Ketosis and Meal Replacement Therapy: How Low To Go?

How Low Can To Go?

What's My Goal?

The numbers on the bathroom scale get all the attention, but isn’t our real goal to reduce our body fat? Fortunately, that’s exactly what happens when your body doesn’t take in enough energy to satisfy its needs. First, it burns the glucose reserves (glycogen) in your liver, and muscles, which can be depleted in less than 24 hours, before switching to “fat-burning” mode.

Fat-Burning Mode (aka Ketosis)

In “fat-burning” mode, your body breaks down fats into ketones and uses them for energy. This process is called ketosis, and it’s the reason you hear so much about ketogenic diets, also called keto diets or simply keto. When you achieve ketosis, your body becomes incredibly efficient at burning fat for energy. 

In fact, it’s so good at it that it will preferentially burn fat for energy over glucose (carbs). This not only results in rapid weight loss, but also has a host of other health benefits, including improved mental clarity, decreased inflammation, stabilized blood sugar levels, and a feeling of well being.

...mental clarity, decreased inflammation, stabilized blood sugar levels

Very Low-Carb to go Keto

The key to achieving ketosis is to severely restrict your intake of carbs. When you do this, your body has no choice but to burn fat for energy. The problem is that most people don’t know how many carbs they should be eating, or what the right balance of fat and protein is. 

Further complicating matters, the human body requires adequate protein and will canibalize its own lean tissue if your diet does not provide enough protein. Extreme dieting can be dangerous to your health, and in some cases even fatal.

Medical Weight Loss

This was addressed decades ago in the medical community with the creation of Very Low-Calorie Diets (VLCD’s), which allowed patients to consume 500-800 calories each day, while eating low-carb (less than 70g) and low-fat (less than 15g), while also eating high-quality protein (75g or more). 

Patients routinely achieved significant weight loss, averaging as much as twenty pounds of weight loss per month for extended periods of time. 

In a study we conducted for WEA Trust Insurance (NAASO 2001), VLCD patients and bariatric surgery patients had comparable weight loss results at five years, which highlights the success of VLCD therapy.

...averaging as much as twenty pounds of weight loss per month

Popular Treatment Trends

Over the last two decades, VLCD’s have become less popular than a more balanced approach which includes both meal replacement therapy and traditional whole foods. This is sometimes called a “modified” or “partial” meal replacement plan, and there are many variations, both medical and commercial.
There are a number of reasons for the rise in popularity of these modified plans. First, VLCD’s are difficult for most people to sustain. This is because they are restrictive by nature and require a high level of commitment and self-discipline. Second, there is now a better understanding of the role whole foods play in maintaining gut health, which is fundamental for overall health and wellness.

Most approaches use shakes, bars and other nutritionally designed products, with one or two additional meals per day. This meal plan can still lead to rapid weight loss; however, The ketogenic effect is less pronounced and the rate of weight loss will be slower. Regardless, many find the less restrictive plan to be easier to follow.

How to Measure Ketosis

The most precise way to measure ketosis is by blood testing with a glucometer, which can be done in both medical and non-medical settings. Urine testing isn’t as accurate but may provide complementary information when used alongside blood tests. However, for the majority of people dieting, the amount of ketones present will not show up on an at-home urine test—that’s more fit for diabetics testing for ketoacidosis.

In most cases, it will take two to three days for the transition to a fat-burning metabolism. Over the first 24 hours you will burn up your carb reserves and shed water (think frequent bathroom breaks). You may get dizzy or lightheaded, and headaches are also a possibility. Stay hydrated and follow your nutrition plan and within the next day or so, you will begin to feel better. Your energy level and lack of appetite will be the best indicator that you are on track.

Final Thoughts

The bottom line is that if you want to achieve ketosis, you need to restrict your carb intake. However, there is no need to go to extremes. A more balanced approach, which includes both meal replacement therapy and traditional whole foods, is more sustainable and can still lead to rapid weight loss.
So, how low should you go? It really depends on your individual goals and preferences. If you’re looking to lose weight quickly and don’t mind being restrictive, then a Total Meal Replacement plan may be right for you. If you want to lose weight at a slower pace and are interested in maintaining gut health, then a Modified Meal Replacement plan may be a better option. Ultimately, the best approach is the one you can stick with long-term.

If you’re ready to make lasting changes in your life, our team is here to help. We have the experience and expertise necessary to help you create a personal plan that fits your lifestyle. Let’s get started today!