After the first six months of bariatric surgery, there is something in our body mechanisms that changes. Our weight loss slows down, some of us reach our goal weight (or are getting very close to), and for some, the weight loss stops completely. It’s at this point that we need to change something up either to gear up for maintenance or to continue losing, getting us to that goal.

For bariatric patients, there are more than one WOE (ways of eating – also known as POE or plan of eating). The hard part is finding exactly what it is that will work for you.

Take note, if you have regained weight, these are not intended for that purpose. Later, we’ll do a series focusing on regain and how to lose it (as this is something that Jen is learning a lot about right now!)

The final WOE we will be talking about in this series is the Ketogenic WOE – AKA the Ketogenic Diet.

The Ketogenic Diet is one that is more recently getting attention from well-known nutritionists and food bloggers, but it is not a new diet as some might think. The Ketogenic style of eating has been used for many years in the medical community as a treatment for epilepsy and autoimmune diseases that attack the nervous system (such as fibromyalgia). Additionally, the Ketogenic style of eating has been known for years as the Atkins Diet’s Phase 1 (Induction Phase). It is a very controversial WOE, however, as some believe that the high-fat content and lower carb content (even from healthy, non-starchy veggies) can cause other underlying health issues over time. Additionally, it can cause an unnatural obsession with food, causing someone with food obsession to constantly be worrying about what they’re eating and how much they’re eating of it. People with a history of eating disorders, food restriction, and food obsession are encouraged to exhibit caution when on this plan. When following a ketogenic diet, eaters are encouraged to use a keto calculator  to find out what their macro-nutrient (macros) count should be for their height, weight, gender, and other factors (body fat, activity level, etc.).

The Ketogenic WOE has the following components:

It’s Very Low Carb.  Most ketogenic plans have you count your macro-nutrients (protein, carbs, and fat). The amount of carbs that one eats ranges anywhere from > 20 to 100 g (the normal amount of carbs is around 300 for a 2,000 calorie/day eating plan). The majority of plans keep the eater at around 30-35 carbs/day. It’s important to be mindful that the amount of carbs one gets on this plan are made up of highly nutritious vegetables (asparagus, spinach, kale, etc.) and lower-carb fruits.

It’s Very High Fat. The standard eating plan for an American with a 2,ooo calorie a day diet is around 24 grams. For a ketogenic eater, that fat content shoots up to 150 + grams of fat.

Protein Is an Afterthought. On the ketogenic diet, protein is an afterthought. In a standard bariatric diet, we are taught “Protein first”. On a ketogenic plan, the thought process is “fat first!” Protein is considered in “moderate” amounts with a total of around 60-90 grams/day.


Anyone 6 months or farther out.


This eating plan has a lot of followers, thus a lot of resources.
This eating plan has more satiety than some – the amount of fat keeps you fuller longer.
Even though it is considered “moderate protein”, for the bariatric eater it is considered “high protein”.
It allows – and even encourages – the use of fats such as butter, bacon, and lard.
There are many different varieties, so almost everyone could find a version that fits their desires and needs.
There are many medical studies that show this WOE can have extreme health benefits, when done correctly, and can even reverse some diseases.


There are many different varieties, and each version has its own gurus, therefore there is a lot of conflicting information on this WOE on the internet.
Because the carb allowance is so low, many people completely forgo important vegetables and fruits with vital fiber and nutrients, causing health issues, malnutrition, and gastric problems.
Because of the high fat and protein counts, this WOE can cause kidney stones and gallbladder issues in some people.
It’s a VERY restrictive diet because of the low carb count.
Fat can be a trigger food for some people, so this eating plan can cause overeating for some, causing a stall in weight loss or even a weight gain.
It can be a VERY complicated plan to follow, always having to count not only calories, but also carbs, fat, and protein to ensure you have the right macro-nutrient counts for the day.

Sample Menu Plan
This meal plan is based on a 2,000 calorie/day meal plan with ketogenic macro amounts of 25 g net carbs, 80 g protein, and 170 g fat

B: 1 egg scrambled with 1 oz cream cheese cooked in 1 tsp butter, 5 cherry tomatoes sauteed in 1 tsp butter
L: 1 C romaine lettuce, 5 cherry tomatoes, 1/2 avocado, 2 slices crumbled bacon, 2 oz grilled steak, 1 T olive oil, 1 tsp red wine vinegar
D: 3 oz grilled salmon with sour cream dill sauce, 5 spears grilled asparagus with 1 tsp butter, 1 C kale salad with 5 cherry tomatoes, 1 T olive oil, 1 tsp red wine vinegar
Snacks: Celery Stalk with full-fat cream cheese, slice of smoked ham wrapped around avocado slice, cubed cheddar cheese w/sliced cucumbers

We hope this was helpful for you!
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Thank you for joining us during this series! We hope we were able to give you a good introduction to these WOE’s.  For more:
Part 1       Part 2       Part 3       Part 4