Keto in Clinic, with Dr Lenzkes

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By Claire McDonnell Liu, Nutritionist at

Dr Brian Lenzkes’ One Size Fits One presentation is now available in our recent video release.  

Dr Lenzkes shares insights from over a decade of using Low-Carb-High-Fat nutrition and intermittent fasting therapy in clinic.  Including the tools that he values most when assessing his patients, why some people lose weight more easily than others, and the factors in addition to diet that can impact weight loss and glucose control.

Why a Low Carb Approach

As an internal medicine doctor, based in San Diego, USA, Brian was voted one of the “Top Doctors” in San Diego for 11 years.  

Despite earning the respect of his medical and patient community Brian became disillusioned with the standard medical care that he saw failing his patients.  The inability of mainstream healthcare to help his patients with chronic disease, combined with his own weight gain struggles, led him to the ketogenic diet and intermittent fasting approach. 

Brian now lectures widely as well as hosting the ‘Low Carb MD’ podcast. Along with co-hosts, Dr Tro, Dr Jason Fung & Megan Ramos, Brian interviews guests on their weight loss, health and disease reversal approaches.

Patient-Centred Approach 

In his presentation, Brian emphasises that there is not a ‘one-size-fits-all’ solution to health or nutrition.  He is very much guided on an individual’s health history and lifestyle. 

Waist circumference measurement and Continuous Blood Glucose Monitors are the tools that provide him with the most important ongoing data for his patient’s health and weight management. 

Whilst stress, sleep and exercise are also important factors to take into account when monitoring glucose, insulin and metabolic health risk markers.  Stress and lack of family support being the two biggest reasons patients fail when adapting to diet changes.  

In his presentation, we see the results of diet, exercise and stress on patient’s blood glucose charts.  With one patient’s blood glucose levels spiking as a response to delivering a stressful presentation to his CEO and board.  

Visceral Fat is our Enemy

Some people appear to drop weight much easier than others on a low carb high fat lifestyle.  Dr Lenzkes explains that often those with more visceral fat will lose weight more slowly.

He sets out the important differences between subcutaneous adipose tissue fat and visceral adipose tissue fat. 

Visceral fat wraps around our internal organs, and is far more dangerous to health than subcutaneous fat.

Subcutaneous fat lies just under the skin, around the belly, thighs and rear, accounting for around 80% of body fat.  It does not carry the same risks as visceral fat, and may even have some protective qualities.

A key take home being that visceral fat is our enemy, associated with multiple cancers, stroke, dementia and premature death.   The good news is that visceral fat around organs can be reversed with low carbohydrate and intermittent fasting approaches.

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