Not losing weight on keto? 7 reasons why

Key Points

• It’s natural to hit a weight loss plateau on keto. It’s a hard diet to follow, especially in the long term.
• Weight loss plateaus on keto often stem from hidden carbs, excessive calorie intake, overlooked lifestyle factors like stress and sleep, and underlying health issues
• Successful weight loss on keto requires proper nutrition, regular exercise, stress management, and figuring out what works best for your unique body
• A registered dietitian can provide personalized guidance to support your health goals

Raise your hand if you’re in a love-hate relationship with the keto diet. You’re doing everything right: carefully planning each meal and tracking your macros. But the scale refuses to budge.

Registered Dietitian Amy Bakios, RD, explains, “The keto diet doesn't work in the long term because it's simply not sustainable over extended periods. My clients frequently report initial weight loss on keto, only to find it becomes impossible to maintain. When they stop the diet, they often gain back even more weight than they had before.”

Before we dive into your keto weight loss plateau, let’s discuss what makes this unique diet tick.

How does the keto diet lead to weight loss?

What is the keto diet?

The keto diet is a low-carb, high-fat weight-loss diet. This extreme low-carb diet was created to force the body to use fat as fuel instead of glucose—a process called ketosis.

The original keto diet involved eating 75-90% fat, 10% protein, and 5% carbs. It was developed to treat severe epilepsy in infants and children under strict medical supervision, not for everyday dieting.

The keto diet you read about is a modified version of the original. Most people who follow this diet today do not achieve ketosis. But that’s okay! It’s possible to achieve weight loss with a modified keto diet, even if you’re not in ketosis.

Let’s look at how keto is meant to burn fat.

How does keto burn fat (what is ketosis)?

When you switch to a very low-carb diet, you’re essentially enrolling in an intensive fat-burning language immersion program.

When you eat fewer calories from carbs, your body starts producing ketones—molecules that serve as an alternative energy source for your brain, heart, and muscles. This process forces your body to use body fat for energy.

Says Bakios, RD, “Here’s the thing: our bodies are designed to burn glucose for energy by default—in fact, we need at least 45% of our daily calories to come from carbohydrates.  This is particularly important because our brains rely on carbohydrates for fuel. On a Keto diet, carbohydrate intake is drastically reduced. So, very few people can stick to a ketogenic diet for a long period of time.”

Plus, it’s common to hit a weight loss plateau, no matter what diet you’re on, including the keto diet. A registered dietitian can help you personalize the macronutrient ratio for your goals and lifestyle.

Reasons why you’re not losing weight on keto

1. Sneaky carbs

Hidden carbs might be sabotaging your keto success without you even knowing it. To lose weight on the modified keto diet, your carbs must stay between 20-50 grams daily. That’s just 5-10% of your daily calories on a standard 2000-calorie diet.

“Many of my clients are surprised to learn they’re consuming more carbs than they realize,” says Bakios, RD. “Common culprits include sugar-free products, keto-labeled cereals, and even some granola marketed as low-carb. Watch out for condiments too.”

Here are some common hidden carbs:

• Sugar substitutes like maltitol can affect blood sugar despite being marketed as keto-friendly
• “Keto-friendly” processed foods may contain fillers and starches
• Certain vegetables that seem low-carb but add up in larger portions
• Dairy products, especially flavored varieties
• Nuts and seeds, which can be easy to overeat

Consider tracking your meals for a few weeks to detect repeat offenders. A registered dietitian can help you identify potential issues and overcome a weight loss plateau.

2. Consuming too many fat calories

While the keto diet is designed to help you burn fat, the fundamental principle of weight loss applies—you still need a calorie deficit. Depending on your fat intake, you may be consuming too many calories (yes, that includes healthy fats).

"The American Heart Association recommends limiting saturated fat to less than 6% of total calories, which can be difficult to achieve on a diet that includes so much animal fat,” says Bakios, RD. “Fat contains 9 calories per gram compared to 4 calories for carbohydrates and protein. This means you can consume a larger volume of food from carbohydrates than from fat, for fewer calories.”

