Hey, everybody!

I see the questions being asked, especially by those new to the lifestyle, as to why they have cravings or are still hungry. I think the reason behind it should be taught in junior high biology along with sex education, but then again, I think financial planning should be taught before kids are able to get jobs, so... here's what I've learned after being in ketosis for two years, in an annotated stream-of-consciousness format. Feel free to correct me if I'm wrong on any of it.

I think the ignorance behind how our bodies work is also why we get a lot of hate directed at us and our lifestyle by those in the main forums. The "Calorie is a calorie is a calorie" myth is trotted out all the time, and although it's technically true, it's not the big picture. I'm mildly autistic (Asperger's) and have trouble with keeping a limited scope of knowledge on certain topics that I find interesting. The subject of biochemistry is definitely intriguing. Everything here is easily found on Google with the right search terms, and I'm bored and have nothing to do at work. The numbers in parentheses are the corresponding references at the bottom.

To start: we should all know by now that nutritional ketosis is NOT Diabetic Ketoacidosis (which is why our lifestyle is dangerous to Type I diabetic patients) and it is NOT *Atkins* as everyone seems to call it so as to more readily dismiss it (0). Atkins Phase 1 (Induction) is the closest to keto, but Atkins Induction limits the food choices and recommends 56% calories from fat, 38% from protein and ~6% from carbs and just increases the carbohydrates from there. It's generally thought of as a "low-carb/high-protein" diet, and this is where the biggest misconceptions about keto come in. The macronutrient ratios recommended for keto are generally 65%/30%/5%, if not higher fat and lower protein. It is "low-carb/high-fat/moderate-protein".

As far as Atkins goes, they specifically steer away from being labeled "high-fat". Fat isn't the problem, though... It's misconceptions.The reason that a lot of people put the pounds back on when following the Atkins Diet is because of adding carbs back after getting used to not having to count calories during dietary ketosis (induction), leading to increased insulin resistance, cravings and eating over TDEE. There is a misconception that it's an "all meat diet", which we all know is not true either. People dismiss it out of hand by saying that it's too expensive to buy lobster tails and salmon all the time; in reality, eggs, cheese, fresh ground chuck roast, and pork sausage is WAY cheaper than pre-made Weight Watchers or Zone diet meals. People claim that following Atkins leads to cardiovascular issues, but the study that showed there was no difference between diets had the Atkins group at 190g of carbohydrates at the end (1). Hardly ketogenic!

Dr. Atkins was on to something, though. The Induction phase, which was only recommended for 2 weeks up to a few months if someone had a lot of fat to lose, was intended to put someone into ketosis. Why? Because of the epidemic of Insulin Resistance. I'm sure we all know what Insulin is; a hormone released by your pancreas in response to carbohydrates (and to a degree, protein) entering the bloodstream. Do we all actually know what insulin does? IT STOPS YOUR BODY FROM USING FAT AS FUEL. (2) The more carbohydrates you take in, the more insulin is released, leading to becoming acclimated and developing a tolerance to it. Then you eat more and more to release more and have the same effect. Insulin is the hormone your body uses to tell the cells "Hey guys, store this fuel as BODY FAT!" This triggers cravings and leads to obesity because your body can't burn off all the food you take in and has no choice but to convert it all to body fat (3), which greatly enhances the risk of Metabolic Syndrome (4), which is all directly linked to Type II Diabetes (5). Metabolic Syndrome is even sometimes called Insulin Resistance Syndrome.

It's been proven that dietary ketosis normalizes insulin response by mimicking it and can help towards reversing Metabolic Syndrome (6). We know that keto will also give you lower bad cholesterol and higher good cholesterol (7). With less insulin response and less carbohydrates to store as body fat, we all know by know that by eating more coconut oil and bacon cheeseburgers, our bodies are using that belly fat as fuel for our brains. Ketone bodies are the byproducts of Gluconeogenesis: tearing apart fatty acid (cholesterol!) molecules to get energy to bind protein together into carbohydrates as glycogen for our brains and muscles. Our bodies are constantly doing this, which is why we still have a "blood sugar level" even though we may have had 0g carbohydrates in the last few days. It's pretty awesome, right? *Note: it is NOT true that having ketones in your blood increases insulin resistance, that being in ketosis is dangerous during pregnancy or just dangerous altogether (8). Everyone has a small amount of ketones produced during sleep, the only people who need to worry about high levels are type 1 diabetics who suffer from a lack of naturally produced insulin anyway.

