Can the Keto Diet Cause Eating Disorders?

When I learned about the keto diet, it didn’t feel too different from my post-Whole30 eating habits. My typical plate was filled with mostly veggies, meat, and tofu; I drank green smoothies for breakfast; and I swore by bulletproof coffee (though I still enjoyed cocktails at happy hour and my favorite pad Thai). I’d heard that some women struggling with PCOS (like myself) found symptom relief with higher-fat, lower- carbohydrate diets — so I stocked up on all the fats and began my own 21 days of keto challenge.

Moment of pure, unfiltered honesty: my first week on the keto diet felt like a mix between repeatedly being hit with a sledgehammer and being punched in the stomach. Torture. I experienced the reality that is the keto flu, which manifested for me as several days of pure exhaustion, headaches, general grumpiness, and poor sleep. I’d read this was all part of the journey, so I took friends’ advice to up my calorie intake and drink a ton of water. But after nearly two weeks, I didn’t feel anything close to the gobs of mental clarity and energy they proclaimed.

As I pushed into my second week, I noticed a general keto takeover of my mind. When I found myself spending more time googling the net carbs in pieces of kale for my salad than eating it, I realized what had started as an enthusiastic wellness adventure had taken a dark turn — one I am still recovering from.

“Diets such as keto and Whole30 can trigger dangerous restriction habits, create a setup for binge-eating, and send obsessive food thoughts spiraling,” said Dr. Ashley Solomon, executive clinical director of Eating Recovery Center in Ohio. “These diets are not effective long-term, and when they ultimately fail, they have people beating themselves up for not ‘trying hard enough’ rather than understanding that a restrictive and unhelpful way of eating was never the answer.”

I dropped five pounds in under two weeks, but I couldn’t shake my constant exhaustion and irritability.

I dropped five pounds in under two weeks, but I couldn’t shake my constant exhaustion and irritability. My coworkers began to take notice. As a fitness professional, my job requires me to be on at all times — and I was less than present. I loved cooking, but I began to dread mealtime for fear of miscalculating carbs or just not having the energy to whip up even the simplest of meals. This unhealthy mindset triggered a slide back down the path of my disordered eating tendencies. Thought patterns, obsessions, and actions that hadn’t been part of my life for years were reappearing at an alarming rate.

I wondered how all of this could emerge from a single diet challenge. “The problem is fundamental to the way that food is framed in these plans,” said Dr. Solomon. “Plans like Whole30 and keto talk about ‘stripping’ and ‘eliminating’ foods from your life, which frames food as something to be feared and avoided. Depriving our bodies of a variety of food experiences and nutrients will have our brains crying. For people at risk for eating disorders, this can be a recipe for disaster.”

When I decided to stop the keto diet, my body revolted. I woke up constipated and inflamed — my stomach was distended in a constant state of bloating, my face puffy and swollen. My body began holding on tight to the influx of carbohydrates, and I quickly gained back any weight I had lost and then some.

Not only did my body physically rebel, but so did my mind. My cravings grew so fierce I was dreaming in carbs. I wanted the bags of candy at the gas station, the glowing cabinet of baked goodies at Whole Foods, the plastic containers of grocery store cupcakes with their neon frosting. Foods I never thought twice about before practically screamed at me. Healthy nutrition habits I’d refined over the past year virtually disappeared, and once again I was a slave to sugar and white carbs.

“Creating rigid rules around food reinforces feelings of fear, anxiety, and shame for people predisposed to disordered eating,” Dr. Solomon said. “Plus, most of these diets even acknowledge that cravings increase upon starting them, which is a key trigger for binge-eating.” I could relate; I felt ashamed of my “failure” to complete a simple 21-day keto trial and of my backslide in an area of my life where I had worked tirelessly to recover.

To compensate for my out-of-control feelings, I was thrown back into the cycle of binge-eating and purging once more. I finally confided in a close friend who urged me to seek out professional support in my recovery journey.

To compensate for my out-of-control feelings, I was thrown back into the cycle of binge-eating and purging once more.

I have dear friends and acquaintances who have had massive success with keto, Whole30, low-carb, vegan, Paleo, and other of-the-moment eating lifestyles. I found my own success in rooting out food intolerances with the Whole30 the first time I did it a year ago, and even in switching to a higher-fat, lower-carb diet.

But now I know there’s a darker side of the fad diet story. Not every new diet that gains popularity is suitable for everyone. Food is so richly tied to ourselves and our emotions. And as much as some preach the benefits of their own particular approach, there really is no solid one-size-fits-all approach to a healthy lifestyle.

When deciding to give a trend or new way of eating a try, chat with a health professional such as a registered dietitian or holistic nutritionist first rather than diving in after skimming the internet or reading up on what your favorite blogger does. There are real dangers to be aware of when beginning any new diet. It’s so easy to get caught up in the pursuit of a healthy lifestyle that we can toe the line between passionate learning and unhealthy obsession. “A focus on health and well-being has been demonstrated to have the best long-term outcomes [rather than diets],” Dr. Solomon said. “And for those without specific medical conditions, enjoying a variety of foods and having food freedom rather than elimination is the key.”

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