Maria Emmerich book cover

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