Another important step in reversing Metabolic Syndrome (which is really a collection of other symptoms) is getting up and moving around more. Sedentary lifestyles lead to obesity, type 2 diabetes, high blood pressure and cholesterol and so on. Changing your diet can fix a lot as far as weight and blood pressure and cholesterol and insulin resistance goes, but the great thing about ketogenic dieting is that you can burn body fat while building lean body mass (a process called recomposition) if you are in a caloric surplus.If you are in a ketogenic caloric deficit, the great thing is that your muscle is spared much more than on a regular low-calorie low-fat diet (9). Training with resistance/weights helps a lot in a lot of ways, signaling to your body "Hey, I need these muscles. Burn some fat first, we have plenty of it." Strength training improves your resting metabolism a bit all day long (10), and also tells your body to strengthen your bones, staving off later-life diseases like osteoporosis and Parkinson's Disease (11). Cardiovascular activity will help you use oxygen more efficiently and transport blood more efficiently, and will burn a lot of calories quickly so you can eat more. Cardio is great, but a much smaller part of what makes you healthy compared to diet and lifts.

To sum up so far: eating carbs makes you insulin resistant which makes you crave more carbs, which makes you overeat, which makes you fat, which makes it harder to move, harder to get a good night's rest because you have sleep apnea, which increases your risk of high cholesterol and high blood pressure, altogether heightening the probability of developing Type II Diabetes and possibly even cancer (12). That makes sense since cancer cells are just normal cells mutated to grow incessantly, and if you're obese and overeating already, they have plenty of fuel for uncontrolled growth. You'll also be more at risk of varicose veins, blood clots (thrombosis), chronic inflammation, and even kidney and heart failure (13). It's an endless cycle. I hope I don't come off as a conspiracy theorist, saying "corn is the devil, wheat is literally poison", but I just want to let people know that it's okay to distance yourself from something you find addicting that is harmful in large amounts. I'm lucky that I can turn down candy/cookies/cake/ice cream with relative ease, but my girlfriend gets really strong cravings due to hormonal fluctuations. The only way to resist is to not have any of it in the house at all, and not to go anywhere where carbs are available.

Okay, so we covered the basics of insulin. Lets hit the other hormones now. The less-well-known hormones that are somewhat responsible for the obesity epidemic are Ghrelin and Leptin. Ghrelin is a complex hormone, used in a lot of biological functions such as growth and learning. It also is basically what makes you hungry. It's the hormone responsible for stimulating your appetite. I'm sure we're all familiar with the process of being sleepy after lunch. I know I was absolutely useless after my pizza and Coke in high school. That's because Ghrelin is released more and more until you eat a meal, at which point it diminishes. Did you miss a few hours of sleep? Your Ghrelin levels are probably elevated compared to usual, leading to feeling famished and overeating. You know what causes you to not sleep well? Obesity. It's a never-ending cycle. The more ghrelin you have, the more you eat. The more you eat, the fatter you get, the worse you sleep, releasing more ghrelin, making you hungrier and so on. Losing weight and getting better sleep will naturally lead to lower ghrelin levels, so the more fat you lose, the less you want to eat. There's even an anti-obesity vaccine being developed to direct antibodies to bind to ghrelin receptors, meaning you get less hungry, leading to eating less and weight loss (14). So you can see how insulin and ghrelin will kind of gang up on you in a vicious cycle of overeating.

