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Understanding Ketosis in the Weight Loss Surgery High Protein Diet

Often when we hear about a diet that puts the body into a state of ketosis, we often fear that we’ve heard that ketosis is a potentially dangerous blood glucose imbalance that results from a low-carb, high-fat, high-protein diet. Ketosis occurs when the body switches from burning glucose for energy to burning ketones for energy. Glucose comes from carbohydrates, which are the body’s first choice for metabolizing energy. Ketones are used for energy when there is not enough glucose (from carbohydrates) present in the bloodstream to use for energy.

Clinically stated: “Ketosis is a condition in which there are elevated levels of ketones (ketone bodies) in the blood. Ketones are formed when glycogen stores in the liver are depleted. Ketones are used for energy. Ketones are small carbon fragments that are fuel created by the breakdown of fat supplies. Ketosis is a potentially serious condition if keynote levels go too high.”

Most bariatric surgery patients are instructed to follow a high-protein, low-carbohydrate, low-fat diet. The body only needs protein and fat to build and repair tissues and cells, carbohydrates do not play a role in this metabolic function. In addition, the body can get all its energy from fats and proteins. First developed in the early 20th century, the ketogenic diet is a high-fat, low-carbohydrate diet. When following a ketogenic diet, the body switches from a carb-burning machine to a fat-burning machine. As a result, weight loss occurs.

Perhaps the best-known ketogenic diet is the Atkins plan, in which ketosis is intentionally achieved through a high-fat, high-protein, low-carb diet. According to the Atkins program, proper monitoring with urine tests will keep ketosis within safe limits and the dieter can achieve ideal body weight without suffering from excruciating hunger. Most patients after weight loss surgery are discouraged from following an Atkins-type diet because of the high fat content. Surgery reduces the amount of gastric juice available for digestion, and many patients cannot tolerate high-fat foods.

When talking to the general population (not necessarily weight-loss surgery patients), experts differ on the health risk versus benefit of the ketogenic diet. Some experts say this is dangerous because if key tone levels are not properly monitored, it can strain the kidneys and a significant loss of calcium excreted in the urine can cause kidney stones or osteoporosis. Proponents of the ketogenic diet cite human evolution in their argument that for most of human existence we were hunter-gatherers living in a ketogenic state for long periods of time. Documented studies indicate that after 2 to 4 weeks of adaptation, human physical endurance is not affected by ketosis. Some studies go so far as to suggest that people don’t necessarily need a high carbohydrate intake to replace depleted glycogen stores for energy.

Patients undergoing weight loss surgery should work closely with their bariatric center to develop a diet and lifestyle program specific to their obesity status and recovery. While many consider the primary goal of weight loss surgery to be weight loss to improve physical appearance, the higher goal is to improve health, energy, and longevity.

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