You’ve probably witnessed the phenomena: You are a female making a great effort to lose weight and as you steadily reach your goals each week, a male counterpart is dropping pounds by the day. What is going on?
Women have intricate hormonal systems different from men, you see. Our monthly hormonal cycles allow us to get pregnant one week, but then not the next. Our bodies are naturally prone to keep a higher body fat percentage compared to men, too. If you’re on a keto diet plan, it’s important to consider factors such as these and make adjustments that work for you, since health is not a one-size-fits-all approach.
Does the keto diet work for women?
The ketogenic diet can work for both sexes and scientific research has suggested it may also help with a variety of conditions, including obesity, diabetes, metabolic syndrome, and polycystic ovary syndrome in women. However, it’s important to note that before embarking on the keto diet, you should consult with a physician and registered dietitian to make sure the keto diet is right for you and that you don’t have any health conditions or use medications that are contraindicated.
Does the keto diet impact women differently than men?
If you and a male partner are both doing the keto diet together, do yourself a favor by not comparing your results to his. Men lose weight at a faster rate than women. It’s science.
For example, in an 8-week study of overweight women and men with pre-diabetes whom were following a low-calorie diet, weight loss was 16% greater in men than in women, even though improvements in insulin resistance were similar.
Generally, men tend to lose fat quicker in the mid-section area that surrounds organs (which has a more beneficial effect on health outcomes), while women tend to lose fat more speedily in fat deposits just under the skin.
How a keto diet plan for women may help with PCOS
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age, resulting in symptoms including weight gain or difficulty losing weight, problems getting pregnant, and irregular menstrual cycles. While the exact cause of PCOS is not known, insulin resistance and high levels of insulin are believed to play a role.
Losing weight by way of healthy eating habits and exercise can help manage PCOS symptoms by lowering blood glucose levels and improving how your body uses insulin. Weight loss may also help make your menstrual cycle more regular which could boost fertility.
In one small study, overweight women diagnosed with PCOS were instructed to follow a low-carb, ketogenic diet that included no more than 20 grams carbs per day. The women lost an average of 12% of total body weight at the end of 24 weeks, plus significantly lowered fasting insulin levels. All five subjects developed ketonuria (they went into ketosis) and food journals showed how they stuck to the diet. While total cholesterol and LDL (the bad kind) in the blood increased by the end of the study, I believe this could be alleviated by replacing high-fat meats and cheeses with leaner proteins, while adding in more plant fats, like olive oil, avocado, nuts, and seeds, which have been studied to improve blood cholesterol. This study was partially funded by Robert C. Atkins Foundation.
When is the keto diet not recommended for women?
The keto diet is not recommended for people with thyroid problems, eating disorders or a history of eating disorders, gallbladder disease or removal, pancreatic disease, or liver conditions.
How the keto diet may affect the thyroid
Hypothyroidism in particular is ten times more likely to affect women than men.
A recent study showed how children with drug-resistant epilepsy who were on the keto diet for at least 1 year experienced thyroid malfunction and required L-thyroxine (used to treat low thyroid hormone). Girls in the study were at a higher risk of developing hypothyroidism compared to boys. On the contrary, a small study demonstrated how thyroid hormones increased in men while on a very low carb diet.
Another study on 12 obese women resulted in T3 thyroid hormone decreasing faster and to a greater extent after 3 weeks on a low-carb very-low-calorie diet compared to a high-carb very-low-calorie diet.
While science is still emerging about promising benefits of the keto diet specific to women, it’s important to talk with your doctor, listen to how your body feels, and make adjustments as you go along.
 Sex and gender differences in health: Science & Society Series on Sex and Science. Science & Society. 2012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388783/
 Ketogenic diet in endocrine disorders: Current perspectives. Journal of Postgraduate Medicine. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664869/
 Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi-centre intervention study after a low-energy diet in 2500 overweight, individuals with pre-diabetes. Diabetes Obesity Metabolism. 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282840/
 Polycystic ovary Syndrome. U.S. Department of Health & Human Services. https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome.
 The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutrition & Metabolism. 2005. https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-2-35.
 What is the ketogenic diet? Academy of Nutrition and Dietetics. https://www.eatright.org/health/weight-loss/fad-diets/what-is-the-ketogenic-diet.
 Changes of thyroid hormonal status in patients receiving ketogenic diet due to intractable epilepsy. Journal of Pediatric Endocrinology Metabolism. 2017. https://www.ncbi.nlm.nih.gov/pubmed/28076316
 Body composition and hormonal responses to a carbohydrate-restricted diet. Metabolism. 2002. https://www.ncbi.nlm.nih.gov/pubmed/12077732
 The effect of varying carbohydrate content of a very-low-caloric diet on resting metabolic rate and thyroid hormones. Metabolism. 1986. https://www.ncbi.nlm.nih.gov/pubmed/3702673