September 8, 2020

14 Ways to Tell if Keto Is Working for You Besides Weight Loss


Based on keto transformation pics on social media, it would be easy to think this very low-carb way of eating is used for just one thing: weight loss. And no doubt, the before and after pictures of people who’ve lost substantial amounts of weight are amazing. But low-carb and ketogenic diets are good for so many other things besides changing the size of your body. Some of these—like lower blood sugar, lower triglycerides, and lower blood pressure—can be shared via pictures of glucometers, home blood pressure cuffs, or printouts of your latest bloodwork. But what about the things we can’t see? What about all the great stuff keto does that you can’t capture in a picture? A picture speaks a thousand words, but what about the great things keto does that you can’t take a picture of? 

People use keto for fat loss, but what if you: 

A) Don’t want or need to lose weight, but you’re dealing with a laundry list of troubling health issues? 

B) Do want to lose body fat but you’re stuck in a stall and the scale hasn’t moved in a while? 

Well, if B is your issue, check out this article I wrote on how to stay motivated during a fat loss stall, and then grab a copy of my book, The Stall Slayer, to help break that stall. (I also encourage you to just stay off the scale altogether for a while.) 


Either way, here are 14 ways to know that keto’s working for you that have nothing to do with weight.

1.     Lower blood sugar

This is a no-brainer. If you don’t know that low-carb and ketogenic diets are an absolute slam dunk for improving blood sugar, I have just one question for you: how big is the rock you’ve been living under? Carbohydrate restriction is one of the most powerful non-pharmaceutical tools we have for improving glycemic control in type 2 diabetes (T2D), pre-diabetes, and yes, even in type 1 diabetes. Even the American Diabetes Association (ADA)—the most mainstream of mainstream organizations, as conventional as conventional gets—has acknowledged that carbohydrate restriction is a good way to go for people with diabetes. 

The ADA’s 2019 consensus statement said it loud and clear: “Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences.” 

Did you see that? “The most evidence.” “THE MOST EVIDENCE!”  

Some of the leading low-carb and keto researchers wrote papers a few years back that didn’t mince words, saying that carbohydrate restriction should be the default treatment and “the first approach” to manage or treat type 2 diabetes and metabolic syndrome. In fact, keto is so effective for lowering blood sugar that in patients with T2D who are taking insulin injections, sometimes insulin has to be discontinued on the first day they start keto. 

Type 2 diabetes gets all the attention with regard to keto, but people with type 1 diabetes can also benefit hugely from this way of eating. Do NOT confuse safe, beneficial, dietary/nutritional ketosis with dangerous ketoacidosis. They are not the same! Check out this video I did on type 1 diabetes for more info on using keto for type 1.  


2.     Lower blood pressure

Contrary to conventionally accepted information, in most people, hypertension (high blood pressure) has almost nothing to do with sodium intake and everything to do with chronically high insulin. Yup, our old friend hyperinsulinemia strikes again. In a small percentage of people, a high sodium intake can raise blood pressure, but for most people, it’s really the sugar and not the salt. (One of my favorite papers on this topic has a great title: “The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease.” The wrong white crystals – HA! 

Sodium is an essential nutrient, y’know. From the research I’ve read, diets that are too low in sodium are more harmful than diets that are high in it. Plus, it’s hard to separate the effects of sodium, itself, from the combined effects of sodium when it comes along for the ride with potato chips, fries, pizza, kettle corn, mac & cheese, and other sweet and starchy items.  

Here are two articles I wrote about this issue. There’s no byline, but they’re both by me: 

(Note: The company these were written for did a transition of the website a few years ago, and all articles written prior to the change somehow lost all their commas! So weird! They all just disappeared! So there are no commas in either of those posts. Just a warning should you decide to read them - which I encourage!) 

Don’t want to read? Here’s a video I did on insulin, blood sugar, and hypertension.

And for some intriguing mythbusting about salt, sodium, and blood pressure, I recommend the book, The Salt Fix. 


3.     Less brain fog

Hello…? *Taps microphone.* Is this thing on? I wrote a whole book about how keto can be beneficial for cognitive function and overall brain health. There’s no research specifically looking at keto for brain fog, but sharper thinking is a commonly reported observation from people who cut carbs. I wrote a blog post a while back on research suggesting that high blood sugar levels even still within the normal range are a risk factor for dementia 

Alzheimer’s and other forms of cognitive decline are only the most severe manifestations of the adverse effects of chronically high blood sugar and insulin on the brain. What about when things are in a much milder state? Could this be brain fog? Indeed, according to one paper, “… even in the absence of manifest type 2 diabetes mellitus or impaired glucose tolerance, chronically higher blood glucose levels exert a negative influence on cognition, possibly mediated by structural changes in learning-relevant brain areas.” 

