Is the KETO Diet Good for PCOS?
Between the news and social media, I probably hear about the ketogenic diet at least once a day. I see women on PCOS facebook groups always talking about it, some swearing that it has helped so much while other saying that it is too hard to them to maintain. But the question is, is this really the diet to go on to manage PCOS?
The answer is not really, if you want a PERMANENT lifestyle change and a PERMANENT way to manage symptoms.
I know when you get diagnosed with PCOS, you will do anything to stop the weight gain or symptoms. Bu the truth is, another diet isn’t an answer. Women with PCOS are always told to loose weight to feel better but to be honest, my PCOS symptoms were the most prominent at my lowest weight😳. Moreover, the constant yo-yo dieting that often occurs when people do Keto, isn’t beneficial for our health as well. Unless you really genuinely love eating fat and protein, and no carbs - do not even try the Keto diet with PCOS. Yes, I know there are influencers out there who say that the keto diet helped but the truth is, it is often not the keto diet in itself but them simply practicing better eating habits. Meaning, that you can eat a balanced diet with protein, fats and healthy carbs - and get the same results.
Moreover, the Keto results are usually from someone going from eating an unbalanced and unhealthy diet, straight to Keto. Of course they will feel better and lose weight because they went to not caring at all to being really diligent as to what is on their plate. I am a firm believer that the results we see in the social media from the Keto diet, can also be achieved with a sustainable long term approach without so much restriction. Yes, it may take longer to see weight loss but it will be PERMANENT. Statistically, 95% of people who go on a diet gain the weight back within 1-5 years so a permanent solution for weight loss is the real #goals. Also, note that most of those influencers never stay on Keto, they go back to eating a more balanced diet that should have been implemented in the first place.
So lets dive into some science as to why I am against the Keto diet for PCOS, but first let's define what a keto diet is:
The ketogenic diet was created close to a century ago to treat epilepsy (1), but now it is a popular diet for weight loss. It is not simply a low carb diet. The goal is to get you in a ketogenic state where you shift your body from using glucose (the body’s preferred source of energy) to using ketone bodies from fat. This is made possible only if you consistently follow a high-fat diet where your daily calories are broken down as follows:
80% of calories from fats
15% from protein
5% from carbohydrates
By following the strict percentages and cutting out (perfectly nutritious) root vegetables, fruits, grains, and legumes, it will deprive your body of glucose (which it usually obtains from carbs), will force it to break down fat into ketone bodies for energy, and you will be in ketosis within two to four days (1).
Usually if following the keto diet, you may also have to track your macros to ensure you are staying within these ranges. This often means counting carbs, protein and fats IN ADDITION to practicing food group restriction.
Keto isn’t the life long diet you need to follow to manage your PCOS.
We know weight loss is often difficult for PCOS so you may be tempted to try keto for its weight loss claims. This low-carb diet is torture for women with PCOS. Women with PCOS often have insulin resistance which means that they have circulating insulin in their blood-stream. Insulin acts as an appetite stimulant.
Meaning women with PCOS crave carbs way more than an average person! And that is OK and NORMAL.
I used to think I lacked willpower around carbs but once I understand it is just part of my medical condition, I realized I need to eat carbs but just choose ones that are healthy and satisfying. The intense carb cravings is often why women with PCOS do not stick with Keto. Then they blame themselves for not being disciplined enough or having enough willpower, which is total BS. PCOS can have such a negative impact on our self confidence and worth and there we are feeling like failures because we are doing a diet not tailored towards us. Some women do claim their carb cravings are less intense when on Keto but personally that is not the case for me or hundreds of my clients. After trying low carb diets or Keto, they often battle with binge eating, stress eating and emotional eating. Suddenly, they really feel like they have no self-control (which isn’t true!).
Another thing that bothers me about Keto is that it doesn’t allow for moderation. I mean you can’t have a “cheat meal” with keto, you cannot enjoy your sons birthday cake, you cannot go on a date night and have popcorn or wine— the only way Keto works is if you constantly stay in ketosis. Yes, this means no wine either😩! If you are jumping back and forth, out and in from ketosis, you are causing more harm than good. Weight cycling aka yo-yo dieting has been proven to have negative health effects such as increasing cardiovascular disease risk and cancer risk.
It is also important to note, that Keto dieters don’t necessarily choose the most healthful foods or strictly follow the 80% fats requirement. They may eat more proteins than fats and choose sources high in saturated fats and salt. The shortage of fiber, fruits, vegetables, and carbs can actually cause kidney stones, vitamin and mineral deficiencies, and nonalcoholic fatty liver disease (2). The keto diet isn’t healthy when you are eating eggs, bacon and cheese everyday. Remember, women with PCOS have a 70% higher risk of elevated triglycerides and low HDL (good cholesterol)! Keto can help loose weight, but how good it will it be for your heart in the long term if you are solely focusing on eliminating carbs?
It is also important to note if doing Keto and you have diabetes - severe hypoglycemia is a risk (2) , because the carb restriction makes it difficult to manage blood glucose levels. It’s also not recommended for pregnant women because of the possible risk of hypoglycemia as well as birth defects in the embryo (3). Therefore, if you are planning on getting pregnant focus on implementing a diet you can continue to follow while pregnant and while breast-feeding. A long term healthy way of eating!
Long-Term Effects of Keto are Unknown!
As I mentioned above, keto is not a long-term diet (2)! While studies show fast weight loss, it is not concrete science. Limited studies show the long-term effects of keto on weight loss, blood glucose, and insulin (2). It is VERY difficult for studies to measure the benefits and risks because it is difficult for participants to commit ot this diet for the long- term. It may be YEARS before we get concrete science and trails. Also, remember, yes, it is possible to lose a lot of weight at the beginning but, unless you maintain the low-carb diet, chances are you will gain it all back when you start including more carbs. To be honest, choosing slow digesting carbs like beans, fruits, vegetables, and oatmeal is more nourishing than eating no carbs for PCOS.
When you are wanting to lose weight, you want to find habits you love and can follow for years to come (even if pregnant!) You can get the same benefits with a more suitable diet as you can with PCOS. Weight loss is possible with PCOS by implementing movement, slow digesting carbs and lean sources or protein. Finding movement that you enjoy! Finding healthy recipes that you have fun cooking! Learning to eat more veggies and fruit!
You know what?
That’s a healthy, nutritious lifestyle you can maintain for the rest of your life. We can’t say the same thing about keto! If you are interested in a balanced healthy lifestyle — you can start with a self love + health habit journal. BUT you need to fill it out daily to see results:)