Weight Loss

Not losing weight on keto? 7 reasons why

January 27, 2025

Written by Chandana (Chandy) Balasubramanian

Medically reviewed by Rita Faycurry, RD

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Contents

Key Points

  • It’s natural to hit a weight loss plateau on keto. It’s a hard diet to follow, especially in the long term.
  • Weight loss plateaus on keto often stem from hidden carbs, excessive calorie intake, overlooked lifestyle factors like stress and sleep, and underlying health issues
  • Successful weight loss on keto requires proper nutrition, regular exercise, stress management, and figuring out what works best for your unique body
  • A registered dietitian can provide personalized guidance to support your health goals

Raise your hand if you’re in a love-hate relationship with the keto diet. You’re doing everything right: carefully planning each meal and tracking your macros. But the scale refuses to budge.

“While the ketogenic diet can be a powerful tool for weight loss, it’s very restrictive and can be difficult to sustain over time,” says Rita Faycurry, RD, Registered Dietitian. “However, in my practice, I’ve seen that personalizing nutrition plans for each person is the best way to lose weight on keto.”

Before we dive into your keto weight loss plateau, let’s discuss what makes this unique diet tick.

How does the keto diet lead to weight loss?

What is the keto diet?

The keto diet is a low-carb, high-fat weight-loss diet. This extreme low-carb diet was created to force the body to use fat as fuel instead of glucose—a process called ketosis.

The original keto diet involved eating 75-90% fat, 10% protein, and 5% carbs. It was developed to treat severe epilepsy in infants and children under strict medical supervision, not for everyday dieting.

Faycurry, RD, explains, “The keto diet you read about is a modified version of the original. Most people who follow this diet today do not achieve ketosis. But that’s okay! It’s possible to achieve weight loss with a modified keto diet, even if you’re not in ketosis.”

Let’s look at how keto is meant to burn fat.

How does keto burn fat (what is ketosis)?

When you switch to a very low-carb diet, you’re essentially enrolling in an intensive fat-burning language immersion program.

When you eat fewer calories from carbs, your body starts producing ketones—molecules that serve as an alternative energy source for your brain, heart, and muscles. This process forces your body to use body fat for energy.

Says Faycurry, RD, “Here’s the thing: our bodies are designed to burn glucose for energy by default. So, very few people can stick to a ketogenic diet for a long period of time. Plus, it’s common to hit a weight loss plateau, no matter what diet you’re on, including the keto diet. A registered dietitian can help you personalize the macronutrient ratio for your goals and lifestyle.”

Reasons why you’re not losing weight on keto

1. Sneaky carbs

Hidden carbs might be sabotaging your keto success without you even knowing it. To lose weight on the modified keto diet, your carbs must stay between 20-50 grams daily. That’s just 5-10% of your daily calories on a standard 2000-calorie diet.

“Many of my clients are surprised to learn they’re consuming more carbs than they realize,” says Faycurry, RD. “Common culprits include sugar-free products, keto-labeled cereals, and even some granola marketed as low-carb. Watch out for condiments too.”

Here are some common hidden carbs:

  • Sugar substitutes like maltitol can affect blood sugar despite being marketed as keto-friendly
  • “Keto-friendly” processed foods that may contain fillers and starches
  • Certain vegetables that seem low-carb but add up in larger portions
  • Dairy products, especially flavored varieties
  • Nuts and seeds, which can be easy to overeat

Consider tracking your meals for a few weeks to detect repeat offenders. A registered dietitian can help you identify potential issues and overcome a weight loss plateau.

2. Consuming too many fat calories

While the keto diet is designed to help you burn fat, the fundamental principle of weight loss applies—you still need a calorie deficit. Fat contains more than twice the calories per gram compared to protein or carbohydrates. Depending on your fat intake, you may be consuming too many calories (yes, that includes healthy fats).