So if chronically high blood sugar has a negative influence on cognition, then maybe lower blood sugar has a beneficial influence. 

Maybe. Just sayin’.  ;-)


4.     Less heartburn – maybe none!

Most people find that keto/low-carb makes their heartburn disappear. Gone! Finito! If you’re living with acid reflux or GERD, maybe you don’t have to pop antacids like they’re candy, and maybe you don’t have to give up your beloved spicy foods, chocolate, acidic foods, and whatever else some well-meaning but ignorant person has told you is causing your heartburn. Some of the keto doctors I know tell me that sometimes a patient’s GERD will resolve even before they’ve lost weight. That’s right—resolution of heartburn can happen that quickly, and it’s not the result of weight loss. 

Want to know more? I wrote an article and also did a video on keto for GERD/acid reflux with all the details you could possibly want, including links to some pretty fascinating papers scientifically substantiating the claims that GERD gets better when you cut carbs. So we have thousands of patient anecdotes, and we also have some solid science in this area.    

I’ll make a book recommendation for a book I have not read, but I’ve heard Dr. Eric Westman and Dr. Mike Eades both recommend. (If it's good enough for them, it's good enough for me.) Heartburn Cured, by Norm Robillard, PhD. (In a nutshell: do a low-carb diet. There, I just saved you a few bucks.) 

I can’t help sharing some excerpts from a paper on low-carb for GERD: 

In a cohort of obese women, after just 10 weeks on a low-carb diet, in all subjects with a confirmed GERD diagnosis, “all GERD symptoms and medication usage had resolved in all women.” That's right: within only 10 weeks, all subjects with GERD had complete resolution of symptoms, including women who’d experienced symptoms twice daily or as often as 5 times per week. All medication, both prescription and over-the-counter, was discontinued. 

The authors noted, “Contrary to long-held belief that higher fat intake promotes GERD symptoms; nationally representative data do not show a strong association between dietary fat and GERD. Thus, the present study provides important insights that contribute to the accumulating evidence of a role for dietary simple carbohydrates in GERD pathophysiology. We found that simple carbohydrates, particularly sucrose, contribute to GERD in obese women and the likelihood of having GERD was predicted by simple carbohydrate (total sugars) intake. 



5.     Fewer headaches and/or migraines

Migraines are NOT FUN. If you or someone you know suffers migraines – especially if they’re a chronic migraineur—then you know these are more than mere headaches. They are full-on, all-out neurological attacks. The good news is, keto seems to be highly beneficial for migraine. Learn more in this article I wrote, or check out this video. I also HIGHLY recommend listening to or watching this podcast featuring Angela Stanton, creator of the Stanton Migraine Protocol. She is helping a lot of people implement keto for migraine, because for this particular condition, it’s not just keto. You also have to be methodical about managing your electrolytes (especially sodium and magnesium), stress, and a couple other issues that aren’t quite as critical for garden-variety keto. Angela is truly an expert when it comes to using keto-plus for migraines. I learned a lot in that podcast that I wasn’t aware of before, which is why I’ve recommend it to everyone who’s ever written to me asking about migraine.   

I first learned about keto for migraine when I came across this paper about two sisters who started the Atkins Diet for the purpose of weight loss, and as an unexpected and happy little “side-effect” … *poof!* … their migraines went away! More recent research goes through multiple mechanisms as to why keto might be helpful for migraine. All I can say is, I’ve never had a migraine, but if I were living with these debilitating episodes, I would try keto. 


6.     Less intense hunger

If your appetite is better controlled on keto than it was on a higher carb diet, raise your hand. *Sees lots of hands go up.* Yep, that’s what I thought. I wrote an article a few years back where I addressed this issue of magically disappearing hunger on keto. It’s not that you’re never, ever hungry. It’s more that your hunger is manageable, right? It comes on gradually and builds almost pleasantly. And it’s a genuine, physical feeling of stomach emptiness, for lack of a better word. What it isn’t is “hanger” – the combination of hunger and anger that comes on suddenly and makes you simultaneously ravenous and infuriated, and moved to eat anything and everything in sight. (More on this with regard to hypoglycemia coming in point 7.) 

Most people (not all, but most) report well-controlled hunger and a more normalized appetite on keto. For some people, this is one of the nicest things about the diet altogether. For some people, going keto/low-carb helps them—for the first time in their life—go several hours comfortably without snacking or even thinking about food.  

