In 87 people who lost ~18 kg on a very low-calorie diet, higher blood ketone levels were associated with lower ghrelin and higher GLP-1 and CCK satiety hormones.
βHB → lower ghrelinHigher ketone levels correlated with reduced hunger hormone ghrelin (r=-0.315, P=0.003) after major weight loss
What the researchers found
Fasting βHB negatively correlated with ghrelin changes (P=0.003) and positively with GLP-1 (P=0.025) and CCK (P=0.035) after 17.7 kg weight loss, but not with subjective appetite.
Why it matters
Weight loss typically increases hunger (the body fights back). Ketosis may counteract this by modulating gut hormones, making very low-calorie and ketogenic diets more tolerable.
The numbers in context
Lost 17.7 kg; BHB 1.24 mmol/L; ghrelin r=-0.315 (p=0.003); GLP-1 r=0.244 (p=0.025); CCK r=0.228 (p=0.035); no PYY correlation
How the study worked
Observational study of 87 adults with obesity (BMI 36.5) on 8-week very low-energy diet. Measured at baseline and week 9: body composition, fasting βHB, active ghrelin, GLP-1, PYY, CCK, insulin; subjective appetite by VAS.
Who was studied
87 individuals with obesity (BMI 36.5, age 42.4, 39 males) on 8-week very low-energy diet
What this study cannot tell us
Observational correlations — cannot prove causation; no non-ketotic control group; subjective appetite didn't correlate with βHB; confounders possible; short follow-up.
How to read the evidence
Moderate — well-designed observational study with 87 participants and validated hormone measurements, but correlational only.
When this study was published
Published in 2020; the ketone-appetite connection continues to be actively studied.
The bigger picture
The appetite-suppressing effect of ketosis may explain the popularity and reported ease of ketogenic diets. Understanding the mechanism (via GLP-1 and CCK) could lead to targeted therapies.
Questions still open
- Does exogenous ketone supplementation suppress ghrelin without calorie restriction?
- Would maintaining ketosis long-term prevent the appetite rebound that drives weight regain?
- What molecular mechanism links βHB to GLP-1 and CCK secretion?
Common questions
Why are people less hungry in ketosis?
Do ketone supplements work the same way?
Read the original research
Association Between Ketosis and Changes in Appetite Markers with Weight Loss Following a Very Low-Energy Diet.
Obesity (Silver Spring, Md.), 28(12), 2331-2338
Citation
Martins, Catia; Nymo, Siren; Truby, Helen; Rehfeld, Jens F; Hunter, Gary R; Gower, Barbara A. (2020). Association Between Ketosis and Changes in Appetite Markers with Weight Loss Following a Very Low-Energy Diet.. Obesity (Silver Spring, Md.), 28(12), 2331-2338. https://doi.org/10.1002/oby.23011