Extreme obesity is one of the biggest health related challenges in the developed world. Medicine is trying to help the patients with a debilitating obesity with more or less invasive methods, one of them being intragastric balloon. However, relying solely on the medical procedures is never quite enough: patients need to change their life-style and eating habits.

But what to recommend to the patients so they can get the most bang for the buck?

The Obesity Surgery journal has a hint. The published a paper by Genco et. al., who actually tested what works better: low calorie regular diet or low calorie ketogenic diet?

They recruited 80 individuals with average BMI 37. These qualified for insertion of intragastric balloons. The first four months after the insertion, all patients underwent a normal low calorie diet: at least 65% of daily energy from carbs, 0.8 to 1 g of protein per kg of ideal weight, the rest of the 1000 kcal plan consisted of dietary fats). Average weight loss in this period: 10.2 kg.

Four months into the study, the patients were randomized to two groups. One was prescribed a low calorie ketogenic diet, the other continued the original diet. The ketogenic diet was structured as follows:  less than 50 g carbs a day, 1.2 protein per kg of ideal weight, the rest: dietary fats).

Results once again proved the efficiency of ketogenic diet, as the keto group lost 19 kg on average, whereas the “normal low calorie” diet resulted in 12 kg lost on average. In the group of 80 patients, there were 36 with diabetes: in keto group, diabetes symptoms subsided in 11 of 15 participants, in the “normal” diet group only 2 of 11 saw an improvement. Similarly, the keto group saw triglyceride levels improvement in 11 of 14 patients, in the “normal” diet group, only 2 of 16 achieved TG levels improvement.