A recent paper from Drs. Eric Westman, Tro Kalayjian, and colleagues, suggests that keto may be helpful for people with binge eating disorder (BED) and food addiction issues. Now that is some serious firepower. This study includes just three case reports, but hey, we’ve got to start somewhere. I’ve heard testimonials at conferences from people who were plagued with horrible binge eating, whose addictive tendency toward food either completely went away or got much better after going keto. Does this work for everyone? No. I wish it were that reliable. But it works for many, and if you are living with BED, I definitely encourage you to try keto if you’re not already eating this way. (And if you are already eating this way and the food demons are still torturing you, I recommend being very, very strict for several days. No net carbs, no keto junk. Do something like a strict Atkins induction or Page 4 Diet, and count total carbs. You will likely find beneficial effects you weren’t experiencing on whatever version of keto you were doing before, including normalization of appetite and eating behaviors.) 


7.     Fewer sugar cravings – maybe none! And no hypoglycemia.

I’m not aware of any research that proves keto reduces sugar cravings, but this is one of those areas where you can be your own judge. If you’re doing keto and you no longer think about sugar all day long, and you don’t fantasize about getting your next “fix” of that refined, white powdery substance, then you are your own research subject, and your result indicates that cutting carbs killed your cravings. 

I mean, honestly, some people are really, truly, addicted to sugar. They eat it all day long, think about it all day long, and have never gone more than a few hours without a “hit.”  For these people, finally being free of that physical and psychological demon is quite liberating. And for people with reactive hypoglycemia, getting off the blood sugar rollercoaster—the crazy carnival ride no one wants to be on—can be darn near lifechanging. No longer is there a need to keep candy in your purse or briefcase for when you’re ravenous and irritable. No longer do you need to memorize the location of every convenience store and vending machine within a ten-mile radius. Finally, you can go hours and hours feeling calm, steady, even-tempered, and not craving sugar. Here’s a video I did on hypoglycemia if you want to know more about how keto corrects this so easily. 

Of course, this isn’t magic for everyone. Some people go keto and still lust after their favorite sweet treats. I think for some folks, that’s just the way it is. Sugar is a tough, tough taskmaster. But if keto treats are a regular part of your diet (almond flour brownies, cookies sweetened with erythritol, etc.), consider ditching those for a while and seeing what happens. Don’t go keto only to trade a sugar addiction for a monk fruit addiction. Feeding the sweet-craving beast inside you doesn’t pacify it and make it go away; it makes it hungrier for more. Starve it to death by not giving it anything sweet, whether made with real sugar or keto sweeteners. (But as always, you do you! I am NOT opposed to keto sweets, and even if I was, I am not your food police. Use them if you’re happy with your results. If you’re not happy with how keto’s been working for you, though, maybe rethink those sugar-free chocolates and “keto” ice cream.)  


8.     Fewer gout attacks

Think you have to stop eating red meat if you have gout? Think again! I wrote a detailed article and also did a video on the actual cause of gout (it ain’t red meat, folks), and why carbohydrate restriction helps reduce frequency and severity of gout attacks – sometimes bringing them right down to zero. Hint, hint … maybe insulin has something to do with it. You can actually eat a relatively high protein diet (including the Atkins Diet) and improve gout – provided, that is, you cut carbs. You can’t make this stuff up. 

However, as I noted in both the article and video links above, if you have gout, it’s possible you’ll experience a few flares if you’re brand new to keto or coming back after being off-plan for a while. Why? Read or watch to find out, but the ten second explanation is, buildup of uric acid in the joints causes gout, and ketones compete with uric acid for excretion from your body. So when you have a bunch of ketones circulating in your blood all of a sudden, your body will get rid some of them first, leaving the uric acid behind to accumulate and possibly crystallize in your joints. Some people with gout sail through adapting to keto with no problems, but you need to be aware of this possibility of increased attacks in case it happens. The good news is, once your body adjusts to keto, the excretion evens out and you’ll likely have fewer gout episodes—maybe none at all.  


9.     Less severe PMS

This is a completely neglected area of research in the keto world! Wake up PhD students; let’s get those studies going! We know, however, that keto is dynamite for improving or normalizing hormones in women with PCOS, so why wouldn’t it also help for PMS? I can’t say keto is a miracle for every woman every month, but the interwebs abound with anecdotes from women who report less intense cramps, mood swings, bloating, and sugar cravings. (See point 13 for details on bloating.) Possibly also fewer skin breakouts, which you can read about in the next point. The reason I can’t link to a bunch of papers on keto for PMS is … they haven’t been written! Seriously, researchers, get going on this! 


