Higher Ketone Levels During Dieting Suppress Hunger Hormone Ghrelin and Boost GLP-1 and CCK

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.

Martins, Catia et al.·Obesity (Silver Spring·2020·Moderate EvidenceObservational
RPEP-04986ObservationalModerate Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Moderate Evidence
Sample
N=87
Participants
87 individuals with obesity (BMI 36.5, age 42.4, 39 males) on 8-week very low-energy diet

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't Tell Us

Observational correlations — cannot prove causation; no non-ketotic control group; subjective appetite didn't correlate with βHB; confounders possible; short follow-up.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
βHB → lower ghrelin Higher ketone levels correlated with reduced hunger hormone ghrelin (r=-0.315, P=0.003) after major weight loss
Evidence Grade:
Moderate — well-designed observational study with 87 participants and validated hormone measurements, but correlational only.
Study Age:
Published in 2020; the ketone-appetite connection continues to be actively studied.
Original Title:
Association Between Ketosis and Changes in Appetite Markers with Weight Loss Following a Very Low-Energy Diet.
Published In:
Obesity (Silver Spring, Md.), 28(12), 2331-2338 (2020)
Database ID:
RPEP-04986

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

Why are people less hungry in ketosis?

This study suggests ketones directly influence gut hormones — suppressing ghrelin (hunger) while boosting GLP-1 and CCK (fullness) — creating a hormonal environment that reduces appetite.

Do ketone supplements work the same way?

Unknown. This study involved ketosis from calorie restriction. Whether exogenous ketone supplements have the same appetite hormone effects hasn't been established.

Read More on RethinkPeptides

Cite This Study

RPEP-04986·https://rethinkpeptides.com/research/RPEP-04986

APA

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

MLA

Martins, Catia, et al. "Association Between Ketosis and Changes in Appetite Markers with Weight Loss Following a Very Low-Energy Diet.." Obesity (Silver Spring, 2020. https://doi.org/10.1002/oby.23011

RethinkPeptides

RethinkPeptides Research Database. "Association Between Ketosis and Changes in Appetite Markers ..." RPEP-04986. Retrieved from https://rethinkpeptides.com/research/martins-2020-association-between-ketosis-and

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.