Common high-calorie pitfalls on a keto diet include:

  • Liberal use of cooking oils and butter
  • Excessive snacking on nuts and seeds
  • Large portions of fatty meats
  • Multiple servings of “keto-friendly” desserts

“For those struggling with calorie intake on keto, I always recommend focusing on filling, low-calorie foods,” says Faycurry, RD. “Try building your meals and snacks around non-starchy whole vegetables paired with lean proteins. Keep healthy fat portions small. These choices keep you feeling full but also add variety and flavor to your keto journey while you see fat loss."

3. Poor diet quality

While hitting your macro ratios is important, your body needs a full spectrum of nutrients to thrive and achieve healthy weight loss. Nutrient deficiencies can slow your progress.

“Many of my clients see dramatically better results when we focus on nutrient density alongside their macro goals,” says Faycurry, RD. “Poor gut health can prevent you from losing weight, even in ketosis. Your body needs micronutrients from leafy greens, cruciferous vegetables, and high-quality proteins. ”

Quick tip: Think beyond macros. Fill half your plate with low-carb vegetables, choose grass-fed meats when possible, and include fermented foods like kimchi or sauerkraut to support your gut health.

Keep in mind that nutrition isn’t one-size-fits-all. What helps one person thrive on keto might cause subtle inflammation in another. A registered dietitian can help identify your personal food triggers and create a customized keto diet plan that works best for your body.

4. Lifestyle factors may affect weight loss

The success of a ketogenic diet doesn't exist in isolation—it's deeply intertwined with your overall lifestyle. Many people focus solely on food choices while overlooking crucial lifestyle factors that can make or break their weight loss efforts.

"Diet is just one piece of the puzzle," explains Faycurry, RD. "Your daily habits and routines play a massive role in how your body responds to dietary changes."

5. Stress and sleep quality

Stress and poor sleep can quietly undermine your keto diet efforts, even when you’re diligently tracking macros. When stress levels remain elevated, your body produces excess cortisol, a hormone that not only triggers cravings but also promotes fat storage. This stress response can lead to weight gain and derail your progress even if you’re maintaining strict ketosis.

Sleep quality plays an equally crucial role in weight loss through its effect on hunger hormones. Research shows that inadequate sleep disrupts the delicate balance between ghrelin (your hunger hormone) and leptin (your fullness hormone).

This hormonal imbalance can intensify cravings and increase appetite, making it harder to maintain your keto eating plan. That’s why quality sleep should be considered just as important as maintaining proper macros for successful weight loss on keto.

6. Lack of physical exercise

Regular exercise can be your secret weapon on keto, even if it doesn’t burn hundreds of calories. Think of movement as your body’s tune-up; it helps your metabolism burn fat more effectively, maintains muscle mass, and makes your cells more sensitive to insulin.

You don't need to train for a marathon. Even daily walks or simple strength training can help you break through weight loss plateaus.

"Movement helps optimize your body's fat-burning machinery," says Faycurry, RD. "Many of my clients find that adding just 20-30 minutes of daily activity helps restart their weight loss, even without changing their diet."

7. Hormonal imbalances and medical conditions

Several medical conditions can significantly impact your weight loss journey on keto:

Your hormones have a close relationship with weight loss. These powerful chemical messengers influence how your body burns fat, even when you're following your keto plan perfectly.

Think of hormones as key players in your metabolism. They influence everything from how hungry you feel to how easily your body burns fat.

"Often, people blame themselves for lack of progress when there might be a medical issue at play," notes Faycurry, RD. If you suspect an underlying condition, work with a healthcare provider to address these issues along with your dietary changes.”

How to break through the keto weight loss plateau

Consult a registered dietitian

The most effective first step in optimizing your keto journey is consulting with a registered dietitian who specializes in keto diets. These experts can assess your unique needs, medical history, and lifestyle factors to create a personalized plan that works for you.

Focus on precise tracking of food intake

Once you have professional guidance, focus on precision, at least in the short term. Track your macros using reliable apps, measure portions carefully, and log everything from cooking oils to seasonings.

Remember that successful weight loss on keto isn't just about cutting carbs; it's about creating a sustainable approach that works best for your body and lifestyle.

