Dr. Ahmed Should the keto diet help you lose more weight if you are also on Ozempic? This seems like a good combination for weight loss, however, before you switch to a keto diet, you should know the pros and cons of combining the keto diet and Ozempic!
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What is a Keto Diet?
The Keto diet is basically a high-fat and low-carb diet. When our body utilizes fats as energy, ketone bodies are released as a byproduct.
The three most common ketones in our body are:
- Acetone
- Acetoacetate, and
- Beta-Hydroxybutyrate
A keto diet is generally used by people who plan to lose weight. A typical ketogenic diet consists of four parts of fats and one part of the protein. The fats are primarily long-chain fatty acids.
The modified keto diet consists of three parts of fats and one part of the protein. Medium-chain triglycerides substitute the fatty part.
This is in contrast to the typical Western and Canadian diets that are composed of 48% Carbohydrates, 32% fats, and 17% proteins [Ref].
The ketogenic diet, apart from its weight loss effects, is best for children with epilepsy. It has also been studied in neurodegenerative diseases like Alzheimer’s disease and dementia.
Does a Keto Diet help you lose weight?
Smaller studies have exaggerated its weight loss effects, however, studies from larger randomized clinical trials have not shown a keto diet to be superior to a simple low-caloric diet.
One Review article concluded that a keto diet might help you lose weight. At the end of one year, a difference of 2 kgs was noted in the keto diet group vs the low-fat diet group. More individuals in the keto-diet group lost weight compared to the low-fat diet group.
Weight loss on a keto diet has been observed to be greatest at month 5. After that, the weight loss may be sustained for a year and regained thereafter.
The weight loss associated with a keto diet is not universal. Individual participants may lose up to 30 kgs or even gain up to 10 kgs [Ref].
Weight loss of up to 10 lbs has been observed especially during the first two weeks. This initial weight loss effect of a keto diet is attributed to the diuretic effect of the keto diet.
What are the health hazards of a ketogenic diet?
It is important to understand that a ketogenic is generally not considered a natural diet. Deviation from nature is always associated with side effects some of which may be very serious.
A keto diet should not be used by the following people:
- People with pancreatitis
- Liver failure
- People with diseases that alter fat metabolism
- People with certain genetic diseases like pyruvate kinase deficiency, carnitine translocase, and carnitine palmitoyltransferase deficiency
- Primary Carnitine deficiency
In addition, people with diabetes are at risk of developing hypoglycemia especially if they are on insulin or sulfonylureas.
There are case reports of people developing DKA (diabetic ketoacidosis), a serious and life-threatening emergency that manifests as:
- high blood glucose levels
- the blood becomes acidic, and
- ketone bodies formation
People on a ketogenic diet may also have a false-positive alcohol breath test. Also, a keto diet is associated with high cholesterol levels in the blood.
Side effects due to the change in time may be severe in some cases. Keto flu is a term used to describe the initial keto-diet-related side effects that include:
- Fatigue and lethargy
- insomnia
- Constipation
- Nausea and vomiting
- Dizziness
- headache, and
- exercise intolerance
People are usually advised to take adequate water and supplements to cover the side effects associated with the keto diet.
Should you follow a keto diet when using Ozempic?
When using Ozempic, especially for weight loss and diabetes, a keto diet seems very fascinating to boost the weight loss results and control diabetes at the same time.
However, the keto diet can have serious adverse effects on your health when you are using Ozempic.
These are:
It is difficult to tolerate Ozempic with a Keto diet:
Ozempic causes bloating and fullness immediately after eating. A high-fat diet as in the keto diet has a similar effect on your stomach.
Most people poorly tolerate Ozempic due to heaviness in the stomach and fullness after eating.
Fullness and bloating sometimes persist throughout the day. Ozempic and keto diets are both associated with nausea and vomiting. This effect is multiplied when combining the two.
A greater percentage of people on Ozempic have a change in their bowel habits. A keto diet can cause severe constipation.
When using Ozempic, constipation can become very severe resulting in bleeding and intestinal obstruction.
Your risk of hypoglycemia increases several folds:
A keto diet is very deficient in carbohydrates. Among all the non-insulin medications, Ozempic has the greatest anti-diabetic effects. It lowers glycated hemoglobin significantly.
When combining Ozempic and keto diets, the risk of hypoglycemia is very high. This is especially true if the person is taking insulin or sulfonylureas concomitantly.
There is a risk of pancreatitis:
A high-fat meal as in the keto diet can cause pancreatitis. Similarly, one of the most common side effects of Ozempic is pancreatitis.
Combining Ozempic and keto diets can make a person prone to developing pancreatitis. pancreatitis is a life-threatening emergency.
People with pancreatitis have severe abdominal pain radiating to the back, nausea, vomiting, and/or hypotension.
Ozempic is contraindicated in patients with pancreatitis or a history of pancreatitis in the past. It is wise to avoid triggers that can result in pancreatitis such as a high-fat meal (keto diet).
Diabetic Ketoacidosis:
A keto diet is based on a fatty diet. When the body consumes a keto diet, ketone bodies are released.
DKA or diabetic ketoacidosis is a serious complication of diabetes. It manifests as high blood glucose, ketones in urine or blood, and acidic blood.
DKA is more common in type 1 diabetes patients. Ozempic is not for use in patients with T1DM. So, most patients on Ozempic have T2DM.
T2DM patients who are on a keto diet [Ref] or novel diabetes medications, SGLT2 inhibitors (Empagliflozin and Dapagliflozin) are at risk of developing DKA.
SGLT-2 inhibitors like Empagliflozin (Jardiance), Dapagliflozin (Farxiga), and Ertugliflozin (Steglatro) are commonly prescribed along with Ozempic.
In Conclusion:
Ozempic and keto diet combinations may be associated with serious health-related issues without any significant benefits. It is best to avoid Ozempic and keto diet combination as it may put you at risk of pancreatitis, DKA, and hypoglycemia.
A keto diet may also increase the gastrointestinal side effects of Ozempic. It will worsen bloating, fullness, and constipation associated with Ozempic.
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