Common high-calorie pitfalls on a keto diet include:

• Large portions of fatty meats and animal protein
• Liberal use of cooking oils and butter
• Excessive snacking on nuts and seeds
• Multiple servings of packaged “keto-friendly” desserts

3. Poor diet quality

While hitting your macro ratios is important, your body needs a full spectrum of nutrients to thrive and achieve healthy weight loss. Nutrient deficiencies can slow your progress.

“Poor gut health can prevent you from losing weight, even in ketosis. The keto diet eliminates many vegetables, legumes, and fruits—foods that offer protective benefits to our gut through fiber, vitamins, and minerals,” says Bakios, RD. “These high-carbohydrate foods also provide more volume for fewer calories, which can help with feelings of fullness when trying to lose weight.”

Quick tip: Think beyond macros. Fill half your plate with low-carb vegetables, choose grass-fed meats when possible, and include fermented foods like kimchi or sauerkraut to support your gut health.

Keep in mind that nutrition isn’t one-size-fits-all. What helps one person thrive on keto might cause subtle inflammation in another. A registered dietitian can help identify your personal food triggers and create a customized keto diet plan that works best for your body.

4. Lifestyle factors may affect weight loss

The success of a ketogenic diet doesn't exist in isolation—it's deeply intertwined with your overall lifestyle. Many people focus solely on food choices while overlooking crucial lifestyle factors that can make or break their weight loss efforts.

"Diet is just one piece of the puzzle," explains Bakios, RD. "Your daily habits and routines play a massive role in how your body responds to dietary changes. This includes hydration, sleep, stress management, exercise, daily movement, avoiding tobacco, and limiting alcohol.”

5. Stress and sleep quality

Stress and poor sleep can quietly undermine your keto diet efforts, even when you’re diligently tracking macros. When stress levels remain elevated, your body produces excess cortisol, a hormone that not only triggers cravings but also promotes fat storage. This stress response can lead to weight gain and derail your progress, even if you’re maintaining strict ketosis.

Sleep quality plays an equally crucial role in weight loss through its effect on hunger hormones. Research shows that inadequate sleep disrupts the delicate balance between ghrelin (your hunger hormone) and leptin (your fullness hormone).

This hormonal imbalance can intensify cravings and increase appetite, making it harder to maintain your keto eating plan.

6. Lack of physical exercise

Regular exercise can be your secret weapon on keto, even if it doesn’t burn hundreds of calories. Think of movement as your body’s tune-up; it helps your metabolism burn fat more effectively, maintains muscle mass, and makes your cells more sensitive to insulin.

You don't need to train for a marathon. Even daily walks or simple strength training can help you break through weight loss plateaus.

"Movement helps optimize your body's fat-burning machinery," says Bakios, RD. "Many of my clients find that adding just 20-30 minutes of daily activity helps restart their weight loss, even without changing their diet."

7. Hormonal imbalances and medical conditions

Several medical conditions can significantly impact your weight loss journey on keto:

• Hypothyroidism, which slows overall metabolism
• Insulin resistance, making fat loss more difficult
• Chronic inflammation, which can lead to a weight loss plateau

Your hormones have a close relationship with weight loss. These powerful chemical messengers influence how your body burns fat, even when you're following your keto plan perfectly.

Think of hormones as key players in your metabolism. They influence everything from how hungry you feel to how easily your body burns fat.

"Often, people blame themselves for lack of progress when there might be a medical issue at play," notes Bakios, RD. If you suspect an underlying condition, work with a healthcare provider to address these issues along with your dietary changes.”

How to break through the keto weight loss plateau

Consult a registered dietitian

The most effective first step in optimizing your keto journey is consulting with a registered dietitian who specializes in keto diets. These experts can assess your unique needs, medical history, and lifestyle factors to create a personalized plan that works for you.

Focus on precise tracking of food intake

Once you have professional guidance, focus on precision, at least in the short term. Track your macros using reliable apps, measure portions carefully, and log everything from cooking oils to seasonings.

Remember that successful weight loss on keto isn't just about cutting carbs; it's about creating a sustainable approach that works best for your body and lifestyle.

