Knowledge, perception, and experience with Ketogenic Diet for the treatment of overweight and obesity among adults: a systematic review

Abstract

Background: during the past decades, the prevalence of obesity has significantly increased around the globe, leading to increased demand for dietary interventions for weight reduction. Among these, ketogenic diet (KD) has gained great attention among adults and has been proposed as a promising option to achieve significant weight loss in a short period of time. Aim: to evaluate and critically appraise the current observational data exploring knowledge, perception, and experience of individuals using KD for weight loss, including their adherence to the diet. Methods: relevant studies were identified through five electronic databases: Web of Science, Medline via Ovid, CINAHL, Scopus, and PsycInfo, which sufficiently covered all key disciplines for the review. Eligible studies included observational studies published from 2020 to 2024, in English language, and exploring adults’ knowledge, perception, and experience with KD to manage their weight. Quality of the included studies was assessed using the AXIS appraisal tool for cross-sectional studies (CSSs). A narrative synthesis was carried out to summaries and interpret the results. Results: five studies were included in the review. The quality of studies varied: three studies were of high quality, one was of moderate quality, and one was of low quality. All of the five studies assessed adults’ knowledge and perception of KD for weight management, and three explored their current/ previous experience with the diet. In general, the overall knowledge level of participants was “good” except for one study that reported inadequate level of knowledge. The majority of participants agreed that KD is a popular weight loss intervention but argued about how safe and easy it is to be followed in the long term and that it should always be followed under medical supervision. Participants’ experience with KD showed effective weight loss outcomes with slight variations in adherence duration. The minimum duration for following KD was less than a month, and the maximum duration was six months, leading to weight regain among some participants. Conclusions: the findings conclude that KD has been an effective weight loss strategy if followed under medical supervision. However, adherence level to the diet was low, which increased the chance of weight regain. Future research: robust studies are required to evaluate KD’s potential long-term health implications, as well as assess KD effectiveness for the treatment of overweight and obesity including its sustainability.