Is Keto Sustainable For Long Term Weight Loss

Justina Nothard
Dec 13, 2024
6 min read

Updated: Dec 23, 2024

Have you ever wondered if the ketogenic diet is truly sustainable for long-term weight loss? It’s praised for quick results, but what happens after the initial success? Stick around to uncover the truth about keto’s long-term potential and whether it’s the right choice for you.

The ketogenic diet is widely celebrated for its ability to deliver rapid, short-term weight loss, primarily due to the body entering ketosis—a state where fat is burned for fuel instead of carbohydrates. During the initial weeks, individuals often experience significant weight loss, much of which is water weight, as glycogen stores are depleted. This immediate success can be highly motivating and provide a sense of accomplishment.

However, sustaining weight loss on keto over the long term can be more complex. My own experience of being on a Keto diet was the same immediate success, but very soon, I found myself struggling. I craved carbs, and it became mentally difficult as I blamed myself for not being able to stick to the diet. I thought there was something wrong with me. Through my research, I actually learned the many reasons why this could happen, including the effect of the female hormone cycle.

Studies suggest that I was not alone. While keto can maintain fat loss for some individuals, its effectiveness tends to plateau after a year. The restrictive nature of the diet—requiring a high-fat, moderate-protein, and very low-carbohydrate intake—can make adherence challenging over time. Social situations, food availability, and personal preferences often lead to lapses or giving up on the diet. So, let's have a look at some of these challenges.

You can also watch this video on my YouTube channel.

Challenges to long-term adherence and the psychological aspect of keto

The ketogenic diet’s restrictive nature is both its defining feature and one of its greatest challenges for long-term adherence. By eliminating or drastically reducing carbohydrate-rich foods like bread, pasta, fruits, and even some vegetables, keto requires a significant shift in eating habits. While this can lead to impressive short-term results, maintaining such strict dietary rules over months or years often becomes difficult. Social situations—such as dining out or family gatherings—can feel isolating when keto-friendly options are limited, leading many to feel excluded or frustrated.

Psychologically, this restriction can create a sense of deprivation, making it harder to sustain the diet. Over time, cravings for off-limits foods may intensify, potentially leading to binge-eating episodes when dietary rules are broken. The constant need to monitor food choices and macronutrient ratios can also contribute to decision fatigue and stress. For some, this creates an unhealthy relationship with food, where guilt and anxiety replace enjoyment.

However, many individuals report mental clarity and mood stabilisation once their bodies adapt to ketosis. These benefits can be motivating but may not outweigh the psychological toll for everyone.

To navigate these challenges, it’s essential to adopt a flexible mindset and focus on progress rather than perfection. Consulting healthcare professionals or dietitians can also provide support in addressing both the physical and emotional demands of keto.

The impact of UPFs in keto diets

One of the most significant factors contributing to the success of any diet—including keto—is the shift away from ultra-processed foods (UPFs) toward real, whole foods. Many individuals find that simply cutting out heavily processed items like sugary snacks, refined grains, and packaged meals leads to noticeable improvements in weight loss and overall health. However, the growing popularity of keto has led the food industry to flood the market with ultra-processed “keto-friendly” products designed to fit macronutrient requirements.

While these products—such as low-carb protein bars, snacks, and desserts—may technically align with keto guidelines, they often undermine the diet’s core principles. UPFs are typically high in artificial additives, low in essential nutrients, and can perpetuate unhealthy eating habits. Relying on these substitutes can stall weight loss progress and diminish potential health benefits by failing to provide the vitamins and minerals found in whole foods.

The real success of keto lies in embracing nutrient-dense options like fresh vegetables, healthy fats (e.g., avocados and olive oil), lean proteins, nuts, and seeds. By focusing on real food rather than processed alternatives, individuals not only improve their chances of long-term success but also enhance their overall well-being. Avoiding UPFs and prioritising whole foods ensures that the diet remains sustainable and beneficial while reducing reliance on food industry trends that often prioritise profit over health outcomes.