Incorporate lifestyle changes

Managing lifestyle factors can significantly boost your results. Incorporate regular exercise into your routine: even a 30-minute daily walk can make a difference. For stress management, consider calming practices like yoga or meditation, which can help regulate cortisol levels that affect weight loss.

Creating a consistent sleep schedule, limiting screen time before bed, and maintaining a cool, dark bedroom environment can improve your sleep quality. These lifestyle adjustments, while simple, can enhance your body’s ability to maintain ketosis and support your weight loss goals.

Focus on whole foods and mindful eating

The key to successful weight loss on the keto diet is choosing nutrient-rich whole foods. Focus on high-quality proteins, vegetables, and healthy fats while keeping your carb intake low. This naturally helps manage your calorie intake while giving your body the nutrients it needs.

"Quality matters as much as counting macros," says Faycurry, RD. "When my clients choose whole foods and pay attention to their hunger signals, they typically find it easier to stay within their goals."

Keto alternatives: when to try something different?

While the ketogenic diet can be effective, it's not the only path to sustainable weight loss. So, if you have been trying the keto diet for a while, but it doesn’t seem to work? It’s okay. There are other ways for you to reach and maintain a healthy weight.

Here are some reasons why you may consider a different path to weight loss:

  • When not losing weight on keto is affecting your mental health
  • If you’re concerned that the intense keto food rules may trigger an eating disorder or disordered eating
  • If cutting carbs triggers binge eating episodes or intense food cravings

Intermittent fasting

You could consider experimenting with intermittent fasting, which involves consuming daily calories within a limited time frame while fasting for the rest. Note: intermittent fasting is not for everyone. Please consult your healthcare provider before you start any diet involving fasting.

Mediterranean Diet

A more balanced weight loss approach may be the Mediterranean diet. It’s based on balanced meals and offers sustained weight loss in the long-term.

The best diet is one that you can maintain long-term while meeting your nutritional needs. Consider your lifestyle, preferences, and health goals when deciding if keto is right for you. A registered dietitian can help you navigate this process.

Start losing weight on keto. Find a weight loss dietitian near you, covered by insurance.


Frequently Asked Questions (FAQs)

Can I lose weight on keto without tracking calories?

Creating a calorie deficit is still essential for weight loss. Consuming too many calories from high-fat, low-carb foods can hinder your progress. Tracking helps ensure you’re not unknowingly overeating.

Research shows that food tracking can help with weight loss success. People who take a few minutes each day to log their meals tend to see better results than those who rely on guesswork alone.

However, if you are concerned about keto triggering an eating disorder, skip the food tracking. There are other ways to achieve your weight loss goals.

How long before I see results on keto?

The timing and rate of actual weight loss can vary significantly from person to person based on factors like metabolism, starting weight, activity level, and how closely you follow the diet.

Could medications affect my weight loss on keto?

Faycurry, RD, says, “Some medications can impact your weight loss efforts. Common examples include certain steroids, diabetes medications, antipsychotics, and some antidepressants. Always consult your healthcare provider before making any changes to your medications.”

Break through that weight loss plateau. Reach out to a weight loss dietitian near you, covered by insurance.


The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.


Sources

Fay Nutrition has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

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Chandana (Chandy) Balasubramanian

Written by Chandana (Chandy) Balasubramanian

Chandana Balasubramanian is an experienced healthcare executive who writes on the intersection of healthcare and technology. She is the President of Global Insight Advisory Network and has extensive experience working in the medical devices and life sciences industries. Chandana holds a Master’s degree in Biomedical Engineering from the University of Wisconsin-Madison, USA.

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Rita Faycurry, RD

Medically Reviewed by Rita Faycurry, RD

Rita Faycurry, RD is a board-certified Registered Dietitian Nutritionist specializing in clinical nutrition for chronic conditions. Her approach to health is centered around the idea that the mind and body are intimately connected and that true healing requires an evidence-based and integrative approach that addresses the root cause of disease. In her books and articles, Rita offers practical tips and insights on how to care for your body, mind, and spirit to achieve optimal health and wellness.

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