OC A Random Collection of Advice for Weight Loss with Keto

Here is an assortment of advice for those who are just starting their keto weight loss journey, based on the experiences I've had with it the last 6 or 7 years. Everyone's experience will be a little different, but this is what worked for me. I used keto to lose roughly 100 lb.

There's a lot here, but I hope it's useful for someone.

Macros

Carbs are a limit: stay under this number every day.
Protein is a goal: reach this number every day.
Fat keeps you full: you have a fat allotment in your macros, but if you're not hungry and you're not meeting your fat number, don't worry about it. It just means your body is using the fat you already have (around your midsection!). For serious weight loss, try to come in under your fat number.

Calculating Macros

Don't overthink this. Most of the calculators online are designed to help you determine your Basal Metabolic Rate, which is the number of calories you burn every day doing nothing: your body is just working to keep your body temp up and keep your heart sending blood to your brain. Once you have that number, then you can work out how many calories you should eat in a day to lose weight. But if you're just starting out, a reasonable guess is fine, and you can adjust later. The BMR range is typically between 1200-2000 calories a day.

So make an educated guess, to the nearest 100. Are you a short person? Pick something closer to 1200. Are you a tall person? Pick something closer to 2000. We can always tweak it later once we're in the habit of eating in a keto-friendly way.

The Protein macro is calculated using your "lean mass", which is what you would weigh with 0% body fat. But that's hard to figure out and the numbers are generally forgiving anyway, so to make things easy, we will use your target weight: your weight at a healthy BMI. What your doctor says you should weigh.

Then we calculate our macros this way:
Each gram of fat has 9 calories, and each gram of both protein and carbs has 4 calories.
Let's assume a 1700 calorie day, and a target weight of 170 lb (78 kg).

Carbs: We will start with a limit of 20g net carbs a day. That's 20x4=80 calories. Most of the population is in ketosis at that level; if your body can handle more and manage to stay in ketosis, good for you! You can always adjust later. But start with 20 grams.
Protein: Eat roughly 1 gram of protein per kg of your target weight (or a little under 0.5 gram per pound). That's 78x4=312 calories, round up to 320.
Fat: Once you have your carb and protein numbers, fat is just the rest of your calorie allotment. So 1700 per day, minus (80+320=400), leaves 1300 calories of fat. 1300/9=144g of fat.

So in this made-up example, our macros are:
20g net Carbs (do not exceed)
78g Protein (meet)
144g Fat (up to, and only if hungry)

You should calculate your own starting macros using the method I outlined above, or use one of the calculators available online.

Net Carbs

There are essentially 3 kinds of carbs: sugar, starch, and fiber. Sugar and starch are treated as essentially interchangeable by your digestive system: they both use the same basic chemical reactions during digestion. Fiber is indigestible, and is ignored by your digestive system altogether. (It goes right through you!) We really only care about limiting the sugar carbs and starch carbs. Together, these are called "net carbs," because they are "all the carbs except fiber." Only net carbs count toward your macro.

Finding the net carbs in a specific food is based on where you live.

In the United States (and in Canada), the nutrition label includes fiber in the "Total Carbohydrates" line. This line represents "Starch + Sugar + Fiber". So to calculate net carbs, you would take the Total Carbs and subtract out the Fiber, which is an indented entry below Carbs somewhere. I live in the US, so this is the system I'm used to using.

In most of the rest of the world, including the EU and Mexico, Carbohydrates do not include Fibre. The Carbohydrates line represents "Sugar + Starch", and Fibre is listed completely separately. In those places, you should not subtract Fibre from Total Carbs.

The best way to tell the difference between the two is the indentation. If Carbs and Fibre are listed at the same indent level, they're separate. If Carbs are listed with Fiber indented, they're included and you have to subtract Fiber to get net carbs. (You can also sometimes tell by the spelling of Fiber/Fibre.)

What do I eat?

