What are the dangers of the K-E diet?

Dr. David L. Katz, MD, MPH
Preventive Medicine
“K-E” stands for ketogenic enteral nutrition. A better, more descriptive term for the new diet is the nasogastric tube diet. The K-E diet involves inserting a feeding tube into the nose, down the esophagus, through the stomach, and into the duodenum, and then infusing a high-protein feeding solution continuously.

This is done in the hospital routinely for people who can’t eat. But that’s not what the K-E diet is about. It’s about brides-to-be who want to lose 10 pounds or so in a hurry to look good in a wedding dress.

This diet is little short of lunacy on the part of any such bride-to-be; colossally misplaced priorities on the part of any groom-to-be watching it happen; and as profound an abrogation of professional ethics on the part of doctors peddling it (for $1,500) as I have ever seen.

Everything about this is appalling. Not so much because of the risk of metabolic complications from a ketogenic diet over a period of just 10 days. These are real, and include stresses on the liver, kidneys, and skeleton -- but for people healthy at the start, such concerns are both minor and remote. Bone loss will occur, but will be inconsequential if limited to a 10-day span. Constipation is the one complication that will occur almost without fail. A ketogenic diet is used in medical practice to treat intractable seizures -- but that's a case where the inconvenience and adverse effects of the diet are the lesser of two evils, because the alternative is uncontrollable epilepsy.

What makes the K-E diet truly appalling is that it transforms a medical therapy into the indulgence of a short-term, short-sighted, vanity-driven whim.

If the K-E diet survives a while -- and I sure hope it doesn’t -- I bet it will come to be defined as an eating disorder in its own right. I fully appreciate the frustration many people feel when trying to lose weight, but if bulimia is not the right answer for that problem, neither is this!

A nasogastric tube is an unpleasant, undesirable medical procedure we impose on sick patients who can't eat. It carries with it a risk of aspiration pneumonia, which can be fatal.

In terms of quick weight loss, this dangerous nonsense is a guarantee of quick rebound with interest, since it involves no useful behavior change whatsoever. As for the doctors involved in peddling this travesty, I condemn their actions. The job of physicians is not to come up with any way to satisfy a patient's whim no matter how fundamentally at odds with health.

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