Can You Be in Ketosis & Still Not Lose Weight? 9 Quick Fixes

Weight Loss & Diets | Written by Nathan Petitpas | Updated on 24 January 2022

A man is running while wondering if he's in ketosis even after he took blood, urine, and breath ketones tests on top of avoiding alcohol and sweets.

If you’ve mindfully incorporated healthy fats into your weight loss efforts to achieve ketosis but the results diminished over time, you’ve probably wondered can you be in ketosis and still not lose weight? The short answer is yes, it is possible. But more importantly, why aren’t you losing weight anymore? 

There are plenty of variables that can hinder a person’s ability to lose weight even while maintaining a state of ketosis, but before we give you those quick fixes, it’s crucial to understand how the keto diet works and what’s happening when someone reaches ketosis.

If you understand ketosis fully, jump down a paragraph to diagnose why weight loss has stopped and learn to fix the underlying issue.  

How Ketosis Works 

For our purposes, all matters pertaining to the keto diet will be in reference to the standard keto diet, as it is the most thoroughly researched and reviewed. The standard keto diet is defined by an average macronutrient split of 55% to 60% fats (saturated and monounsaturated fats are best), 30% to 35% protein, and 5% to 10% carbs with the intent of inducing a ketogenic state [1]. When this diet is implemented, our bodies begin to utilize fat as a source of fuel (ketones) rather than the carbs that it typically uses.

In turn, this effectively lowers the BMI (Body Mass Index) of obese participants by a significant margin, making it a viable strategy to lose weight [2].

Before people let their frustrations get the better of them and dismiss the keto diet, let’s explore some of the factors that might be preventing weight loss with 9 quick and actionable fixes.

1. Test to Be Sure Ketosis is Achieved

Not being in ketosis is the most common reason people don’t lose weight on keto, it could be an array of reasons which you’ll see below.  Despite our best efforts, it’s possible to accidentally knock yourself out of ketosis (the fat burning state).

If you aren’t seeing results since starting keto, it’s best to check if you are actually in ketosis before looking into other factors. Again, the answer to “Can you be in ketosis and still not lose weight?” is yes, but we should begin with the fundamentals first. 

There are plenty of options for you to test yourself at home, some of which can be delivered right to your door! There are three forms of at-home keto tests; a finger-prick blood test, a urine test, and a breath test.

Blood Test: An at-home blood test is generally considered the most reliable and accurate way for people to test themselves and determine whether or not they are in ketosis. Not only does a blood test give you an accurate reading of whether or not you are in ketosis, but most blood tests involve a reader that will measure the volume of ketones in your blood, giving you significant insight into how effectively keto is working for you.

Its obvious drawback is that you’ll need to prick your finger every time you want to get a reading, making some users averse to the process. Luckily, there’s another reliable option on the market.

Urine Test: If you would rather not have to prick your finger every time you need to do a keto test, a urine test is the next best at-home option. Keto urine tests work similarly to a pregnancy test in that you’ll typically expose a physical strip to urine which acts as a sort of litmus test. The reaction, or lack thereof, of the strip, will determine whether or not you are in the keto state.

Unfortunately, many factors make the reliability of a urine test questionable. For example, something as simple as daily hydration can significantly affect the reading of a keto urine test due to ketone volume fluctuation. Another reliability issue is the efficiency at which your body is metabolizing ketones.

Suppose you get into a state of ketosis for a prolonged period of time. In that case, it is possible to have a false reading on a urine test for lack of ketones due to how efficient your body has become at metabolizing them. While the blood test may not be ideal and the urine test found to be less than reliable, there is a third option.

Breath Test: While the breath test might not be as accurate, if the other two don’t suit your likings then this is the next best at-home option. To understand how the breath test works, we need to understand what “keto breath” is.

Keto breath is a temporary symptom that manifests at the start of a proper keto diet when you enter ketosis. Excess ketones that are not used as fuel are expelled through our urine and through our breath in the form of acetone [3]. It follows that this temporary symptom could cause issues in test reliability, but in fact, it does not.

While the distinctive odor associated with acetone on the breath will fade, the presence of ketones will remain, making the breath test consistently reliable. While considered somewhat less accurate than the blood test, breath tests come close. The obvious appeal of the breath test is the ease of use, as there are no downsides to testing as frequently as you like. 

Lab Blood Test: If testing at home sounds like a hassle, or you would prefer a more comprehensive test and want to be absolutely certain about your keto status, you can visit a doctor for a more thorough blood test. Beyond controllable variables that might be keeping you out of ketosis, a blood test at the doctor’s office is an opportunity for you to gain insight into any medical conditions contributing to your inability to get into and maintain ketosis, which we will discuss later in greater detail.

It’s also important to recognize that dipping in and out of the keto state is quite common. Getting into a state of ketosis and consistently maintaining it are two different things. While it may not always be easy, maintaining the keto state is critical to the efficacy of the diet, and perpetually fluctuating in and out will not serve as helpful to weight loss.

If you’ve taken the appropriate steps to ensure that you get into ketosis, but are still not losing weight, it might be worthwhile to analyze your dietary approach.