Ghrelin makes you hungry, huh? What's the opposite of that? Leptin! Leptin is the third hormone we should have a basic knowledge of; it's the satiety hormone. It's what makes us feel "full" when it's released. Leptin is produced in your adipose tissue, your fat cells. The way it is "supposed to work" is: the amount of leptin is supposed to be proportional to the amount of fat you have, and it should keep your appetite suppressed until the fat amount falls to normal levels. Well, it's more complicated than that because if you have poor sleeping patterns, your amount of leptin decreases, which gives you more appetite. Also, some very rare people are genetically low in leptin, leading to constant overeating It's also been thought to have a large effect on pregnancy cravings/morning sickness/PCOS (15).
It's a relatively new discovery about the human biology and it's effects are still being studied, but the theory is put forth that obesity (often caused by insulin resistance+metabolic syndrome) leads to leptin resistance as well. You can put 1+1+1 together... If you eat enough of the foods that trigger insulin+ghrelin response and you get resistant to that, you keep eating even though you're full so your body becomes resistant to that, and YOU BECOME CONSTANTLY HUNGRY. NOTHING YOU EAT IS EVER ENOUGH TO SATISFY YOU. It's basically the sad cause of most posts in reddit.com/r/fatpeoplestories . Leptin resistance (or increased circulating leptin levels) can even lead to being "big-boned". Yes, your bones literally grow because of a hormone released after you become fat, in order for your skeleton to handle the weight of your body. Leptin is an inflammatory agent. More leptin in your bloodstream is why your joints hurt, your blood pressure is high, and you're sick more often. Being desensitized to leptin will literally change your metabolism to store more food as body fat. The worst thing? High-fructose diets probably contribute heavily to leptin resistance. Thankfully, there's some artificial leptin injections being researched for use in people with metabolic abnormalities, just like artificial insulin (15).
After most people traditionally lose weight, their body is still desensitized and circulating leptin levels remain low (because of lower amount of body fat), which means you're as hungry as you were when you weighed more. Sadly, your basal metabolic rate and total daily energy expenditures are much lower than when you weighed more. You need less calories but you're just always hungry. That's why most people gain back diet-lost weight within a year or two. It's really tough to keep it off because those biological metabolic changes in your body don't reset by themselves. WHAT THE HELL, HUMAN BODY.

If only we could reset our body's hormonal responses to baseline levels. What's that? WE CAN? With a KETOGENIC DIET (16)?
Even if you don't lose any weight at all on a ketogenic diet, your hormonal responses to food stimuli change. Ketosis is thought to be an adaptation to survive against starvation. You can think of it as using superpowered metabolic pathways normally only available in starvation to repair your body while still retaining an adequate amount of nutrition. It's not "real" starvation because you still have calories and vitamins and stuff. Like putting a NOS tank in your car that is only used when you're on empty. You're just tricking your body into rehabilitating from it's fat-storing criminal ways. Normally, if you lose a good bit of weight while not in ketosis, your body sees the circumstance as a threat and reacts to store more fat, whereas in ketosis, you're triggering the starvation response while eating steak and bacon (17). In fact, the major ketone body, CCK, directly triggers satiety and counteracts the effects of ghrelin. Insulin and leptin sensitivity can be both be reset with a ketogenic diet (18).

In conclusion... carbohydrates can go die in a fire. I'm done with high-fructose-corn-syrup eggnog milkshakes and all-you-can-eat bleached enriched wheat pancakes and calorie-dense but nutrition-free chocolate cake. I'm not even down with Friday endless fried fish and chips (with a nice beer!) anymore. Because I know I'm one of the people who will overdo it, feel terrible the next day, and have cravings for a week. I know it gives me pimples and gas and headaches and GERD and makes me slow and out of breath; those products have been designed over the last century to make my body lie to my brain about feeling good by releasing an unnatural amount of serotonin and dopamine. I don't wanna die from being depressed and having high cholesterol, high blood pressure, being sick and achy all the time. I'm going to go lift some heavy things and run.


(0) http://www.ketogenic-diet-resource.com/ketosis.html
(1) http://www.msnbc.msn.com/id/15625548/
(2) http://en.wikipedia.org/wiki/Insulin
(3) http://www.drwhitaker.com/how-obesity-causes-insulin-resistance
(4) http://www.nhlbi.nih.gov/health/health-topics/topics/ms/
(5) http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/
(6) http://www.ncbi.nlm.nih.gov/pubmed/22673594
(7) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/
(8) http://ajcn.nutrition.org/content/93/4/901S.full
(9) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1373635/
(10) http://www.ncbi.nlm.nih.gov/pubmed/8175496
(11) http://www.ncbi.nlm.nih.gov/pubmed/23318666
(12) http://www.ijbs.com/v07p1003.htm
(13) http://jcem.endojournals.org/content/89/6/2595.long
(14) http://en.wikipedia.org/wiki/Ghrelin
(15) http://en.wikipedia.org/wiki/Leptin
(16) http://www.ncbi.nlm.nih.gov/pubmed/23632752
(17) http://en.wikipedia.org/wiki/Starvation_response
(18) http://ispub.com/IJNW/4/2/8738

Further reading: http://www.ketogenic-diet-resource.com/resources.html