This review paper outlined mechanisms by which a keto diet (KD) may be helpful, including improving insulin resistance, managing the inflammatory response, and facilitating weight loss while preserving muscle mass. Quality of life scores also tend to improve significantly in patients with lipedema who follow a keto diet.
The paper also explores the possibility that a low-calorie version of a KD may be more effective, at least at the beginning, compared to a standard KD. The very-low-calorie ketogenic diet (VLCKD) calls for 700-800 calories per day consisting of 30-50 grams per day of carbohydrates, 20-40 grams per day of fat, and 1.2-1.4 grams of protein per kg of ideal body weight per day. The main difference between a standard KD and a VLCKD is the reduction in fat intake on the latter. Nutritional supplementation is encouraged (B-complex, vitamins C & E, select minerals and omega-3s), and emphasis is on proteins of high biologic value – from animal sources and higher biologic value non-animal sources, such as soy and peas.
More research is needed, but the limited number of clinical trials so far suggest that ketogenic diets – whether specifically very low calorie or not – may offer a bit of light against a condition that has woefully few treatments that are effective over the long term. The authors of the present review wrote, “From the few studies available to date, KD is effective not only for rapid weight loss but also in improving pain symptoms and quality of life in subjects with lipedema.”
See this previous article for more details on the use of ketogenic diets for lipedema.