2. Examine & Adjust Caloric Intake

Regardless if ketosis has been reached, as long as your calorie intake is higher than how much your body burns throughout the day, you will not lose weight. It is important that you find a balance in what you eat daily, as too few calories can make losing weight a challenge since it can trigger your body to go into “starvation mode.” Or in other words, when your body is at too much of a caloric deficit, it will begin to hold onto any fuel sources you eat, fat or otherwise [4]. 

Sure, counting calories can be a hassle, but if you find that what you eat has been a stumbling block to losing weight consider tallying up the calories to fix over or under consumption. Once you get use to counting calories and gauging how many calories certain foods contain, you can even step back and try an intuitive keto approach since your calorie estimates will be more accurate. 

Another powerful tool to help you and your keto arsenal is MCT oil. MCT oil is an easily digestible, healthy, fatty oil and will help you boost blood ketones. Add it to your coffee in the morning or to your dinner recipe for an easy boost in healthy fat content.

3. Count & Adjust Protein and/or Carbs

Excess protein and/or carbs can lead you to being in ketosis, and still not lose weight. It’s likely you have a sound understanding of what healthy foods are so you have no qualms when reaching for that second piece of grilled chicken at a BBQ. But did you know excessive protein can actually be a detriment for maintaining keto?

If you favor protein over fat in your meals throughout the day, your body will begin to break down the excess amino and convert them into “sugar”, throwing your body out of the keto state. Adequate protein is needed for weight loss, but do your best to hit your macros. 

Being vigilant of protein consumption is vital for weight loss, but the carbs you eat need to be watched even more carefully. If you have a craving for carbs, help yourself to low-carb vegetables like bell peppers, broccoli, and asparagus for manageable and minimal-carb sources.

4. Avoid Cheat Meals & Sugar

We’re all familiar with the term “cheat meal,” and many say you should reward yourself here and there; but unfortunately cheat meals can easily de-rail  a state of ketosis which you worked so hard to achieve. When the thought comes along, try your best not to squander your hard work by eating some low-carb berries or another food that’s enjoyable, yet still keto friendly.

Although, be sure to be wary of fad diets such as the pickle diet that promises to shed belly fat, but is a bad idea all around. 

Remember that the short-lived gratification of having unhealthy foods won’t outweigh dipping in and out of ketosis, which can impede results. Rest assured that while this might be tough in the beginning, much like sugar, these cravings will waver little by little as your body and mind adjust to your new approach.

Glucose (blood sugar) is ultimately the enemy of keto and sugar-free gum can help fight those dessert based cheat meals. 

Ps, sugar alcohols like Maltitol and xylitol can still spike blood sugar, but to a lesser extent than sugar. So use these in moderation, but they don’t need to be outright banned like sugar. To avoid sugar and cheat meal cravings, try to keep low-calorie, keto-friendly snack foods to eat like popcorn, baked cheese crisps, and pumpkin seeds

5. Mitigate Stress & Monitor Sleep

Stress will inhibit weight loss and can be the cause of a slew of health issues due to the production of cortisol. Cortisol is your body’s primary stress hormone and has many functions including increasing blood sugar levels [5]. Simultaneously, cortisol creates an environment where your brain requires additional glucose as fuel.

Unfortunately, this additional blood glucose will result in more difficulty when losing weight. Having strategies for mitigating stress is invaluable so it’s important to develop a routine that involves stress reduction techniques.

Meditation might be a foreign concept to some, but it is worth trying. Practicing meditation for as little as ten minutes per day is scientifically proven to lower our stress level and help with our mental health [6].

If meditation isn’t your thing, or you’d like to try something more active, spending time in nature is also a great way to reconnect with a peaceful state of mind. Exercise will also help mitigate stress and help you achieve your weight loss goals.

Even if you incorporate these stress reduction strategies, they may not work for you if your sleep patterns are erratic. The decreased energy and lack of concentration that comes from sleep deprivation will only add difficulty to your weight loss goals. Having a balanced circadian rhythm is critical to many, many health metrics. Further than bolstering our weight loss efforts through keto, getting quality sleep will improve almost all aspects of our health, so whatever you do, do not sacrifice restful sleep.

6. Enhance Keto With Exercise

If you haven’t made an attempt to get into an exercise routine yet, it should be a first stop before wondering if you can be in ketosis and still not lose weight. Not only will exercise work wonders for mitigating your stress levels, but it also stimulates your metabolism and enhance keto’s weight loss benefits

Not to mention, exercise will raise your resting metabolic rate (RMR) which is the number of calories burned throughout the day while at rest. The more you exercise daily, the higher this number will go. And who doesn’t want to burn more calories while resting, right? 

If you don’t have experience exercising for weight loss, know that you are not alone! Exercising, in the beginning, can be intimidating, but keep in mind that every person who’s ever set foot in a gym had to begin with the first step. If you don’t know where to start, the starting strength program is ideal for those seeking to begin weight lifting

7. Avoid Alcohol (Or Certain Types)

Avoiding alcohol entirely is best, but let’s be real. Many of us like to relax after a long week and have a drink or two with friends — and that’s okay! A sustainable reward system is important for a balanced life, weight loss, and even your well-being. With that being said, knowing what types of alcohol is suitable can help you maintain ketosis and still relax over the weekend.

