The ketogenic diet involves strictly limiting carbohydrates and increasing fat intake. From a TKM perspective, a severe lack of carbohydrates can strain the 'transportation and transformation' (Yun-hwa) function of the Spleen. The Spleen governs the digestion and absorption of nutrients and their conversion into energy; when this function weakens, it leads to a state called Spleen Deficiency (Bi-heo). This can manifest as fatigue, lethargy, and indigestion, and in severe cases, may lead to the accumulation of Phlegm-Fluid (Dam-eum) or Damp-Heat (Seup-yeol), resulting in constipation or headaches. On the positive side, the production of ketone bodies can reduce appetite and lead to rapid initial weight loss. Additionally, the minimal fluctuation in blood sugar levels may be beneficial for those in the pre-diabetic stage. Conversely, the drawbacks include potential long-term weakening of Spleen function, which can increase the likelihood of a yo-yo effect. The process of metabolizing high levels of fats can also place a burden on the liver and kidneys, requiring caution for those with pre-existing renal issues. Furthermore, a lack of dietary fiber can compromise gut health. Ultimately, whether this diet is suitable for you depends entirely on your constitution and current health status. For example, those prone to Spleen Deficiency may find a traditional Korean diet focused on easily digestible foods more effective. On the other hand, those with a Damp-Heat constitution or severe abdominal obesity might consider combining a short-term keto approach with herbal medicine or acupuncture. At Baengnokdam Clinic, we determine the best dietary strategy for each individual through body composition analysis and pulse diagnosis (Maek-jin). Since there is no one-size-fits-all method, we recommend consulting with a TKM practitioner to find the most comfortable and sustainable approach for your body.