OT: Keto and similar diets: do they really work?

It definitely does work. Most diets do, actually, but you have to follow them. I'm a former health coach, personal trainer, and holder of a CSCS, so I've done a ton of research and have some actual experience coaching and teaching different diets, types of training, etc. 

Diets work but the best diet is the one you stick to. Find whatever diet that is. Keto is not necessarily the easiest to follow for most people. Also, most people doing "keto" aren't doing keto. Generally they're just doing low carb diets, but thats a different topic all together.

Something to consider is the fact that anytime you go low carb, you'll lose weight instantly, but that's typically water weight. Stick through that, or all you did was shed water weight and as soon as you adjust your diet back to "normal" you will gain it back in the matter of a day or two. 

Well, here's what Harvard and UCSF (not exactly repositories of medical quackery) had to say about keto diets recently:

https://www.health.harvard.edu/blog/ketogenic-diet-is-the-ultimate-low-carb-diet-good-for-you-2017072712089

https://www.ucsf.edu/news/2018/08/411526/ketogenic-diet-gains-popularity-scientists-research-what-we-do-and-dont-know

Just one anonymous person, but amusing:

https://www.skepticalraptor.com/skepticalraptorblog.php/ketogenic-diet-scientific-evidence/

(Off-topic, the vaccine part of that site is definitely funny: https://www.skepticalraptor.com/skepticalraptorblog.php/vaccine-search-engine/ )

But, this is America, and you can find out whatever you please. For example, this guy has been "curing cancer" in his own way for many years now in the shadow of Houston's M.D. Anderson Cancer Center:

http://www.burzynskiclinic.com/

Exercise 3 times a week, be active the other days, and don’t eat or drink like a 21 yr old and the weight gain will go away and stay away...diets are just band-aids

You will likely get short-term results on just about any fad-diet [personally defining this as a diet with a name] you try but you'll eventually plateau and get frustrated if the diet is the only thing about your lifestyle you change. Keto, by itself, is really just going to allow you shed a bunch of water weight. That's fine if the only thing you care about is the number on the scale but it won't necessarily get you looking fit by itself.

I've seen all the nouveau nutritional gurus on PBS. Low carbs are the common denominator. Carbs produce sugar / fat and are stored.

I used the Dr. Kelly Ann 10-day bone broth belly fat diet over the holidays this year and lost around 10 lbs. I'm 5'-7" and weigh under 165 now @ 66. I played HS football @ 160; was 150 in college. The best thing from that diet is to eat between noon and 7 pm to promote fat burning. I've noticably lost a couple inches off my waist. I started dieting because my pants were starting to fit too tight. I don't adhere to it religiously. I want to get down to under 160. 

It is similar to the keto diet without as much fat. It is not as strict in the fruit and starchy vegetable  reduction. I've eliminated the breakfast cereal and restricted my cracker snacking. It promotes grapefruit and pickled foods which I like.

I can't find or remember the reporting article, but an NIH researcher who is an expert in metabolism and weight loss said the number 1 reason an individual has trouble with managing weight is the propensity to under estimate total calorie consumption.

I’ve noticed in last couple of years my metabolism slowing down as well, due to age.

I have lost about 10 pounds recently over about a month, by cutting out simple carbs. No beer, potatoes, pasta, beans, rice, bread of any kind. I’ve alllowed only protein and green vegetables.

And about 6 hours of cardio exercise per week.

also i guess i forgot to state the obvious that weight loss and being fit isn't the same thing.

I think you can find numerous side by side comparison pictures of individuals at the same weight but total different composition of weight distribution.

So i would recommend talking with a doctor, nutritionist and or certified trainer.

Everybody has their own method but honestly, the only diet you really need to consider is a diet of moderation. 

My wife and I tried the paleo diet about 4-5 years ago. I lost 15-20 lbs, but I realized pretty quick it was not a sustainable diet. There was just stuff I was not willing to part with permanently. So I went off the diet, and that weight came roaring on back.  