Health impacts beyond weight loss

The ketogenic diet’s effects extend beyond weight loss, influencing various aspects of health—both positively and negatively. On one hand, research suggests that keto can improve blood sugar control and insulin sensitivity, making it particularly beneficial for individuals with type 2 diabetes or prediabetes. It has also been linked to reduced triglycerides and increased HDL ("good") cholesterol levels.

However, concerns about long-term health impacts remain. The high intake of saturated fats common in many keto plans may elevate LDL ("bad") cholesterol levels in some individuals, potentially increasing cardiovascular risk. Additionally, the exclusion of fiber-rich foods like whole grains and certain fruits may negatively affect gut health over time.

Keto has therapeutic applications beyond weight management; it has been used successfully in managing epilepsy and shows promise in neurological conditions such as Alzheimer’s disease. However, these benefits must be weighed against potential risks like kidney strain from high protein intake or bone density loss due to reduced calcium absorption.

Ultimately, consulting healthcare professionals before starting keto is essential to ensure it aligns with individual health needs and goals.

The role of individual differences in success

The ketogenic diet’s effectiveness varies widely among individuals due to factors such as genetics, lifestyle habits, metabolic health, and personal preferences. For instance, some people naturally thrive on high-fat diets due to genetic predispositions that influence how their bodies metabolise fats versus carbohydrates.

A factor that I learned about in my research that made me feel a lot better about myself is the female hormone cycle. A woman's body is actually designed to be able to break down carbohydrates more effectively during some parts of her cycle, and this is the reason you crave carbs! This knowledge shifted my thinking towards a varied diet in different phases.

Lifestyle factors also play a significant role; those with demanding schedules or limited access to keto-friendly foods may struggle more with adherence. Additionally, metabolic conditions like insulin resistance can make keto particularly effective for some individuals but less impactful for others without these issues.

Psychological factors are equally important—those who enjoy structured eating plans may find keto easier to follow than individuals who prefer flexibility in their diets. Personal preferences for certain food groups (e.g., aversion to fatty foods) can further influence long-term success.

Ultimately, tailoring the ketogenic approach—or considering alternative dietary strategies—to align with individual needs is key for achieving sustainable results. Consulting healthcare professionals or nutritionists can help identify whether keto is an appropriate choice based on unique circumstances.

Transitioning off keto

Transitioning off a ketogenic diet requires careful planning to avoid rapid weight regain or metabolic disruptions. A sudden reintroduction of carbohydrates can cause water retention and bloating as glycogen stores replenish—a phenomenon that might be misinterpreted as fat gain.

To transition safely:

Gradually increase carbohydrate intake by incorporating whole foods like fruits, legumes, and whole grains while maintaining healthy fat consumption.
Monitor portion sizes to prevent overeating during this adjustment phase.
Focus on nutrient-dense carbohydrates with a low glycemic index (e.g., sweet potatoes or quinoa) to stabilise blood sugar levels.
Maintain protein intake to support muscle mass and satiety.
Continue regular physical activity to offset any caloric increases from added carbs.

Mindful eating practices are also crucial during this period to avoid emotional overeating after prolonged restriction. By taking gradual steps and prioritising balanced nutrition, individuals can transition off keto while maintaining their progress toward long-term health goals.

As we close out, we've explored whether the ketogenic diet is sustainable for long-term weight loss. While keto can offer quick results and potential health benefits like improved blood sugar control, its restrictive nature, reliance on ultra-processed "keto-friendly" foods and potential health risks make long-term adherence challenging for many. Success with keto—or any diet—ultimately depends on focusing on whole, nutrient-dense foods and creating sustainable habits that fit your lifestyle and individual needs. Remember, there’s no one-size-fits-all solution to health and weight loss. It’s about finding what works best for you and maintaining balance for the long haul.

Diets like keto often focus solely on food, but lasting success starts in the mind. The My BMB program helps you address the thoughts and emotions that influence your choices, empowering you to build healthier habits and a more positive relationship with food. With guided meditations and practical tools, it can help you rewire your mindset for long-term health. Check out the My BMB program today to start transforming from the inside out.