Incorporate lifestyle changes

Managing lifestyle factors can significantly boost your results. Incorporate regular exercise into your routine: even a 30-minute daily walk can make a difference. For stress management, consider calming practices like yoga or meditation, which can help regulate cortisol levels that affect weight loss.

Creating a consistent sleep schedule, limiting screen time before bed, and maintaining a cool, dark bedroom environment can improve your sleep quality. These lifestyle adjustments, while simple, can enhance your body’s ability to maintain ketosis and support your weight loss goals.

Focus on whole foods and mindful eating

While the Keto diet can be effective in reducing excess sugar and encouraging more mindful eating, a more sustainable approach to consistent weight loss is having a balanced plate at each meal. 

Bakios, RD, elaborates, “A healthy, balanced plate might include 4-6 ounces of lean protein, like chicken or fish, paired with ½ cup of brown rice, and the other half of the plate filled with vegetables, such as a salad or green beans.”

She adds, “By focusing on adding lower-calorie, volume-dense, nutrient-packed foods—especially plant-based options—you can fill your plate with more food and still feel full, thanks to the higher volume. Additionally, plant-based foods provide beneficial phytochemicals that offer protective benefits to your body.”

Keto alternatives: when to try something different?

While the ketogenic diet can be effective (particularly in the short term), it's not the only path to sustainable weight loss. 

“Diets that eliminate food groups that our bodies rely on can lead to an unhealthy obsession with food. Often, people fail to enjoy a balanced diet and feel a physical strain from fighting cravings or the urges to “cheat” on their diet,” says Bakios, RD.

So, if you have been trying the keto diet for a while, and it doesn’t seem to work anymore, it’s perfectly fine! There are other ways for you to reach and maintain a healthy weight.

Here are some reasons why you may consider a different path to weight loss:

• When not losing weight on keto is affecting your mental health
• If you’re concerned that the intense keto food rules may trigger an eating disorder,  disordered eating, or constant thoughts of food (”food noise”).
• If cutting carbs triggers binge eating episodes or intense food cravings

Intermittent fasting

You could consider experimenting with intermittent fasting, which involves consuming daily calories within a limited time frame while fasting for the rest. Note: Intermittent fasting is not for everyone. Please consult your healthcare provider before you start any diet involving fasting.

Mediterranean Diet

A more balanced weight loss approach may be the Mediterranean diet. It’s based on balanced meals and offers sustained weight loss in the long term.

“As a Registered Dietitian with years of experience in weight loss counseling, I’ve seen many clients succeed by learning to enjoy food in a balanced, sustainable way. At my practice, we focus on incorporating foods that fit their lifestyle and provide all macronutrients in evidence-based proportions,” says Bakios, RD. “We also go a step further by emphasizing the importance of adequate micronutrients.”

The best diet is one that you can maintain long-term while meeting your nutritional needs. A registered dietitian can help you navigate this process.

According to Bakios, RD, “It’s crucial to understand the 'why' behind what we eat. That’s where I come in—to teach you the science behind food and how to lose weight sustainably without relying on fad diets.”

Start losing weight on keto. Find a weight loss dietitian near you, covered by insurance.

Frequently Asked Questions (FAQs)

Can I lose weight on keto without tracking calories?

Creating a calorie deficit is still essential for weight loss. Consuming too many calories from high-fat, low-carb foods can hinder your progress. Tracking helps ensure you’re not unknowingly overeating.

Research shows that food tracking can help with weight loss success. People who take a few minutes each day to log their meals tend to see better results than those who rely on guesswork alone.

However, if you are concerned about keto triggering an eating disorder, skip the food tracking. There are other ways to achieve your weight loss goals.

How long before I see results on keto?

The timing and rate of actual weight loss can vary significantly from person to person based on factors like metabolism, starting weight, activity level, and how closely you follow the diet.

Could medications affect my weight loss on keto?

Bakios, RD, says, “Some medications can impact your weight loss efforts. Common examples include certain steroids, diabetes medications, antipsychotics, and some antidepressants. Always consult your healthcare provider before making any changes to your medications.”

Break through that weight loss plateau. Reach out to a weight loss dietitian near you, covered by insurance.

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