Dr. Eric Westman - Adapt Your Life - Are the Rumours True? Is Keto Dangerous? — Dr. Eric Westman [Personal Story]

Short Summary

Main recommendation: Dr. Eric Westman says, in his clinical experience, the keto diet is not dangerous or risky, and he says he uses it clinically to treat obesity, type 2 diabetes, pre-diabetes, metabolic syndrome, and arthritis pain, while warning that anyone on diabetes or blood pressure medication must be supervised by someone who understands how those drugs will be affected. He frames lifestyle change, including keto, as the lowest-risk option among the obesity treatments in the Obesity Medicine Association's current panel.

Key Points

• Westman says he has studied the diet for about 20 years and used it clinically for about 13 years, including at Duke University and in private practice.
• He says the feared long-term adverse consequences have not appeared in research or clinical use, and he calls claims otherwise fear-mongering.
• Westman says short-term side effects, often called the "keto flu" (headache or fatigue for a few days to a week), are possible but not common, and can be reduced.
• He says that, with monitoring, he can sometimes take patients off medication by changing their diet this way.
• He notes that a recent review at a medical clinic said patients should be informed of possible long-term adverse consequences of keto, but he says those consequences have not materialized in his experience and research.

Details Worth Noting

• Concrete instructions: To reduce the chance of the keto flu, drink plenty of fluids, make sure you are doing the diet correctly, use a good source of information on how to do it, and avoid drinking large amounts of fats and oils, which he says upset the stomach. He describes his program as simple.
• Concrete instructions: If you take medications, especially for diabetes or high blood pressure, do not start on your own. Work with a supervisor who understands how the medicines will be affected, since you will probably need a diabetes medication reduction on the first day you change carbohydrates.
• Westman places lifestyle at the lowest-risk end of the obesity treatment panel, ahead of medication, very low calorie diets (consuming products instead of food), and surgery, which he places at the highest-risk end.

Bottom Line

Westman's view is that keto is safe and therapeutic when monitored by a clinician, especially for patients on diabetes or blood pressure medication, whose doses may need adjusting.