Wine and beer tend to be highest in carbs and should be the drinks you should make an effort to avoid while trying to lose weight. While liquors such as vodka and gin are much lower in carbs so you can enjoy a few shots without the risk of dipping out of keto. Be sure to pace your drinks and remember that alcohol essentially has zero nutrients.

So long as we can be mindful of our intake, alcohol can fit into keto, and we can mitigate its impact by choosing low-carb options.

8. Intermittent Fasting to Jump-Start Ketosis

While intermittent fasting isn’t an essential component of a keto lifestyle, it can certainly help jump-start the process of entering the keto state [7]. It works to expedite the keto process because fasting will result in your body draining its glucose reserves over a short period of time, switching over to burning fat as a fuel source. A person can even get into a state of mild ketosis overnight as they sleep until they eat breakfast in the morning and break the fast.

Try choosing a span of six to eight hours that fits your schedule and eat food during that time — this includes calories from drinks! 

9. Test for Medical Conditions, Allergies, & Sensitivities

If all else fails, and you are still not losing weight, it may be time for you to consider underlying issues contributing to your weight difficulties. Schedule an appointment with your doctor to discuss potential causes of your inability to lose weight and/or weight gain. Conditions such as depression, diabetes, hypothyroidism, polycystic ovarian syndrome (PCOS), Crushing’s syndrome, hyperinsulinemia, or even interactions with existing medication could be holding you back from your weight loss goals. 

On top of that, understanding genetic dispositions and family history could be key to figuring out the best weight loss approach for a given individual. Be sure also to discuss whether or not you potentially have food allergies and sensitivities and ask if you can have a food allergy test. These tests tend to be exhaustive but are worthwhile if you’re uncertain.

While speaking with the doctor, it’s a good idea to ask about leptin resistance as well. Leptin is a critically important hormone that tells your brain when your stomach is full. A simple blood test can determine whether or not you are dealing with leptin resistance. If your leptin levels are low, you and your doctor can discuss a treatment plan to raise them back to normal and get your weight loss goals back on track.

If your keto weight loss efforts have been at a standstill and you still have weight to lose, take the time to implement some of these quick fixes — you might see improvement quick, or you may have to dry a few to figure out what’s going on. You’d be surprised on how much weight you can lose on keto if you implement these fixes into your keto journey. One of several of these solutions could be the answer if you’ve been wondering why you’re still not losing weight, despite being in ketosis.

We encourage you to keep trying different things and remember, if all else fails, check with your doctor to see why the weight loss has plateaued.   

References

[1] Masood, W. (2021, August 22). Ketogenic diet. StatPearls [Internet]. Retrieved December 6, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK499830/

[2] Dashti, H. M., Mathew, T. C., Hussein, T., Asfar, S. K., Behbahani, A., Khoursheed, M. A., Al-Sayer, H. M., Bo-Abbas, Y. Y., & Al-Zaid, N. S. (2004). Long-term effects of a ketogenic diet in obese patients. Experimental and clinical cardiology. Retrieved December 6, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/

[3] Alkedeh, O., & Priefer, R. (2021, January 19). The ketogenic diet: Breath Acetone Sensing Technology. Biosensors. Retrieved December 6, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835940/

[4] Benton, D., & Young, H. A. (2017, September). Reducing calorie intake may not help you lose body weight. Perspectives on psychological science : a journal of the Association for Psychological Science. Retrieved December 6, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639963/

[5] Dias, J. P., Joseph, J. J., Kluwe, B., Zhao, S., Shardell, M., Seeman, T., Needham, B. L., Wand, G. S., Kline, D., Brock, G., Castro-Diehl, C., & Golden, S. H. (2020, July 13). The Longitudinal Association of changes in diurnal cortisol features with fasting glucose: Mesa. Psychoneuroendocrinology. Retrieved December 6, 2021, from https://www.sciencedirect.com/science/article/abs/pii/S0306453020301177

[6] U.S. Department of Health and Human Services. (n.d.). Meditation: In depth. National Center for Complementary and Integrative Health. Retrieved December 6, 2021, from https://www.nccih.nih.gov/health/meditation-in-depth

[7] Intermittent fasting. Charlie Foundation. (2020, November 23). Retrieved December 6, 2021, from https://charliefoundation.org/diet-plans/intermittent-fasting/

About the Author

Nathan Petitpas

Nathan has been a fitness enthusiast for the past 12 years and jumps between several types of training such as bodybuilding, powerlifting, cycling, gymnastics, and backcountry hiking. Due to the varying caloric needs of numerous sports, he has cycled between all types of diets and currently eats a whole food diet. In addition, Nathan lives with several injuries such as hip impingement, spondylolisthesis, and scoliosis, so he underwent self-rehabilitation and no longer lives with debilitating pain.