Participants met with researchers 10 times over a four-month period. During 4 of the 10 visits, researchers analyzed participants’ blood and body fat for changes in body weight, hormones, ketone bodies (which are produced during ketosis), and muscle losses. After 60 to 90 days, participants were gradually taken off ketosis and placed on a low-calorie diet consisting of between 800 and 1,500 calories per day, and then a maintenance diet consisting of 1,500 and 2,000 calories, depending on the participant. Out of the 20 participants enrolled in the study, 12 completed the regimen and lost about 44.5 pounds each.
Despite the efforts to decrease weight loss, obesity prevalence is increasing worldwide [36]. The obesogenic environment and the unsuccessful effect of current treatments are consistently contributing to an increase in obesity prevalence. Obesity is promoted by several factors, including genetic, environmental, metabolic, and behavioral factors [8,11,37]. These same factors are involved in the unsuccessful effect of many weight-loss therapies [38]. Apart from the biochemical and genetic factors, in the literature, obesity has consistently been related with a poorer quality of life [39] and lower self-esteem and lower life satisfaction [40]. Additionally, food addiction was proposed as a plausible causal factor contributing to obesity and weight regain after a weight-loss therapy, at least in the same individuals [41]. Therefore, it is important to control these factors to attain success in weight-loss therapy. In this context, a VLCK diet has previously been shown to induce severe body-weight loss that has been maintained for at least 2 years after dieting [6]. This nutritional weight-loss method resulted in the beneficial effects of decreasing body fat mass by preserving body muscle mass and strength [4] and maintaining the resting metabolic rate [7]. Thus, the new open question was whether the beneficial effects of this nutritional method on body composition and energy metabolism are associated with a modulation in the psychobiological phenomena of obese patients.
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]

We have a super supportive group of “squeakers” over on Facebook who love helping newbies with questions and cheering on everyone’s weight loss progress and Non Scale Victories (NSV’s). Join us over there and see the radical results the SCKC is having on so many people!  And stay tuned for my new book Squeaky Clean Keto – which will include over 120 new SCKC and Whole 30 friendly recipes, and at least 4 weeks of new meal plans!


I think you may be experiencing what I did on an ultra low carb diet. I did try to follow the "20 grams of carbs" approach but it didn't work for me. I felt sluggish, I was tired, and anxious (especially that anxiety!). Having said that, I have Hashimoto's (autoimmune hypothyroid condition) and I can't do very low-carb for that very reason. These days I eat 20-30 grams of net carbs, sometimes up to 50, especially after a workout when my body naturally craves carbs. Keep in mind that some people tend to overemphasise the importance of high ketones while it's not as simple and most people don't even need high ketones: The Ketone Craze - Who Really Benefits From High Ketone Levels? I hope this helps!
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In steps 4 or 5, the ketogenic phases were ended by the physician in charge of the patient based on the amount of weight lost, and the patient started a low-calorie diet (800–1500 kcal/day). At this point, the patients underwent a progressive incorporation of different food groups and participated in a program of alimentary re-education to guarantee the long-term maintenance of the weight loss. The maintenance diet consisted of an eating plan balanced in carbohydrates, protein, and fat. Depending on the individual, the calories consumed ranged between 1500 and 2000 kcal/day, and the target was to maintain the weight lost and promote a healthy lifestyle.
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