Food! Real food. Meat, green veggies, eggs, cheese, nuts. Keto is frequently derided as the Bacon-and-Eggs Diet, but it can also be the Steak-and-Salad Diet, or the Chicken-and-Broccoli Diet, or the Dry-Rub-BBQ Diet, or the Eggroll-Bowl Diet, or the Pizza-Casserole Diet, or the Sausage-and-Mushrooms Diet, or the Spinach-Fritatta Diet, or... whatever you want it to be. Technically, nothing is off the table as long as you meet your macros. If you want to blow your entire daily carb budget on one tortilla, go for it. But I'd much rather spread those carbs out to lots of broccoli with cheese sauce, or salad with oil & vinegar, or some onions in my Fritatta, etc.

The best way to do keto is to cook your own food. Buy fresh, whole ingredients and make simple, wholesome meals. I personally steer clear of anything in the grocery store with the word "Keto" on the box, because that means it has a bunch of fillers and other nonsense in it to make it both shelf stable and appetizing: two mutually exclusive properties. I also avoid any Keto replacement desserts, first because eating sweet things gives me cravings, and second because it's just not worth it (see the toilet section below).

It's fine to eat out on Keto. Get a bunless burger, order a steak, get the salad. Be willing to customize your order a bit; most chefs and wait staff will understand what "low carb" means. Pro tip: at the steak house ask for "loaded broccoli". That's steamed broccoli under a pile of everything that would normally go on a loaded baked potato: butter, cheddar cheese, sour cream, chives, bacon.

Keto is not the same as gluten free: most things labeled "gluten free" have a bunch of rice flour in them, which is carb city.

There are lots of resources for getting started with keto recipes if you search for them. Stick to the ones that use a simple meat/veggie/eggs combo at first. Finding a meal plan and doing some weekly meal prep is a great way to enforce the first couple weeks.

Yes, it's totally possible to be vegetarian or vegan on keto, it's just a little more work. You have to find some way to keep your protein number high without resorting to the usual substitutes like beans (which have lots of carbs).

Keto Flu

The Keto Flu is experienced during the first couple weeks of someone just starting keto for the first time. The person is tired all the time, gets headaches, maybe muscle cramps, and generally has a terrible time.

This is almost certainly due to dehydration and a lack of electrolytes, and is completely preventable.

When your body is transitioning to fat burning, the first thing it does is flush a bunch of glycogen out of your liver, and all that glycogen was held in there by lipid chains held together with water. So you lose a lot of water the first few days. (You'll hear this referred to as "The Whoosh", and it's the reason keto newbies can drop a lot of weight the first week!) This means it's vitally important to stay hydrated when you first start keto, since headaches and tiredness are both symptoms of dehydration. The secondary effect is that on its way out, all that water takes a bunch of dissolved electrolytes with it, and your body ends up with a deficit if you only replace them with plain water. Electrolytes are salt ions that help your muscles and nerves conduct electricity, typically sodium, potassium, and magnesium. It's important to keep electrolytes in balance when you first start and your body is shedding water.

So make yourself some Keto-ade! This is a mixture of electrolyte salts dissolved in water, sometimes with a little flavor to mask the taste. For a complete solution, check out brands like LMNT: they make easy-to-use powder packets you can mix into water, and contain all the right electrolytes in the right proportions, but they're a bit expensive to use all the time. A cheaper "good enough" solution is to get a package of Lite Salt (or low-sodium salt), which is Sodium Chloride and Potassium Chloride in equal proportions, and mix that with water. I mix a little less than a teaspoon in 20 oz, and add a squirt of Mio flavoring (lemonade flavor is my jam). Generally sports drinks like Gatorade/Powerade don't have enough electrolytes in them to be useful to ketoers, plus you have to be careful not to get the ones with sugar, so I'd steer clear. Also: use salt when you cook! Not only will it provide electrolytes, but it makes everything taste better, too.

The Word "Keto"

There is a lot of misinformation about nutrition out there. Entire generations of people grew up with the incorrect assumption that saturated fat and cholesterol were the enemies to good health, and that idea has pervaded our culture and endured even in the face of solid scientific evidence to the contrary. Keto works, but anytime you talk to someone about it, they will inevitably tell you how unhealthy you are and how you shouldn't be eating so much fat.

People also, psychologically, have a hard time watching someone be successful with weight loss, and will try to get you to cheat every chance they get. "It's just a slice of cake, no big deal."

