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Use of a Low-carbohydrate, Ketogenic Diet to Treat Obesity

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Overweight and obesity have reached epidemic proportions in the United States. For individuals affected by obesity, clinical studies have shown that carbohydrate restriction, including a low-carbohydrate, ketogenic diet, can be a safe and effective treatment. This article includes a narrative review of clinical research studies and a practical description of implementing a “keto” diet for obesity.


The prevalence of overweight and obesity has increased dramatically over the years, with obesity levels now reaching 39.8% in the United States. 1 Obesity brings with it an increased risk for premature mortality and development of comorbidities, including hypertension, dyslipidemia, and type 2 diabetes mellitus. 2 Although in the past, many healthcare providers regarded obesity as a problem of “lack of will power,” now it is recognized as a disease by the Obesity Medicine Association (OMA) and the American Medical Association. 3,4 The designation of obesity as a disease compels primary care providers to become involved in its treatment, and has led to an increase in insurance coverage of its treatment.

Obesity medicine specialists are specially trained in safe and effective medical treatments that include nutrition, physical activity, and medications to treat and maintain long-term remission of obesity. 5 In fact, it is now possible for physicians to receive advanced training and a diploma from the American Board of Obesity Medicine (ABOM). 6 However, not all doctors need to become ABOM certified in obesity medicine, as many of the principles that obesity medicine specialists employ can be used in the context of a primary care practice.

The OMA publishes its guidelines for the treatment of adult obesity in the form of an algorithm, 3 in which obesity is defined as “a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in...