Ketogenic (‘keto’) diets are having a major moment.
You’ve seen the headlines, right? "Burn fat faster than ever!" "Drop a dress size in weeks!" Sounds tempting. But let’s hit pause for a second.
Is it really that dramatic? That easy? Or is it another overhyped trend that’ll leave you weeping into your carb-free crackers?
If you’ve been wondering:
Can I actually burn fat faster?
Will this make my midlife belly vanish?
…then keep reading, my friend. I’ve got the lowdown on what keto is, whether it’s worth it, and – spoiler alert – if it’s even sustainable for us mere mortals.
I want to start by telling you how I first discovered the keto diet in midlife (and I believe it’s one of the main reasons thousands of other women go down this path).
Menopause weight creep. Everything was fine before menopause then, by my mid-40s, the extra pounds wouldn’t shift even though I did all things that used to work (cutting calories, more exercise). I was also feeling a bit bleugh in general (obviously not an official term).
A couple of nutritionists I was working with were trying it and losing weight but not just that, they were feeling amazing. Not hungry, energised and sharp as a pin in the brain department. So I thought, I can do this. And I did. I lost the weight. I was very strict and it was easy. I was the only adult in the house so I was more in charge of what I ate or didn’t eat than if I were in a couple.
It was great until it wasn’t. I’ll talk more about that in a bit, but let’s rewind and get clear on what the keto diet means for you and whether it could be helpful in menopause and midlife.
What is the keto diet?
In a nutshell, the keto diet is the Beyoncé of low-carb diets: it’s bold, it’s dramatic, and it’s got everyone talking.
Here’s the deal: it’s ultra-low carb, moderate protein, and very high fat. Yes, you’re basically swapping your toast for butter and your pasta for… well, more butter.
Sound a bit like the Atkins diet? You’re not wrong. Keto is like Atkins’ cooler, more scientifically backed younger sibling. Recent research has shown keto’s potential for health conditions like:
Diabetes
Polycystic ovary syndrome (PCOS)
Neurological disorders (hello, brain boost!)
Cardiovascular risk management
But here’s the twist: keto’s not just about weight loss. Its fans rave about its therapeutic benefits, which might explain why some stick with it beyond just fitting into smaller jeans.
So… what is ketosis?
Glad you asked! Ketosis is your body’s backup energy plan.
Normally, your body loves carbs – they’re like the fast food of energy sources. Quick, easy, and everywhere. But when you cut carbs, your body has to hustle harder. It starts breaking down fat in the liver, creating ketones – a super-efficient energy source your brain actually prefers. (No wonder people on keto claim to feel sharper and more focused.)
What do you eat on keto?
Get ready for some serious commitment. The keto diet is high in fat and protein, with very little room for carbs. It’s filling, satisfying, and can keep those hunger cravings at bay. But what’s on the menu?
Keto-approved foods:
Meat, fish, poultry, and eggs
Leafy greens – spinach, kale, and all your above-ground veg like broccoli and cauliflower
High-fat dairy – cheese, cream, butter (basically, a dairy lover’s dream)
Avocado – the keto poster child
Nuts and seeds – but easy on the cashews, they’re sneaky high in carbs
Low-sugar berries – raspberries, strawberries, and blackberries are all good
Foods to avoid:
Carbs, obviously – that means bread, pasta, rice, potatoes, and your beloved pastries
Starchy veg – like carrots and sweetcorn
Most fruits – apart from those low-sugar berries
Sugary treats and drinks – including the sugar in your wine (sorry!)
Even some nuts, like cashews, and drinks like lattes and cappuccinos are no-go zones. And yes, alcohol gets a downgrade too – spirits are your best bet, but mixers need to be sugar-free.
How can keto help in menopause?
First a bit of biology. If you’re eating more carbs than your body can handle on the regular, your insulin levels stay high – and that’s where the trouble starts. Over time, your cells stop responding to insulin as they should. The signal gets weaker, so your body pumps out more insulin to get the same job done. It’s like asking your partner to take the bins out for the 100th time – eventually, the message just doesn’t land.
This is called insulin resistance, and it’s incredibly common in midlife women. Why? Because of declining oestrogen.
Oestrogen is so much more than a sex hormone. It plays a huge role in how your body handles energy and glucose. In fact:
Oestrogen increases insulin sensitivity, protecting you from diet-induced insulin resistance.
It encourages your body to burn fat for energy instead of storing it.
There’s even a link between insulin resistance and brain health – women are more likely to develop Alzheimer’s Disease (sometimes called "type 3 diabetes") because of declining oestrogen and insulin issues.
How insulin resistance impacts menopause symptoms
When your cells stop responding to insulin, it’s like a domino effect. You’re left with higher blood sugar levels, which contribute to symptoms like:
Hot flushes and night sweats
Exhaustion
Brain fog and difficulty concentrating
If left unchecked, insulin resistance is just a hop, skip, and a jump away from prediabetes or even type 2 diabetes.