I wouldn't go with a diet that forces you to 100% give up something you love eating. You're get through about a few weeks to a month of it, hate it, be miserable because all you're doing is thinking about the food you're not allowed to have, then you break the diet and you're right back where you started. 

Just take everything in moderation. It's okay to have a cheeseburger for lunch if you're having a light dinner, or if you're planning on having a 1-2 hour workout before or after work. My wife and I eat light during the week so we can splurge a little more, if we want to, during the weekend. It's all one big ratio. If you consistently burn more calories than you take in, you're going to lose more weight, regardless of what diet you're on. 

No point in forcing yourself to give up food you love when you don't have to. 

I have been on virtually every diet out there, and I can tell you that, to some extent, they all work, but they all have their pitfalls that lead to them being unrealistic for long term success, unless you either don't care about food or are super disciplined.  

As background, I am 42 years old. I have been lifting hard since freshman year of college.  I have good size for a 5'9" guy, and generally am at my best when I am 185-190, around 8-10% body fat.  Over the past year or so, I have crept up to 196, with the additional 6 pounds being mostly bad weight.  My focus has been to lose that weight without losing hard-earned muscle.  Here's my take on the current popular diets:

1.  Keto (since that was the one you asked about).  It works.  And works well.  In the short-term.  Personally, as someone who likes foods, I find it way too restrictive.  I am generally fine with giving up the rice / pasta most of the time, but I like dessert and cheat foods on the weekends, and not just one cheat meal.  I did lose 6--7 pounds of fat in a few weeks, but found the diet to be unsustainable.

2.  Vegan - I knew I would only do this for a few weeks (like a 14 day challenge), but I didn't last the week.  I like meat, fish, chicken, etc. too much.  Very restrictive, and in even a week, I lost size and strength.

3.  Atkins - also works (put on muscle and lost fat over a few weeks), but like the others, it is too restrictive for the long term.  When I went off, all of my gains evaporated quickly.

4.  No / almost no carbs.  Recently, ARod and JLo did a 14 day carb free challenge.  They basically cut out all fruit, grains, etc, and limited carbs to just low cal greens.  I really liked the results - weight melted off and because protein was high, I didn't feel that I lost muscle.  But, again, very restrictive and something that you can only do for a week or so.

5.  Controlled fasting - the goal of this diet is to completely calorie-deprive your body for a block of time because of the fat-burning hormonal response (along with other benefits).  There are a ton a variations, but the most common is 16-8 - you eat all of your calories in an 8-hour block, and completely fast other than water for the other 16 hours.  I like to snack at night post dinner, so this worked for me.  My eating window was 2 pm to 10 pm.  the results were so so, but getting through the fast was just too unpleasant.  I ended up stopping in a week or so. 

My experience is that the best diet is one in which you eat 3 healthy meals a day consisting of high lean protein and healthy veggies, and cut out the crap carbs (rice pasta and sweets) as much as possible.  No hard and fast rules, just really watch what you eat.  If you are lifting hard or want to add muscle, add in a protein shake or to between meals or after you lift, but otherwise, just cut the crap as much as possible. In this approach, plan to cheat once or twice a week and you will be fine.  If you combine this with a good lifting and cardio routine, you will see regular, sustainable results. 

I'm 100% on board with the keto diet, I went from looking pregnant to feeling like my old self in probably 2 months, I can fit in some button up shirts that looked the button may pop off to a loose feeling. My heart rate also dropped 10 bpm. I don't know how much I've lost because I haven't cared about weight, it was more about feel. I can still eat manly foods like steak, chicken, chops and fish, I have trained myself to eat veggies and found that I like raw better than cooked. 

"Eat food, mostly plants, not too much."

The biggest problem I've had, and what I've heard from others who have lost weight without.drastic diets, is that they interpret "bloated" as "full." Learning that difference and then developing the ability to stop eating at that point is the key. (Obvious caveats about medical conditions, etc. apply.)

