(Editor's Note: The following article is the first of a two-part series on attempts to use a ketogenic diet to improve health and lose weight. See below for Part II.)
One night last month, my wife caught me with my head buried in the refrigerator again and suggested we start a new diet. I thought, "Oh no, here we go again."
We have tried a few diets over the last four years and they always run their course the same way -- motivation to succeed, followed by frustration at minimal to no success, followed by feelings of starvation leading to even more frustration, followed by one infamous night of falling off the chuck wagon, followed by sadness, concluded by acceptance that I'm fat and that's just who I'm going to be.
Pushing the scales at about 225 pounds -- not quite my highest number ever, but obese according to health standards -- I knew something needed to change. And there were greater, more pressing reasons to try a diet thing again: reasons that included chronic high cholesterol, borderline hypertension, acid reflux, fatigue and a rotund gut.
My wife explained the ketogenic diet, then smiled at me and asked, "Want to do it?"
I returned her smile with a fake smile. "Okay."
Four weeks later, I've lost 15-plus pounds. Pants that I struggled to get into in April are practically falling off of me now, and I have reached a new belt hole I didn't even know existed. I feel good, really good. No heartburn. I'm not exhausted and out of breath when I tie my shoes, and I actually jog up the stairs at my office each day.
Laura Bottoms, one of two dieticians at Ireland Army Health Clinic, said it's not all that surprising.
"A diet that is high in fat has a high satiety level," said Bottoms. "People on it will overall eat less and self-impose a caloric restriction, but they feel satisfied because of how fat makes us feel."
Bottoms has been helping people at Fort Knox with their diets for about 13 years now. Though the ketogenic plan is not new, she said renewed interest in it is because many people are seeing real results.
"The ketogenic diet is just newly popular, but it's been around for years," said Bottoms. "Normally, it was used in treating children with epilepsy. That's been my experience with it, working with families with children with epilepsy that's difficult to manage with medications or the side effects of medications."
Diet plans that surge in popularity end up at Bottoms' office, where she researches them to determine their merits so she can properly counsel Soldiers, retirees and their family members who are seeking diet advice.
"Clients come in interested in it; they hear about it at the watercooler, church or on the internet, and they want to try it," said Bottoms. "Most people are looking for some strategy, some way to lose weight and lose it effectively."
More than 93 million adults living in the United States today are considered obese, roughly 40 percent of the adult population, according to the Centers for Disease Control (see link below). Closer to home, 34.3% of adult Kentuckians and 20.2% of adolescents in grades 9 through 12 struggle with it.
Add to it obesity-related health care costs that reach as high as $210 billion a year, it's no wonder many Americans are in the market for solutions that actually work.
"There's lots of strategies out there, and the challenge for people is finding one that works for them," said Bottoms. "The big challenge with weight loss in general is once the weight's there, it's really hard to lose it. Any time we force the body into some level of deprivation, the sustainability of that is questioned."
Although fast, effective weight loss is attainable with the ketogenic diet, Bottoms said people often misunderstand what it is.
"Keeping a moderate level of protein and a very high level of fat intake and a very low carbohydrate intact is very difficult to achieve," said Bottoms. "Most people who say they're often compensate for carbohydrates with a lot of protein, so really they're following more of a modified Atkins diet."
Because a true ketogenic diet can be difficult to follow, Bottoms explained that lasting success can seem elusive for most.
Many people also mistakenly think they're losing fat cells when they lose weight.
"We just empty them out," said Bottoms. "I think of them kind of like Tupperware. Once fat cells are there, we can fill them up very easily and we empty them out a little harder, but they're always kind of there."
My wife and I have been watching a lot of obesity shows lately. Oddly, many of them seem to be imported from England and Australia -- not sure why. Many have the same common thread running through them: People are eating too much of the wrong things, or just too much of everything.
In these shows, dieticians work on portion sizes and quality foods. These two areas are what my wife and I focused on with our diets. What surprised me was that I have never felt hungry. Instead, I struggle at night, after dinner, shortly before going to bed. It's like this panic alarm goes off in my head that says, "I need something to eat, now!"
But I'm actually not hungry; well, not the kind of hungry where I need to sit down and eat.
Some of the documentaries we have recently watched suggest there is nothing you can do about obesity. Scientists on these shows blame it on genetics. During one show, a doctor emphatically said while we may see short-term successes, long-term success is ultimately unattainable for the vast majority of folks.
Bottoms doesn't agree entirely.
"Is it a nature versus nurture issue? The research is showing that there is a little bit of nature, but I think there's a lot of nurture going into eating and food," said Bottoms.
She suggests that a bigger problem manifests itself when we impose restrictions on our diets that are too strict and unrealistic. Much like a pendulum, motivation and excitement to succeed eventually gives way to overindulgence when we hit the wall in a restrictive diet.
"What I work with clients on is, 'How do we get to that middle?'" she said. "How do we eat in a way that is going to support us in our goals and support us in health but also build a healthy relationship with food so that we don't feel restricted."
Maybe that's where I am at the moment.
On May 17, my wife and I attended an appreciation dinner at a popular local restaurant. We prepped by going down a list of things to avoid with a plan on what we should eat -- stay away from carbs, stay away from sugary stuff like desserts and fruit, focus on fats, veggies and proteins. Bread? Bad. Small steak? Good. Avocado? Great.
In our eagerness to go out and socialize with friends, we arrived on time but apparently early by the others' standards. Within two minutes, a waitress took our drink orders -- unsweetened tea for my wife, water for me, thank you -- and set down a basket. Right in front of us. With four beautiful, perfectly glistening buttery bread rolls inside.
"Seriously?" I whispered to my wife. She cringed. The night was starting off on the wrong track.
Before it ended, we both had downed two rolls. That was the first bread either of us had touched in a month. We went to bed filled with bread -- and dread. The next morning, we woke filled with regret. It felt a bit like we were starting all over.
I began to internally analyze the situation. "Did I gain huge amounts of weight?" No, probably not any. "Does that make the ketogenic diet wrong for me?" Absolutely not. "Does it work?" It sure does. "So what went wrong, then?"--
Suddenly, I remembered what Bottoms had said about diet plans that are too restrictive.
Like any other diet, keto isn't necessarily right for everyone, according to her.
"If you've got a strong family history of colon cancer, I'm probably not going to recommend you do keto," said Bottoms. "But if you don't and you just have a risk of obesity, these are foods you enjoy, and your lifestyle supports it, it may be worth a shot.
"But it's definitely not a one-size-fits-all."
Bottoms recommends calling one of the four dieticians who work at Fort Knox -- two at Ireland, one at the Veterans Administration and one at 19th Engineer Battalion -- to get some sound advice. Clients can call Central Appointments at Ireland and be seen without a referral. The dietician will discuss the latest plans and work up a strategy tailored for each person.
For me, keto is the way to go. This morning, I was shaving when my wife walked by and smiled.
"You're looking great!" she said.
I returned her smile with a sincere smile. "So are you."
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