When Keto Does not Work, This is Why.

Does keto always work? Keto is a tool – a solution to a problem. But, what problem are you trying to solve? Let us say you want to use keto for weight loss.

There are various things that can cause someone to be overweight, including:

1. High insulin (the most common cause of someone being overweight)

Keto can help in this situation.  The most common cause is high insulin in which case keto will help you.

2. Slow metabolism. Keto can help, but you also need to do intermittent fasting.

A slow metabolism could be a combination of issues.  Perhaps you are post-menopausal, you are getting older, you have a thyroid issue, or you spent your whole life dieting and your metabolism is very slow. To lose weight you are doing keto.  You are doing three keto meals you are doing keto snacks in between the meals. Is it going to work, probably is not. Why, because you need to also add intermittent fasting because your metabolism is very slow. 

Insulin is at the root of the problem and insulin will determine whether you are going to lose weight. If insulin is high as a result of frequent eating or eating too many carbs, you are not going to lose weight if it is low the chances are you may lose weight but depending on your metabolism you may need to add some other things like intermittent fasting.

3. Stress/high cortisol (from injury, trauma, surgery, or loss)

You need to address the high cortisol issue for max effectiveness on keto.

If your stress is too high you have high cortisol you had a huge injury, surgery trauma, major loss, or loss of a loved one. That high cortisol can literally block the effectiveness of keto so you might need to do keto plus something that address stress. Dr. Berg has a lot of videos on cortisol.

Here is one, How To LOWER Cortisol Levels? https://www.youtube.com/watch?v=L2fKo_dbXS0

You are going to have to add some other things to keto.

4. High estrogen. Keto may help, but you also need to counter your high estrogen levels for max effectiveness.

For example you just got pregnant and you gained a lot of weight and your estrogen went up and from that point on you just could not lose weight because you have high estrogen. Is keto going to fix high estrogen? It may help but you might need to do something to counter this high estrogen level and this is why the information Dr. Berg has on body types where he talks about what to do for high estrogen and what to do for high cortisol.

To learn more please read the following posts.

Part One – What To Eat For Your Body Type? This Week Adrenal and Ovary Body Types. https://2healthyhabits.wordpress.com/2022/04/29/part-one-what-to-eat-for-your-body-type%ef%bf%bc/

Part Two – What to Eat for Your Body Type? This Week Liver and Thyroid Body Types. https://2healthyhabits.wordpress.com/2022/05/06/part-two-what-to-eat-for-your-body-type/

5. Hypothyroid. You need to work on your gut health as well as do keto.

If your thyroid is a problem that is going to not only affect your metabolism but 90% of hypothyroid cases are autoimmune, Hashimoto’s. In that case you might need to work on your gut because that is where the autoimmune cases originate. For more information please view these links:

Gut and Autoimmune Conditions:

6. Antibiotics. If you were on antibiotics and did not replace your good bacteria, you may have difficulty losing weight despite being on keto.

If you were on antibiotics and didn’t replace your good bacteria, you may have difficulty losing weight despite being on keto. A hidden reason why you are fat beyond carbs could be due to antibiotics. Antibiotics are known to cause weight gain.

Farmers fatten their cattle by putting them on antibiotics if you had an antibiotic you may find if you do not replace the good bacteria, a good probiotic, you may have a very difficult time losing weight despite going on keto.


You may need to alter the type of keto diet you do, trying more of a carnivore diet for a few months.

If you have SIBO (small intestinal bacterial overgrowth) you might need to alter the type of Ketogenic diet you do and do more of a carnivore for a couple months, which is a slight version of keto you are still in keto but you may not be able to deal with all the vegetables that are creating irritation in your gut.

8. Lack of exercise. Exercise has a very small effect on weight loss. It has a place and should be done along with the keto diet and intermittent fasting. But, exercise alone is not effective for weight loss.

Exercise has a very small effect on weight loss; it is about 15% of your weight loss success. 85 % is the Ketogenic diet with intermittent fasting.  Exercise does have a place and you should add it into the mix but realize that exercise alone is not going to solve your problem because if you are on a high carb diet and you are exercising you are not going to be that successful you might lose a little bit of weight but then you are going to plateau.

9. Liver problem or ascites. Keto can help, but you also need to do things to help repair your liver. Eating foods high in potassium may help.

A liver problem is where you have ascites (belly) where you have this fluid-filled gut well it might appear to be that it is fat and there might be some fat in the liver but you have gone past the fatty liver. Chances are you have cirrhosis in the liver and the liver is so damaged that it is leaking fluid into a sac around the gut. Is keto going to help that? It is definitely going to help that but you are going to have to also do some things for the liver to help prepare the liver to help get that fluid out and you are going to have to probably eat foods high in potassium to push that fluid out.

To learn more please read, Keto: The Best Fatty Liver Diet https://2healthyhabits.wordpress.com/2019/06/14/keto-the-best-fatty-liver-diet/

The Ketogenic diet is a powerful solution. But, it is important to realize that you may need to alter the plan and add additional things.

You also need to make sure you are doing the keto diet correctly. Doing “sort of keto,” dirty keto, or cheating while doing the keto diet may not be effective. I recommend a specific version of the keto diet called the Healthy Keto diet, which is much more effective.

You will not loose weight if you are doing sort of keto, or not consistently doing keto, or cheating, or have a cheat day. If keto is not working, try to find out are you actually applying it correctly because if you are doing sort of keto or maybe dirty keto with any ingredients from a fast food restaurant but they are not applying the Ketogenic diet correctly.

To learn more please see this post, How To Start Keto Correctly – For Beginners https://2healthyhabits.wordpress.com/2021/02/05/how-to-start-keto-correctly-for-beginners/

With more and more people gaining weight 71 % of adults being overweight in the US and 39.8 % of them actually obese, keto is going to become more and more popular but you might need to tweak the plan but then you also need to apply it correctly.

This Post has been condensed from Dr. Berg’s video, When Keto Doesn’t Work, This is Why. https://www.drberg.com/blog/when-keto-doesn-t-work-this-is-why

Dr. Berg is a chiropractor, who specializes in Healthy Ketosis & Intermittent Fasting, is the author of the best-selling book The Healthy Keto Plan, and is the Director of Dr. Berg Nutritionals. He no longer practices, but focuses on health education through social media. He has taught students nutrition as an adjunct professor at Howard University.

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Lydia Polstra


Author: 2healthyhabits

My goal in life is to experience the exuberance of true good health by returning my body to the healthy state it was meant to have.

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