Keto Diet vs Bariatric Surgery: Can The One Replace The Other?

Keto Diet Vs Bariatric Surgery

Keto Diet vs Bariatric Surgery: Can The One Replace The Other?

The keto diet has become a huge trend and a viable option for anyone looking to lose weight. However, a big question amongst candidates for bariatric surgery is if a keto diet can actually replace bariatric surgery. We’re here to answer the biggest question regarding the keto diet vs bariatric surgery: can one actually replace the other? Or do they go hand in hand?

What is Bariatric Surgery?

Bariatric surgery includes procedures like gastric bypass, sleeve gastrectomy, gastric bands, and BPD/DS (Biliopancreatic Diversion with Duodenal Switch). For more information on each, check out our Guide to Bariatric Surgery, where we outline the different types of surgery, their advantages and disadvantages, and the difference between robotic and laparoscopic procedures. 

What is The Keto Diet?

According to West Medical, the keto or ketogenic diet “has been around for a century, as a medical diet to treat children with epilepsy.” It has only just recently been viewed as an option for weight loss. “The idea behind keto is that eating foods very low in carbs can put the body into a state called ketosis. During ketosis, the cells do not have carbohydrates to use for energy, so they turn to your stored fat instead. This ‘forces’ your body to burn fat, and in turn, you lose weight.” So basically, during the keto diet, you have to cut out one of the main food macronutrients in your diet: carbs. 

The keto diet has become extremely popular due to the massive amount of weight people have lost when using this regime. Some people have claimed to lose over 40 pounds of weight after years of dieting without any results. Thus, the popularity.

Keto Diet vs Bariatric Surgery

Keto Diet vs Bariatric Surgery

So which is better? Can the keto diet replace bariatric surgery? Below, we’ll discuss a few comparisons between the two. 

The Food Intake

Because keto is low in carbohydrates but high in proteins and fats, most people love the keto diet because they can still eat savory foods like cheese, steak, eggs, butter, avocado, etc. The problem with this diet is that even though you can eat a lot of delicious foods, the diet is very hard to follow. For most people, carbs represent around 50% of their daily food intake. For keto dieters, carbs represent around 5% of your daily calories. And because the carbohydrate intake is so low, it can be very challenging to follow a keto diet for a long period. 

For example, just one banana could consume all the carbs you can eat in a day. You have to say goodbye to bread, pasta, french fries, sweet potatoes, and most fruits. A good diet is all about balance – and keto, while effective, is not centered around balance.

On the other hand, bariatric surgery focuses on healthy, sustainable food changes that are developed through the development of healthier lifestyle habits. A balanced diet, regular exercise, and even mental health are taken into account when you plan on undergoing weight loss surgery. In other words, it’s much easier to follow a post-bariatric surgery eating plan (where you can allow yourself the occasional treat and focus on enjoying your life) than it is to follow a hard, rigid diet that allows little room for flexibility. 

Health issues

Any type of weight loss is a great step forward for anyone looking to improve their health. However, there is not enough research to ensure that the keto diet is safe in the long term. This is due to the high fat, high salt, and high processed foods the diet allows, which may be tied to high cholesterol, heart disease, and mortality. Another concern is the low amount of carbohydrates. Carbs have been demonized throughout the fitness industry, but in the end, we need carbs. They feed our body, provide energy, and also, they’re downright delicious. 

Bariatric surgery focuses on aiding people who have obesity-related illnesses like type II diabetes, sleep apnea, hypertension, non-alcoholic fatty liver disease, osteoarthritis, gastrointestinal disorders, and heart disease. They also focus on helping people who are morbidly obese find a way to lose weight. A balanced diet, along with the healthy change of habits, is the main focus behind weight loss surgery. In the end, bariatric surgery focuses on improving health issues, not on creating new ones. 


Like we already mentioned, keto doesn’t have any proven long-term risks. That is, yet. However, the high fat, high salt food intake has been known to be related to other conditions like high cholesterol and heart disease. According to an article by Deb Hart, keto can have some nasty side effects, including “dehydration, constipation, vomiting, kidney stones, and bone loss.” There’s also more research needed on the impact a ketogenic diet can have on cardiovascular and microbiome health in the body.

Bariatric surgery, like any other surgical procedure, has its risks. A few of them include infection, excessive bleeding, reactions to anesthesia, blood clots, lung problems, leaks in the gastrointestinal system, and very rare occasions, death. However, in the long term, a successful bariatric surgery procedure can pose no risks whatsoever and can aid in a patient’s weight loss efforts. 

Weight Loss Speed

Keto is famed for its rapid weight loss results. This speed can help keep people motivated, because they are immediately seeing results, reinforcing the habit of sticking to the diet regime. However, in any health-focused journey, speed does not win the race. Losing weight fast doesn’t necessarily mean that you are losing fat. Since carbs can make you retain liquids, some of the weight lost may be, quite simply, water weight. This means that the rapid weight loss you’ll see at the beginning of the keto diet is not replicable throughout the entire journey. Also, leaving a ketogenic diet can result in weight regain – AKA, the dreaded yoyo dieting, because the diet does not focus on generating balance or healthy habits.

Bariatric surgery can help provide fast weight loss, but it works differently. So it can both help limit the amount of food you can ingest and limit the amount of nutrients (ergo, calories), that are absorbed by your body. This process is aided by the development of healthier habits, like regular exercise and a balanced diet. Even if it isn’t fast, it’s a sure way to win the race.

Commitment & Mental Health

Like we mentioned before, the keto diet can aid in commitment at the beginning of the dieting process thanks to the speed at which weight can be lost. However, the lack of flexibility of the diet can make it extremely difficult to follow in the long term. This can impact negatively on a person’s mental health because there is no room for error when it comes to following a ketogenic diet.

Bariatric surgery, on the other hand, is done after a patient passes a series of examinations that include surgical, medical, nutritional, and psychological factors in order to ensure that a patient will be truly committed to not only losing the weight but also keeping it off.

Keto Diet Vs. Bariatric Surgery: The Conclusion

So is the keto diet a replacement for bariatric surgery? In a nutshell, yes, maybe. The ketogenic diet – or any diet for that matter -, can be a great alternative before deciding to undergo weight loss surgery. However, since the keto diet focused on an imbalance of micronutrients, keto fans may find themselves gaining back weight once they decide to go back to normal. More research is also needed to conclude the safety of the ketogenic diet as a long-term approach. 

Bariatric surgery is a great choice for those who have been trying to lose the weight for 6 months or more and simply can’t seem to shed off the pounds. The candidates also need to pass several evaluations, including psychological ones, to ensure that the process will become a success thanks to the patient’s long-term commitment to their health.

So if you’ve struggled to lose weight or have any other conditions that make you a candidate for bariatric surgery, you can contact us today to find out more about our  robotic bariatric surgery processes and whether bariatric surgery is right for you

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