Can a person who wants to lose weight eat no carbs and eat good fats and proteins to go into ketosis or is this counterproductive because of the fats? The other factor is the person can't exercise because they have inborn errors of metabolism making them exercise intolerant so their situation is different from a regular person that can exercise alongside a ketogenic diet. Another question is that they also have protein maldigestion problems and many of their Amino acids are low. Doctors lack knowledge regarding this area so I need some help here. Would they be better just eating low calories or is a keto diet still possible? Thanks
Yes, an overweight person can certainly lose weight on a ketogenic diet (assuming they're one of the people who does well with ketosis in general). Ketosis makes your body drastically better at burning fat for energy, which includes both dietary fat and the fat in their own body. As long as they are still running a small to moderate caloric deficit, they have a good chance of losing weight.
Getting into ketosis involves a period of low energy and general ill-feeling (the "low-carb flu"). This can be a double whammy along with exercise intolerance, so the startup period may be really tough. Many people find that ketosis dramatically increases their energy levels, but some find that even after a couple of months they're still sluggish and fatigued. If that's the case, ketosis is probably not a good idea (especially since afaik the best known treatment for exercise intolerance is to push yourself to exercise anyway).
Keto is hard work, and there are some potential side effects, but these are probably less than those you would incur by not losing any weight. In the short term at least, I think it's the most effective way of quickly shedding weight, with or without exercise.
I'd recommend Phinney and Volek's "The Art and Science of Low Carbohydrate Living".
The protein maldigestion thing is a bit of a red flag though. Keto is a low-carb, restricted protein diet. What happens to your undigested protein? You need to be careful to eat enough protein to meet your structural needs, and to fuel gluconeogenesis, but not so much that you kick yourself out of ketosis. I wouldn't know how to do the calcs with you.
Thankyou. The problem with the protein is Achlorhydria(absent gastric acid) due to chronic gastritis. the problem with the exercise intolerance isn't "exercise difficulty" like some normal people have,it's actually exercise intolerance in the medical sense, where exercise causes ill health as opposed to good health,due to their being a mitochondrial myopathy,lactic acidosis and rhabylosis ( unsure of the spelling) where the muscle is breaking down during exercise and turning the urine red/brown.