Why do keto, intermittent fasting, low-carb diets, and other approaches all seem to work for weight loss?

In this first lesson of How Weight Loss Really Works, we explore the fundamental principle of energy balance, why different diets can produce similar results, and why understanding how weight loss works is more useful than searching for the perfect diet.

We'll also consider why losing weight and maintaining that progress are two different challenges.

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How Weight Loss Really Works is my free five-part email course exploring the principles of sustainable weight management, including nutrition, exercise, mindset, and long-term maintenance.

The goal is to help you understand the science, think more critically about common weight-loss advice, and make more confident decisions about your health.

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The Hidden Rule Behind Every Weight Loss Diet

If you’ve ever felt frustrated or confused by weight loss, you’re not alone.

Most people I’ve worked with over the years haven’t struggled because they didn’t try. They’ve struggled because they’ve tried lots of things. Keto. Intermittent fasting. Paleo. Points-based programs. Plant-based eating. Sometimes even medication-supported approaches.

And here’s the important thing to say right up front:

If these diets didn’t work at all, they wouldn’t be popular.

People wouldn’t keep coming back to them, recommending them to friends, or swearing by them online if they never produced results. The frustration usually isn’t that weight didn’t come off. It’s that it didn’t stay off.

To understand why that happens, we need to look at what all of these approaches actually have in common, and what they tend to cost.

The Question Most Diets Don’t Answer

Most diets are very good at telling you what to do:

  • Eat these foods.

  • Avoid those foods.

  • Only eat during certain hours.

  • Track everything.

  • Trust the system.

What they rarely explain is why those rules lead to weight loss, and almost never what to do once the rules loosen.

If you don’t understand why something works, it becomes very hard to repeat the result on purpose… or to know how to stop dieting without sliding backwards.

The Hidden Rule

Here it is, stated plainly:

All successful weight loss diets work by creating a caloric deficit.

That’s the rule.  At the most basic level, this comes down to energy balance.

When you consistently take in less energy than your body is using, weight tends to decrease. When you take in more than you’re using, weight tends to increase. And when intake and output are roughly matched, body weight usually stays fairly stable over time.

Every diet that produces weight loss is creating a deficit in one way or another, whether it talks about calories explicitly or not. Everything else (like food lists, eating windows, points systems, apps, supplements, even medications) is just a tool for getting there.

A caloric deficit simply means you’re taking in less energy than your body is using. When that happens consistently, weight loss occurs. Not because of magic foods or metabolic tricks, but because the body has to make up the difference.

Different diets create that deficit in different ways. They also create different trade-offs.

Popular Diets, Their Trade-Offs, and What Happens When They End

Keto and Very-Low-Carb Diets (Including Carnivore)

Low-carb and ketogenic diets work by dramatically shrinking food choices. Sugar, grains, and most starches are removed, and meals tend to revolve around protein and fat. Appetite often drops, at least initially, and early scale changes are amplified by water loss.

Weight loss happens because calorie intake usually falls.

The downside of this level of restriction is that fibre intake is often very low, which can affect digestion and gut health. Electrolyte imbalances are common early on, leading to fatigue, headaches, and muscle cramps if sodium, potassium, and magnesium aren’t deliberately managed. Many people also notice reduced performance during higher-intensity exercise.

At the far end of this spectrum is the Carnivore diet, which removes plant foods almost entirely. While it operates through the same basic mechanism, extreme food elimination, it narrows nutrient intake even further. Fibre, vitamin C, and many phytonutrients are absent unless organ meats and supplements are used. Sustainability and social flexibility become even bigger challenges.

When carbohydrates are reintroduced after strict low-carb phases, hunger often rebounds and early water weight returns quickly. Without a clear transition strategy, regain in the first few months is common.

Intermittent Fasting

Intermittent fasting changes when you eat rather than what you eat. Fewer eating hours or fasting days usually mean fewer chances to consume calories.

Weight loss happens because eating opportunities are reduced.

The trade-off is that compressed eating windows can unintentionally crowd out protein and micronutrients, especially if meals are rushed or poorly planned. Some people experience irritability, low energy, or sleep disruption during fasting periods. For others, fasting can encourage a restrict-and-overeat pattern rather than steadier intake.

When fasting schedules loosen, most people drift back toward their previous meal timing and portion sizes. Without some form of ongoing structure, calorie intake often rises gradually and weight follows.

GLP-1 Medications (Ozempic, Wegovy, Mounjaro)

GLP-1 medications reduce appetite and slow digestion, making it much easier to eat less without constant hunger.

Weight loss happens because calorie intake drops sharply and consistently.

