The ketogenic diet—high in fats, moderate in protein and low in carbs—has been associated with more sustained weight loss than low-fat diets in early trials.

Participants in studies of the ketogenic diet have also reported less hunger versus other diets with similar caloric intake, according to an article published by the Journal of the American Medical Association. Potential reasons include the satiating properties of fat and protein, changes in appetite-regulating hormone on a low-carb diet and the direct hunger-reducing role of ketone bodies.

According to JAMA, clinical ketogenic diets restrict daily carbs 20 to 50 grams, a fraction of Americans’ average range of 200 to 350 grams per day. With fewer dietary sugars and starches, the body reduces insulin production and switches to a fat-burning mode for fuel.

This can lead to weight reduction and improved glycemic control, which may have implications for treating diabetes.

“It seems to help people not only lose weight but reduce their requirement for [diabetes] medications, and they get improvements in their hemoglobin A1C, which is an end point for diabetes management,” Steven Heymsfield, MD, a professor in the department of metabolism and body composition at Louisiana State University, told JAMA. “Those are all the good things that happen over the relatively short-term—six months perhaps to a year. I think that the question is, is this a diet you can tolerate long-term?”

Some physicians reported cases of good long-term adherence to the diet, resulting in more than 100 pounds of weight loss. And more trials are underway evaluating the long-term effects of the high-fat diet.

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