10.  Clearer skin

Did you know that chronically high insulin is a major factor in various skin issues? Yep! Maybe acne doesn’t come from the “greasy” pepperoni and cheese on a pizza after all, but from too much of the crust, plus the breadsticks and soda people consume along with it. And maybe it’s not chocolate or cocoa, per se, that causes breakouts, but rather, all the sugar it’s usually sweetened with. And what about skin tags? Or do you or someone you know have dark, gray or ashy patches in places where the skin folds, like your knuckles, neck, or the back of your knees? This is called acanthosis nigricans, and it’s almost a sure sign you have chronically high insulin. (If you’ve never heard of this, see here for imagesNSFW!! Also, just a warning…they’re pretty shocking.) Check out this blog post or watch this video to learn about the role insulin plays in adult acne, skin tags, acanthosis nigricans, hidradenitis suppurativa, psoriasis, lichen planus, and more. 

All I can say is, metformina diabetes drug—has been used for dermatological conditions, and that kind of says it all. 


11.  Less joint pain

I can’t give you links to dive into on this because there’s pretty much no research specifically looking at the effects of carbohydrate restriction on joint pain. But improvement or complete resolution of joint pain is certainly something a lot of people report after adopting a low-carb or ketogenic diet. And the cool thing is, they report it long before they’ve lost a substantial amount of weight, which tells us that keto does great things for inflammation even when there’s not a lot of weight loss. And why would weight loss be tied to joint pain, anyway? Sure, carrying a lot of excess body fat can cause extra wear and tear on the joints, but there are plenty of people at a “normal” weight who have joint pain, so arthritis and other kinds of joint pain can be caused by things that have nothing at all to do with body weight. If we were to assume that weight loss is the “cure” for arthritis, what would we tell people with arthritis who are not overweight? Obviously something else is at play, and keto seems to address whatever that is. (This has always been a huge sticking point for me -- doctors and nutritionists blaming everything on excess weight in a heavy person -- even things that happen just as much to people who aren't overweight. No, excess weight is NOT always the cause of everything.) 

Some people experience improvements in arthritis without even going full-on keto. Paleo diets have been known to be very good for joint pain. Way, way back in grad school, I wrote a paper on rheumatoid arthritis and I cited research from well-known Paleo diet authority Loren Cordain, PhD, in which he explains how dietary factors (specifically from select modern foods) may be causing rheumatoid arthritis. Wheat seems to be one of the biggest offenders, so to the extent that a low-carb or ketogenic diet would dramatically decrease—or possibly totally eliminate—one’s wheat intake, it stands to reason that dietarily-induced RA would improve. 


12.  Improved erectile function

Fellas! Is this one a surprise to you? Does it blow your mind to know that chronically high insulin is a factor in erectile dysfunction (ED)? It’s true! If you happen to be a dude living with ED, then you already know it’s not due to lack of attraction to your partner (if you have one), nor from an overall decreased sex drive. So if it’s not that, what else might it be? Check out this blog post or watch this video to learn more about how elevated insulin affects at least three male health issues: erectile dysfunction, male-pattern baldness (particularly in younger men), and benign prostate hypertrophy (BPH, a.k.a. “enlarged prostate”). Don’t take this lightly, guys. Erectile dysfunction—particularly in young, seemingly healthy men who should be virile and raring to go at all times—can be an early warning sign (maybe the earliest) of insulin resistance and/or cardiovascular disease.) Can’t get it up? Your little soldier is trying to tell you something. Don’t ignore him. 


13.  Less bloating, fluid retention & swelling

Another area where there isn’t much research (if any), but pretty much anyone who’s ever tried a ketogenic diet—even if they didn’t stick to it long-term—can vouch for losing excess fluid. This is an argument the low-carb “haters” like to use against this way of eating – that all you lose is water. Right, okay. So the people I know personally who have lost over 200 pounds… that’s all water? Okay, sure. (*Insert eye roll.*) Ketogenic diets are natural diuretics, meaning they facilitate your body getting rid of water. How? Less insulin. Insulin stimulates increased retention of sodium, which results in increased water retention. (This is one of the many reasons why keto is good for lowering blood pressure. Some commonly prescribed drugs for hypertension are diuretics. So you can take a pill to help your body get rid of excess water, or you can cut carbs and let your body do it on its own.)  


14.  More energy & physical stamina

Again, no published research confirming this particular observation, but perhaps you’ve noticed it in yourself. If you’ve experienced something firsthand in your own body, you don’t need a randomized controlled clinical trial to tell you it’s a real thing. Some people who start keto and who were previously sedentary take up exercise or physical hobbies because they have more energy than they’ve had in a long time. They’re more active because they can be. This doesn’t mean that you jump out of bed first thing in the morning, ready to tackle the day sans caffeine. But you probably notice that you’re not dragging quite as much throughout the day, and that you have more oomph than you had in the past. Like so many other non-weight loss benefits of carbohydrate restriction, increased energy probably has a lot to do with no more wild ups and downs in blood sugar and insulin all day, and having access to a premium, steady fuel supply: fat. 