The main nutritional risk is that eating too little becomes easy. Protein intake often falls short, and overall food volume can be so low that micronutrient intake suffers. Without resistance training and deliberate protein prioritisation, lean muscle loss becomes more likely.

When medication is discontinued, appetite suppression fades quickly while calorie needs remain lower than before weight loss. Without new habits in place, weight regain can be rapid. The medication buys time, but it does not replace the need to build long-term skills.

Mediterranean-Style Eating

Mediterranean-style eating emphasises vegetables, fruits, whole grains, olive oil, fish, and minimally processed foods. It’s one of the most nutritionally complete patterns available.

Weight loss happens when this approach leads to lower overall energy intake through improved satiety and food quality.

The main downside is subtle rather than dramatic. Energy-dense foods like olive oil, nuts, and bread are easy to overconsume, and weight loss can stall if portions aren’t managed. It also assumes access to certain foods and a willingness to cook regularly.

When structure fades, weight regain tends to be slow and gradual rather than abrupt, but it still happens if intake creeps up over time.

Paleo

Paleo simplifies eating by removing grains, legumes, dairy, and refined foods. Protein intake often increases, and food quality usually improves.

Weight loss happens because many calorie-dense and highly palatable foods are eliminated.

The trade-off is reduced dietary variety. Calcium and iodine intake can fall when dairy is excluded, and fibre intake may drop if vegetable variety is limited. Social friction is common, which affects long-term adherence.

As excluded foods return, calorie intake usually rises. Regain is often partial but predictable without clear boundaries.

Commercial Programs (WW, Noom)

These programs use tracking, points, and behavioural tools to create awareness and accountability.

Weight loss happens because consistent monitoring supports a calorie deficit.

The downside is reliance on external structure. Protein intake may be under-emphasised, and tracking fatigue is common over time.

When tracking or coaching stops, the feedback loop disappears. Because the body now requires fewer calories than before weight loss, returning to previous eating habits often leads to regain even if those habits feel “normal”.

Volumetrics and Low-Energy-Density Eating

This approach focuses on eating larger volumes of low-calorie foods to feel physically full.

Weight loss happens because calories per bite are lower.

The trade-off is that fullness does not always equal adequate nourishment. Protein and fat intake can fall too low unintentionally, leading to fatigue or persistent hunger later in the day. Meal preparation demands can also be high.

When convenience foods and restaurant meals return, energy density rises and weight tends to follow.

Flexitarian and Plant-Leaning Diets

Plant-leaning diets increase fibre intake and lower average energy density, while allowing flexibility with animal foods.

Weight loss happens when this pattern reduces overall calorie intake.

The downside is that protein adequacy requires attention, especially if animal foods are limited. Iron, B12, zinc, and omega-3 intake can also fall without planning. Highly processed plant-based foods can undermine results quickly.

As food quality slips, calorie intake rises and weight regain becomes more likely.

Why Regain Is So Common (And Not a Personal Failure)

There’s a crucial piece most diets leave out.

After weight loss, the body actively pushes back.

Hunger increases. Feelings of fullness decrease. The body becomes more efficient and burns slightly fewer calories at rest. At the same time, people relax food rules, stop tracking, and return to familiar environments.

What often follows is confusion. Intake and activity feel similar to before, but weight starts to creep back up. When the numbers don’t line up the way we expect, it’s rarely because the rules stopped applying. More often, intake, output, or both aren’t quite what we think they are once structure loosens.

Old eating habits that once maintained weight can now cause gain.

This isn’t a lack of discipline. It’s a predictable interaction between biology and behaviour.

The Missing Skill: Maintenance

Most diets teach restriction. Very few teach maintenance.

People often move straight from strict rules back to “normal” eating, without practising how to live in the middle. When structure disappears and hunger increases, weight regain becomes the expected outcome.

Maintenance isn’t a single calorie number. It’s a skill set.

And an important reframe here: even when some regain happens, most people remain lighter and healthier than when they started. Partial maintenance is still progress. The goal isn’t perfection. It’s durability.

What Comes Next

Understanding the rule behind weight loss is the first step. Creating a caloric deficit is what drives fat loss, no matter which diet you choose.

But there’s an equally important question most people are never taught to ask:

How long can you stay in a deficit before it starts working against you?

In the next lesson, we’ll look at what happens when calorie restriction is pushed too far or held for too long. We’ll talk about metabolic adaptation, changes in hunger and energy, and why extended deficits can disproportionately affect women, especially when carbs or fats are aggressively reduced.

Weight loss isn’t just about creating a deficit. It’s about knowing when that tool stops helping and starts creating new problems.

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