Do not do anything fancy.  Eat a balanced diet, drink water and get your protein.  Keep your calories under 2000 per day.  I highly recommend working out on a heavy bag 3-4 times per week, as well as doing pushups, crunches and some yoga.

This is me at age 46.

Hard to say what any of these would do to your body but I can tell you the 4 hour body by Tim Ferriss really worked well for me. You have to up your protein load significantly, add in all the veggies and slow carbs you want (beans/lentils, etc) and eliminate all dairy, sugars, cheese and fruits for 6 days out of the week. On the 7th day, you can eat whatever you want.....literally load up on all the food you had to eliminate and then start over the following day. I lost 30lbs in 3 months doing that diet.

Aside from the one day a week all you can eat fest, another benefit is you're allowed 1 glass of wine a day....that helped a lot. It's extremely boring diet as you end up eating the same thing over and over again but it really works. I had my blood tested before and after and my cholesterol AFTER eating scrambled eggs and bacon for breakfast 3 months straight was lower than when I started. Not sure if that would be the same for you, though. 

Get the book and check it out for 7 days to see how you like it - I lost 5lbs in the first week. If you don't see some form of immediate weight loss, it's not the right fit for you.

I find the best diet is to consume fewer calories than you normally consume. Crazy, I know.

My wife has lost over 35lbs on the Keto diet.   The biggest problem is that you have to be very conscientious about what you eat.   She never goes over the required # of carbs.   If you cheat, it takes a long time to get back on track.  

the only thing that matters is calorie intake. Anything diet scheme works if it lowers your calorie intake, and would not work if it does not.

From someone who's lost a good amount of weight, diets don't work because as soon as you get off the diet, you're going to gain it all back. You need to make a life style change and it doesn't need to be huge. Just watch your portion size on a regular basis, drink lots of water, and try and exercise a few times a week. You'd be shocked how quickly those small changes can have a huge effect on your life

My wife my wife was keto. It works if you stick to it. She lost a ton of weight and convinced her friend to do it. He friend was bigger on the 280lbs side. She lost like 35-40lbs the first month. 

I dropped over 100 pounds on Keto over about 10 months (330 to 221) with only mild increase in physical activity.  Unfortunately, I put back about 40 or 50 of those pounds afterward, as I got less restrictive about carbs.  The diet works gangbusters, but isn't a truly sustainable lifestyle diet - still working to find a long term be less fat solution. 

Standardizing your nutrition in any way will result in better outcomes but that's because you're tracking your food and thinking about it/trying to be healthier.

Is the Atkins diet better than Keto? I don't know, but either are better than not getting on a regiment especially because practically all diets cut fast food/eating out where the worst nutrition is found. Home cooked meals are almost always going to be healthier than going out to Applebee's and getting their "low calorie" options.

I go up and down with weight frequently.  When I go up, it's because of excess consumption of something I absolutely love, tasty beers, coupled with a lack of exercise.  When I go down, I significantly cut the beer consumption and add in mountain biking(a real good cardio workout). Other than that, the food intake is all common sense...fruits, vegetables, lean protein, and, of course, calorie counting. 

Genetics will dictate how quickly you lose it.

Bottom line is you'll lose it if you expend more calories than you take in.

Might want to cut back on your calories. That doesn't mean you should starve yourself.

Adding in aerobic exercise will help.

Light weight lifting too.

You will lose weight on Keto if you stick to it, but I’m not sure about the long term effects. Taking a triple bacon cheeseburger off of the bun and convincing yourself it’s healthy is an odd concept. 

CARBS DON’T MAKE YOU FAT!!!

7-8lbs should be pretty easy to lose (unless you weigh like 35). I would focus more on just developing a healthy/active lifestyle than looking in to fad diets. 

