Hormonal
A ketogenic very-low-energy diet (VLED) induces a transient increase in subjective hunger and desire to eat during the first 3 weeks (up to 5% weight loss), despite the presence of ketosis, with appetite suppression only emerging after 10% weight loss.
If you start a ketogenic very-low-energy diet, expect your hunger to increase significantly during the first 3 weeks, even if you are in ketosis. This is a normal, transient phase. Do not mistake this hunger for the diet not working; appetite suppression typically emerges only after you have lost about 10% of your body weight. Preparing for this initial hunger spike can help you stick with the diet.
WL with a ketogenic VLED transiently increases the drive to eat up to 3 weeks (5% WL). After that, and while participants are ketotic, a 10–17% WL is not associated with increased appetite.
Why this rating
Randomized controlled trial design with repeated measures, though limited by sample size (n=31) and lack of a non-ketotic control group during the weight loss phase.
Source
Timeline of changes in appetite during weight loss with a ketogenic diet
Siren Nymo et al. · International Journal of Obesity · 2017
DOI 10.1038/ijo.2017.96
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