Should You Go Keto After Weight Loss Surgery?

keto beef lettuce wrap burrito

Should you be going keto after weight loss surgery?

Unless you’ve been completely removed from recent pop culture, you’ve probably heard the term keto posted on social media or in the news. 


What the heck is keto anyway?

The term “keto” is an abbreviation for the word ketogenic, which refers to a metabolic state known as ketosis. When you’re body is in a state of ketosis, the body runs on a form of energy called ketones rather than glucose. The ketogenic diet (also called a low-carb, high-fat (LCHF) diet) supports the transition and maintenance of this metabolic state.

Normally, when the body is getting adequate carbohydrates from the diet, it runs on glucose (sugar) as energy. If the body is getting enough carbohydrates to function, than it will not need to rely on its stored energy (fat) for fuel. However, a ketogenic diet is so low in carbohydrates that the body is forced to switch to a different metabolic state and use it’s stored energy (fat). Because of this shift, weight loss is a common side effect of this metabolic state.


Should I go keto?

Although the dietary changes can be challenging, many individuals find the benefits worth the effort. Research has shown benefits such as improve mood, increased energy, better blood sugar control, mental clarity, improved hunger control, decreased blood lipid levels and blood pressure, and clearer skin.

Although the benefits of a keto diet can be very attractive, the diet isn’t necessarily for everyone. First, the keto diet is very restrictive. Keto dieters eat only meat, fish, seafood, eggs, healthy fats (think nuts, avocado), low-carb dairy foods, and non-starchy veggies like leafy greens. Foods often avoided include grains, fruit, starchy veggies (think corn and potatoes), legumes, processed or packaged foods high in carbs, and of course, sugar.

Keto dieters, may also experience some unpleasant side effects during the induction phase including fatigue, headaches, muscle cramps, bad breath, and dizziness caused by dehydration and loss of electrolytes. “Keto flu” is often the name for the symptoms during this transitional time period.


So, how is the keto diet different than a bariatric diet?

The general macro ratio of a ketogenic diet is 70% fats, 25% protein, and 5% carbohydrates. When starting a keto diet, NET carbs shouldn’t exceed 20 grams.

A post-op patient following the keto macro ratio guidelines and eating 1000 calories per day, would have the following macro breakdown:

  • 70% fat= 700 calories/78 grams fat
  • 25% protein= 250 calories/62.5 grams protein
  • 5% carbohydrates= 50 calories/12.5 grams carbs 

However, there are some things to take into consideration:

1.      The American Society of Metabolic and Bariatric Surgery suggests eating at least 60-80 grams of protein per day.

2.      Some surgical patients may not be able to tolerate such high levels of fat per day.

Instead, a Bariatric-modified keto diet may look something like this:

If intake is ~1000 calories per day:

  • 80 grams protein (320 calories) = 32% of total calories
  • 20 grams NET carbohydrates (80 calories) = 8% of total calories
  • 67 grams fat (600 calories) = 60% of total calories

This modification still keeps NET carb intake less than 20 grams per day but adds in more protein and takes away some fat.

What are net carbs?

Not all carbs are treated equally when looking at a nutrition label. On a keto diet, you will focus on NET carbs which are Total Carbs – Total fiber. Because fiber does not affect your blood sugar level, it is considered a net zero carbohydrate.


What does a sample day look like?

Breakfast: Eggs and bacon

Snack: String cheese and deli meat

Lunch: Chicken and broccoli roasted in olive oil

Snack: Tuna salad with cucumber slices

Dinner: Salmon with asparagus roasted in olive oil


What are some good resources if I want to follow a keto diet? 

Here are some popular websites with great information about keto living and recipes: 


I'm not sure I want to go strictly keto, how could I do a modified version?

A modified keto diet would look more like a general low carb diet. Rather than reducing your carbohydrate intake to less than 20 grams per day, you might aim to keep your carbs less than 40-80 grams per day. Although your body might not be in a state of ketosis, you will likely still have many of the same benefits of a keto diet, including weight loss.

Many find that after a few days to a few weeks of cutting out their sugar and processed carb intake, they experience increased energy, improved hunger control, improved blood sugar, weight loss, and better mental focus.

As always, it’s best to talk with your doctor before making any dietary or lifestyle changes. This diet may not be a healthy option for those with heart disease, Type 1 Diabetes, Type 2 Diabetes, or women who are pregnant.


Do you follow a keto diet? If so, tell us more about your experience in the comments below! 

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