The Ketogenic Diet–Induced Weight Gain With Decreased Energy Consumption

The ketogenic diet (KD) has been used to improve seizure control in patients who have intractable epilepsy. It typically stimulates energy metabolism and, thus, calorie requirements, raising the concern of growth impairment among children. We have identified 3 patients who paradoxically gained weight over time with decreased daily calorie requirements while on the KD. Although the exact mechanism for this unexpected side effect is unknown, it is likely related to improved seizure control.