The flip side? When your body is sensitive to insulin, everything changes. You’re less likely to gain weight (especially around the middle), hot flushes are less frequent, and cravings seem to vanish. Your energy returns, you sleep better, and you feel like you again.
The keto diet keeps carbs super low so your body makes minimal insulin and can start healing your body so it becomes more sensitive to insulin. It’s not the only thing driving weight gain in menopause (declining muscle mass is another biggie), which is why the keto diet in menopause isn’t always the salvation you want it to me. But there’s more…
The honest bit about keto in menopause
For starters, it’s strict – and by strict, I mean you’ll be Googling “carbs in spinach” at 9 pm just to make sure you don’t blow your macros. Plus, cutting out entire food groups can feel, well, a bit joyless (looking at you, pasta).
On the flip side, if you’re dealing with midlife weight gain, hormonal chaos, or metabolic sluggishness, keto can be a game-changer. But here’s the catch: it only works if you can actually stick with it AND if your body can handle it.
Let’s start with the first bit. “Life” has a habit of getting in the way. Not everyone wants to be ‘that friend’ who doesn’t eat this and doesn’t eat that and picks over the ingredients in restaurant menus. As I can’t eat gluten, my starting point for over-analysing is higher than most. My point? Eventually, keto starts interfering with real life and that can be a problem for many ‘normal women’.
And not all bodies are compatible with a high-fat diet. Can I pull you for the ‘gallbladder’ talk?
Keto and gallbladder problems in menopause
When it comes to midlife health, the gallbladder doesn’t usually steal the spotlight. But for women over 50, this small organ can have a big impact on digestion – especially when it comes to fats.
Your gallbladder is a little pear-shaped organ tucked under your liver. Its main job? Storing and releasing bile. Bile is a digestive fluid made by your liver that helps break down dietary fats into smaller molecules your body can absorb and use.
When you eat a meal containing fat, your gallbladder springs into action, releasing bile into your digestive tract. Without enough bile, digesting fats becomes a struggle, and you might notice symptoms like bloating, nausea, or greasy stools (yep, TMI, but it’s a key sign!).
Gallbladder problems, like gallstones or sluggish bile flow, are more likely to pop up as we age – particularly for women. Here’s why:
Hormonal changes
Declining oestrogen levels during perimenopause and menopause can affect bile composition, making it thicker and more prone to forming gallstones.
Progesterone (also lower in midlife) slows down gallbladder contractions, which can lead to bile stagnation.
Weight fluctuations
Midlife weight gain or frequent dieting can increase your risk of gallbladder issues. Rapid weight loss (especially on extreme diets) is a known trigger for gallstone formation.
Genetic predisposition
Some women are genetically more likely to have gallbladder problems, particularly if there’s a family history of gallstones.
Dietary factors
A low-fibre, high-sugar diet can increase gallbladder problems, while yo-yo dieting or very low-fat diets (popular in the ’80s and ’90s) may have left some gallbladders underused and sluggish.
If your gallbladder isn’t working properly – whether due to stones, inflammation, or poor bile flow – digesting fats becomes harder. This can cause:
Bloating and discomfort after meals (especially fatty ones).
Fat malabsorption, leading to deficiencies in fat-soluble vitamins (A, D, E, and K).
Energy dips since fats are a key source of long-lasting fuel.
For women trying low-carb or ketogenic diets, gallbladder issues can make these eating approaches particularly challenging. High-fat meals require efficient bile production, and without it, these diets may leave you feeling worse rather than better.
Your genetics and the keto diet in menopause
I’m not talking about what percentage Viking you are, but the genes relating to the metabolism of glucose, risk for insulin problems, and also fat metabolism. Some women need to be more careful with their carb intake (ie keep it low) because their DNA suggests they might be prone to more problems with glucose and insulin. Some women have genetic variations on the genes that code for fat metabolism. In short: some women can’t handle their fats and this means a keto diet is not going to work. The chance of fats being malabsorbed or not transported well enough into cells (so they stay in the blood) could be higher. How can you tell? The Lifecode GX Metabolics Report. Take a look on the DNA Testing page on my website.
The verdict on keto in midlife
Keto can be a powerful tool for weight loss and improving certain health conditions, but it’s not a magic fix – and it’s definitely not one-size-fits-all. If you’re curious, start with small changes. Experiment. And always listen to your body.
Still wondering if keto is right for you? Get in touch – let’s figure out if this high-fat, low-carb life is a good fit for your midlife goals.
Thinking of getting started with the keto diet and want to know more about whether it's right for you, grab my free guide. Click the button or on the book image to download.
Have you seen our fab new food diaries & journals?
Created for anyone who wants to keep track of what they eat but without the need to measure calories, macros or syns. Just really simple: what have you eaten, what did you drink, how are you feeling today, what did you do for your self-care, what are you grateful for and - if needed - what didn't go the way you wanted? 8 and 12-week journals available in a range of lovely designs. The only food diaries I know of that have been created by an experienced nutritionist with real women in mind who recognise their life is much more than a maths equation! Check them out HERE
Comments