The correct answer to all of this is to never talk about your diet with anyone unless they ask first, and even then, don't ever use the word "keto." Just say you are cutting back on sugars and snacks, and that usually shuts them up. If they offer you something, just say "no thank you" and smile. No reason required.

Then when you are in line at the grocery store, and see that guy over there in the shirt one size too big who is holding a slab of beef, a block of butter, 2 dozen eggs, and big bag of pork rinds, you can just quietly make eye contact and nod knowingly to each other. He gets it.

Never Trust a Keto Fart

Lots of newbies have stories to tell about their horrible toilet experiences when first starting keto. These, too, are mostly preventable, but it might take some time to dial it in for your specific digestive system.

There are two primary causes of the "keto diarrhea"...
First, electrolytes, like the ones you are drinking in your tasty Keto-ade, can easily act as a diuretic and cause your intestines to "clean house," especially if you drink them all at once. Never chug your Keto-ade. Sip slowly, like a fine wine. Start small with the amount of Keto-ade you drink each day, and only add more if you get more Keto Flu symptoms.
Second, lots of sugar substitutes like erythritol, xylotol, sucralose, aspartame, etc., can cause your system to clean itself out as well. Different people react differently. So if you are starting keto by replacing your desserts with keto versions, or drinking a lot of diet sodas, you are likely ingesting much more fake sugar than you used to which can lead to the aforementioned issues. I tend to avoid all fake sugars for exactly this reason.

There's a third reason which is probably not primary, but may have some effect: your gut biome, meaning the sum total of all the bacteria living in your digestive tract that help you digest your food, is made up of lots of different species that all feed on different things. As you adjust your diet, the ones that fed mainly on sugar, starch, and the other stuff you've given up will slowly die off, and the species that fed on the wholesome, healthy food you're eating now will thrive and take over. This is a gradual process, but it will have some interesting follow-on effects, including changing your tastes and cravings and generally uplifting your mood. Yep, that means your sweet tooth will eventually go away if you stop eating sweet things long enough, and simply eating better can work wonders on your depression. Wild stuff.

Cravings

Oh my god the cravings! What do I do?! I could eat a whole cheesecake!

Relax. Cravings happen. There are a few ways to handle them.

First, make sure you remove temptation. Throw out all the carbs in your house if you have to. Have some healthy keto snacks on hand just in case (but don't go overboard with the snacking since it sneaks up on your calorie total). A handful of nuts like almonds, or maybe a teaspoon of peanut butter, or a square of cheese, or a few pork rinds will help get you over the hump. Avoid sweets, even with fake sugar, since that just triggers more cravings (it certainly does for me).
Second, find something else to do. Fat people spend a lot of time eating, and when I moved to keto I found myself with more free time than I thought possible. Pick up a hobby, something where you use your hands, like knitting or carpentry or playing an instrument. Go for a walk. Call a friend. Find a way to distract yourself.
Finally, remember that these cravings are not your body yelling at you... they're actually your gut biome yelling at you. Those nasty, angry species of bacteria that used to feed on all the starch and sugar you ate are currently starving, and they're screaming about it. So be patient while those species finally die of starvation, and are replaced by the much more stoic and reasonable species that munch on fat and leafy vegetables. Those guys are cool.

I also found that resisting cravings helped me to reframe my entire relationship to food. I simply convinced myself that things that are good for Keto, like meats, veggies, eggs, and so forth, are FOOD. Anything else is NOT FOOD. At least, it's NOT MY FOOD. Starch and sugar made me fat, and are therefore bad for me. If I treat them a little like an allergy, I can more easily say no. I can watch others eating cakes and cookies and chips, and think to myself "I'm glad those people are enjoying those things, but they're NOT MY FOOD. They will make me sick." And the thing is... that attitude is not wrong. When you spend enough time on Keto, and then cheat and eat a bunch of carbs in one sitting, not only will you get horrible muscle cramps as your liver sucks the moisture out of your muscles to pack the carbs into glycogen stores, but you'll feel a carb hangover the next day, with foggy brain and a splitting headache and everything. Carbs really do make you sick.

So stop eating things that make you sick. Enjoy real food, wholesome tasty food that is fresh and was made with butter and salt, and tastes like a slice of heaven.

Keep calm and keto on.