Weight loss is the key reason many switch over to the keto diet. Here’s why its fat-burning objective can be harmful and a danger to the body.


The ketogenic diet is the diet right now. It’s becoming more trendy and in vogue as more people are flaunting their ‘successes’, leading others to be more curious about what it can do for their health.

By now, most people can generally define the ketogenic diet: no carbs and a lot of fat.

This concept may or may not appeal to you, but the interest in proposed weight loss likely does. But, do you know what is actually happening in your body on the ketogenic diet? Under medically necessary situations, you’ll find that many nutrition and health professionals are in favor of the ketogenic diet.

However, the issue that most of them have with the ketogenic diet is the way that this proven, medically-therapeutic, and beneficial way of eating has been snatched up by the wellness world and turned into a fad diet that’s typically followed inappropriately and incorrectly.

Let’s take an unbiased look at what ketosis actually is, the the proposed benefits are, why our wellness efforts are often ill-informed, and finally, what to do if you’re interested in trying this way of eating.

But first, a quick primer on the biochemical basis of ketosis and its physiological role.

Ketosis is the state of the body when the carbohydrate intake of a diet is low enough, and the protein intake moderate enough such that the body burns fat for energy to produce ketones that circulate in the bloodstream for energy use. This is meant to mimic fasting.

The body feels it is in starvation because there is not enough glucose, it’s preferred energy source, and so it produces ketones in the setting of reduced blood glucose by breaking down fatty acids in the liver. These ketones serve as an alternate energy source.

When the body is first deprived of carbohydrates, usually felt at around 50 grams per day or less, the body starts with gluconeogenesis which is the body using stored glucose (glycogen) from the liver and muscles for energy. When the stored glucose can no longer keep up with energy demands, which will happen because there’s limited storage of glucose, the body turns to using ketone bodies for energy.

In order for this process of fat breakdown to ‘work’, the protein content must be kept low enough to prevent gluconeogenesis. So, just because you are eating a low carbohydrate diet, does not mean you are in ketosis. It is important to note here, that this nutritional ketosis is different from ketoacidosis, which is the setting of low blood pH level that occurs in people with diabetes and can be very dangerous.

So when is a ketogenic diet actually medically appropriate?

Ketosis has been shown to help with seizures, particularly in children. While there is still much to learn, one reason this diet can work for children is because ketones can be used by the developing child’s brain as a building block.

I must note here, that as a nutrition professional who has worked in pediatrics and seen children who must follow this diet, it is incredibly challenging for both the child and family. Most people who must follow this diet for therapeutic medical reasons have trouble actually reaching ketosis with diet alone, and need to drink poor-tasting formula drinks to keep their carb-to-fat ratio in tight control. Many of these individuals must follow this way of eating to survive or have any sort of quality of life.

There is also growing research that has explored the use of a low carbohydrate diet (but not necessarily ketosis) as potentially beneficial to other populations. Lower carbohydrate diet may be beneficial for those with diabetes, metabolic disease, and other disease burden, at least in the short term.

Lower carbohydrate diets (varying amount of carbohydrates in each study) have shown promise in improving A1c and weight management in Type 2 diabetes, is shown to be better than low-fat diets in improving blood pressure and lipid levels, and more. Along with that, more ketosis studies on different disease states are out there and growing. Ketosis has also been explored for its promise, at least in the short term, for metabolic disease, Alzheimer’s disease, and diabetes.

Unfortunately, as with other fad diets, the context of its benefits are mishandled as they reach the wellness world.

Keto has become synonymous with low carb, but as you have just read, reaching ketosis is much more complex than just eating fewer carbs. Healthy, young active people are taking up ‘the keto diet’ recreationally without any clinical reason in an attempt to lose weight, drop body fat, get a six-pack, or just to follow a trend their friends have taken up.

But following ketosis recreationally can be dangerous.

The initial weight loss is usually short-lived as carbohydrates hold onto fluid in the body. Beyond that, we need fat on our bodies in order to function and survive. Fat is essential and plays a vital role in many basic physiological functions of our body. This notion of ‘burning’ as much fat off our bodies as we can can be downright dangerous because biologically, we need fat. Having too little body fat can lead to issues such as:

  • Heart disease
  • Fat-soluble vitamin deficiencies
  • Low energy
  • Hormone imbalance
  • Weaker muscles
  • Severe mood swings
  • Fertility issues in both men and women
  • Missed menstrual cycles

But the problem we face as humans: we are drawn to diets because they become an identity.

We all already know that the more sensible, healthful way to diet all comes down to doing something that’s sustainable in the long term. And for most, that means eating fewer refined and starchy carbohydrates, and more fruit and vegetables, essential fats, and protein at each meal to improve your health and energy. But it just isn’t as fun or interesting to say, “I’m eating more vegetables and healthy fats!”  

Ultimately, it’s your body, and your call.  But, picking up a diet just because your friend is doing it, or it claims to help you drop those ten pounds you don’t actually need to lose, are not good reasons to start the keto diet.  There are many other healthy habits you can take up that are less drastic and more beneficial:

Getting quality sleep, stress management, joyful movement, more fruits and vegetables, and cooking at home.

Put your focus on something that will grow your wellness, self-care skills, and help you stay healthy for life. And if you are trying to make serious changes to your diet for your health, it’s highly recommended to work with a nutrition professional who will guide and support you in figuring what’s best for your unique body.

Whatever way of eating you abide by, don’t assume it should be based on the trendy diet that everyone else is on.


Courtney Ferreira, MS, RD, LDN is a Registered Dietitian based in Baltimore, MD with a passion for helping individuals reach their health and wellness through flavorful whole foods and freedom from counting calories, fat, and minutes on a treadmill. For more insightful tips on living your healthiest life, visit Courtney at the RealFoodCourt.


  1. Your article started off well when you began to explore the science behind the diet. However you missed the mark by saying that the reason to stay away is because it’s being done wrong and theorizing that people are doing it because their friends are. Rather you should have explored the proper way to adhere to the diet and then made an informed decision about its benefits or negatives. You cannot start and article with science and end with personal feelings or opinions

  2. this article actually promotes the keto diet even more because there were no convincing or logical arguments given that go against it.

  3. So silly. Your argument is that people are losing all their fat? ???? You must hang with some really skinny folks.

  4. Dr. Volek at Ohio State has over 20 years of research on so many platforms that you saying its dangerous seems assinine.
    I’ve been in ketosis for almost 2 years and my health has improved astoundingly. I sleep better. Stopped snoring. Lost 20 percent body fat. No more joint swelling agter exercise. My VO2 max increased by10. I’ve gotten massively stronger at the gym. My cholesterol improved, triglycerides went down, my resting heart rate went down by 10 beats a minute, and my blood pressure is always perfect. I can almost guarantee your articles crap. If anybody that reads this one’s real information check out Dr. Volek from Ohio State. He’s an actual research over the last 20 years not just giving his opinion. And if this article isn’t just your opinion then your research skills need work.