(If you feel like you’ve gone in the opposite direction and you’re more tired on keto than you were before, here’s some info on why that might be, and what to do about it.) 



15.  Improved mood – depression, bipolar disorder, anxiety

This is a very promising area of research. It’s starting to explode these days, with more and more psychiatrists and other mental health professionals beginning to understand the incredible potential of keto for a host of mental health issues. See here for a video in which I explained a few different mechanisms that explain why keto might be good for mental health. I feel fortunate to have a few psychiatrists who are well-versed in keto to refer clients to when their issues are beyond my scope of practice. I can help with the diet, but I certainly can’t manage someone’s medication and all that jazz. 

Anyway, new papers are coming out constantly looking at keto for bipolar disorder, schizophrenia, depression, and mood disorders in general. Really fascinating stuff, considering the horrible side-effects many psychiatric drugs induce. (Highly recommend listening to this podcast featuring Christopher Palmer, MD, a psychiatrist who has some fascinating case reports about keto for schizophrenia.) 

Note: If you have a mental health condition and keto hasn’t magically made it all better, you’re not alone. It doesn’t mean you’re doing something wrong, although there’s always the possibility that some tweaks to your diet could have profound beneficial effects you’re not experiencing now. Regardless, don’t beat yourself up if you’re living with some “stuff” and keto didn’t make it disappear. I wish it were that easy. (And so does my own depression.) 


*Whew!* I hope you enjoyed this whirlwind tour of great things keto can do for you besides weight loss. And even more, I hope it encourages you to stick to this way of eating to continue reaping the physical and mental health benefits, even if you’re disappointed with your weight loss. At this point, with everything I’ve learned about keto during the last 15 years or so, I’ve come to think that fat loss is one of the least impressive things this way of eating can do for a human being. (Not that we should dismiss fat loss, of course. That can be lifechanging! And we certainly can’t forget epilepsy…see here or listen to this podcast for a mind-blowing account of that.) 

I hope you didn’t mind the copious links to my blog posts and videos. This wasn’t intended to be a giant advertisement for my own work. Those links are there in case you want to learn more about any of these specific topics. (And look how long this post already is—over 4400 words—without me going into great detail about each of them. That’s what those links are for. Want more information? Read the posts or watch the videos.) 

I’ll have another post coming up relatively soon that will take this weight loss discussion in a different direction. And yes, I realize that “relatively soon” could be a year where my blog’s timeline is concerned, but the post is actually already written and ready to go! I just don't want to post it right away and end up going 6 months until the next one after that. Maybe I can get a small stockpile built up and start posting more regularly again.) 


P.S. Did you know that for $5/month on Patreon, you can get early access to blog posts and also exclusive patron-only videos? Yes -- I'm on Patreon! See here for details and ways to support my work if you enjoy my writing and videos. 


Disclaimer: Amy Berger, MS, CNS, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.


  1. Long time Amy. Great article, have sent to my daughters.

  2. Excellent list, Amy, and a great reinforcing reminder of all the benefits. It's so easy to forget the bad skin, bloating and heartburn! NSNG, indeed.

  3. wow that one was detailed and PERFECT. I've copied the link and emailed it out thanks Amy

  4. Wow - EXCELLENT - already copied and shared thanks Amy

  5. I've been keto/LCHF for four years. The first problems to go away were acid reflux and high trigs. The consistent energy levels have been a blessing, and of course all that fat weight has stayed off without constant hunger. In my book, the lack of constant hunger is the real game-changer for living a low-carb/keto life. I relied on your writings a lot the first few years to help me understand the process without getting tangled up in rules, sketchy products, and over-thinking. I appreciate all you've done for the low-carb community, and I still delight in your no-nonsense approach, recommending your work for people who ask me for good blogs.

    1. Thanks, AR! What a nice comment! I'm glad my work has been helpful. I hope people continue to find me in the vast sea of craziness that keto has become the last few years.

  6. Great blog...the weight loss has been great, but feeling so much better after 45 years of being overweight, PCOS, brain fog, exhausted, and ravenous (starving) from every diet under the sun. Why didn't anyone tell me it was too many carbs? I can do keto for the rest of my life. It has been great to focus and improve my health during COVID19. Now, I feel like the virus has no chance with me. I am so glad that my risk of dementia is less as well.