Every diet is guaranteed to work if you consume fewer calories than you burn (and do so consistently). There is nothing about any specific diet that allows a person to gain more or less weight than would be expected if we accounted for zero else than metabolic rate and caloric intake. It's simple thermodynamics. Faddists may tell you otherwise and be super convinced they are right, but false confidence isn't enough to overturn these laws of physics.

-Your friendly resident MD/PhD student

Yes, keto absolutely does work.  I did it for 5 months and lost 45 lbs. but ultimately decided it was too restrictive to maintain.  I've been off for 2 months and transitioned to more of a general low carb diet and gained about 5 lbs back.  It's crazy how much sharper you feel mentally, and how great you feel physically once the bloat from excess carbs leaves your body.

The first week or 2 will kind of suck as your body adjusts to burning fat as a fuel source.  A few tips if you try it:

• Drink LOTS of water, then drink some more. 
• May need to supplement electrolytes or drink plenty of powerade zero/gatorade to keep electrolyte levels up
• My *opinion* on the studies about cardiac events is that the sample of people doing keto is skewed towards people who probably had a higher likelihood of heart issues in the first place, and many people "do keto" by gorging on red meat and eating nothing else, which is, in fact, NOT what keto is all about.
• During first couple weeks eat small meals or snack frequently to avoid headaches and dips in energy levels.
• Absolutely read up on what veggies to eat and which to avoid - I was pretty shocked to learn how sugary some veggies are.
• Veggies are your new best friend, and be picky about which types of fat you eat.  Eating all bacon and red meat, though tempting, is not really how keto should be done. 
• Read up on artificial sweeteners and the difference between carbs (required to report on nutrition labels) and glycemic index.  There are plenty of low carb foods that have a high glycemic index and these need to be avoided for keto.  

Many of the so-called "fad diets" incorporate aspects of food conversion science not readily addressed by the standard low-fat, low-calorie advice.  There is, in part, a reason that these diets have some success.  Most of it starts by forgetting what you have been taught:

https://www.economist.com/news/2019/03/16/death-of-the-calorie

I am currently on the Keto Diet plan with the same goals you posted (75% fat).  I am 41 and have had extra weight on me since college.  My take on it so far:

On the surface, as a scientist, eating a keto diet makes a lot of sense.  Our species evolved without much access to sugar or other refined carbohydrates.  A diet rich in carbs isn't how our bodies were refined to operate based on thousands of years of evolution.

I haven't lost a lot of weight - 12 lbs in roughly 2 months - but it has been a consistent drop without fluctuations.  I haven't had any problems keeping it off despite a couple of carb cheat days mixed in.  

I was a serious snorer, with apnea.  Within a week of starting the keto diet I stopped snoring completely.  Some nights I have had some mild snoring - seemingly related to allergies - but have not had a bout of apnea since starting the diet.  I also have no more problems with acid reflux, despite a long history of it.  I take no meds at this point.

I can't speak to the long term implications for heart health, but many recent studies have debunked saturated fats as the culprit and I personally believe sugar is much worse for your heart.  I plan to stay on the keto diet as my normal diet going forward.

OP, I have researched this thoroughly and have been on all of the diets.  I am not an expert, just passionate about good health.  Bottom line, all the diets work, including and especially keto.  Problem with keto is that it is hard to get your body into ketosis and maintain it without a very disciplined diet.  Its also not a diet you want to sustain for more than a few months.  Seems unneccisary for what you are looking to do. If you are just looking to lost 7-8 pounds, I recommend eating lean meats, cruciferious veggies, nuts and seeds.  Don't worry about portion sizes or counting calories (although don't go to crazy). Avoid any white colored carbs, or carbs that could be white - rice, breads, potatoes. Exercise 3x per week.

All diets are some variation of this and it doesn't need to be exactly this, but by and large, you'll lose 7-8 lbs in a month if you do this - easily.

Dr. Darren Schmidt of the nutritional healing center of Ann Arbor has your answers.

https://www.youtube.com/watch?v=ZvBM5Ql2OOE