How to Build (and Keep) Muscle on a Ketogenic Diet Without Sacrificing Your Gains

For decades, the fitness world has preached a simple gospel: carbohydrates are the fuel for performance and muscle growth. This dogma creates a major conflict for viewers trying to reverse insulin resistance. They hear experts telling them to cut carbs and embrace a ketogenic diet to lower insulin, but their fitness-oriented mindset screams that this will inevitably lead to muscle loss, poor workout performance, and an inability to build a strong, metabolically healthy body. This tension is a significant barrier, causing many to abandon or avoid low-carb approaches out of fear of sacrificing their hard-earned muscle.

The core concern is that a ketogenic diet is fundamentally incompatible with building and maintaining muscle. Viewers are worried that without carbohydrates to fuel their workouts, their bodies will break down muscle tissue for energy (catabolism), leading to weakness and a slower metabolism. There is also practical confusion about how to consume enough protein—the building block of muscle—within the compressed eating windows of intermittent fasting or within the macro constraints of a high-fat diet. For many, the fear of "losing muscle and bone" is a primary reason they hesitate to try keto or are concerned about new weight-loss drugs.

The most powerful insight from the creators is a complete reframing of muscle's role in metabolic health. Prioritize resistance training and adequate protein, because muscle is not a vanity asset; it is your body's most powerful metabolic organ for managing glucose. Stimulated muscles can absorb glucose directly from the bloodstream without needing insulin, making them a "glucose sink" that actively fights insulin resistance.

Several creators directly addressed the synergy between exercise, muscle mass, and insulin control, providing clear, actionable advice.

• • Dr. Benjamin Bikman (on The Diary Of A CEO): He positions strength training as the best form of exercise for insulin resistance. He explains that when a muscle is stimulated through exercise, it can "eat glucose without needing insulin knocking on it for glucose to enter, thus lowering your Insulin levels". A commenter on his video perfectly summarized this concept, calling muscle the "ultimate glucose sink" and noting that returning to lifting 3-5 days a week was the key to changing their body composition and health. Dr. Bikman also advises to "prioritize protein" and "don't fear the fat," as protein and fat consumed together lead to significantly greater muscle growth than protein alone.
• • Dr. Pradip Jamnadas (on The Diary Of A CEO): He offers specific guidance on the type of exercise. He strongly recommends resistance training and High-Intensity Interval Training (HIIT) over long-duration aerobic activity, which he warns can be inflammatory. He directly counters the fear of muscle loss by stating that exercising while fasting actually preserves muscle due to an increase in growth hormone, and advises patients to work out at the peak of their fast. He also notes that fasted resistance training is perfectly fine for women.
• • Dr. Sten Ekberg: He includes exercise as a key tool to speed up the reversal of insulin resistance. While he ranks diet and fasting as more powerful overall, he places exercise as the foundational first step in a comprehensive plan.

Plan a resistance training session for tomorrow. This could be lifting weights at the gym or doing bodyweight exercises like push-ups and squats at home. Your immediate goal is to send a signal to your largest metabolic organ—your muscles—to get ready to absorb glucose.

• Mistake: Focusing exclusively on long-duration cardio for weight loss.
  Fix: Prioritize resistance training and HIIT. Dr. Jamnadas warns that excessive aerobic training can be inflammatory and less effective for improving metabolic health.
• Mistake: Under-eating protein on a ketogenic diet out of fear it will kick you out of ketosis.
  Fix: Focus on getting adequate protein to support your muscles, which are your primary "glucose sink". The fear of protein significantly spiking insulin is often overstated, especially in the context of an overall low-carb diet.
• Mistake: Believing you must "carb-load" to have a good workout.
  Fix: Once you are fat-adapted, your body becomes incredibly efficient at using fat for fuel, even for intense workouts. Ensure you are well-hydrated and have sufficient electrolytes (especially salt) to prevent dehydration-related performance drops.

• • “I’m type 2 diabetes 62yrs old on mounjaro yeah they are great get your sugars down but my body is slowly dying losing muscle and bones ache just like this gentleman has said. Thank you for all his advice I will try Keto.”
• • “how can I bulk without insulin resistance getting in the way?@HealthCoachKait”
• • “nordic walking - 6-8h a week helps me combat insulin ressistance, my bloodwork nos is much better - lower insulin from 19 to 7.3 in 2 months... the key is to use muslces then changes in diet or trying IF”
• • “I started working out and unknowingly did everything he has listed here... Now that I’ve discovered both of their YouTube channels I’m excited that there’s even more that I can learn and implement. I feel like I have another leap forward to go.”

The fear of losing muscle is a major hurdle for many people considering a ketogenic diet to fight insulin resistance. However, the expert consensus from the sources is clear: resistance training is not just compatible with a low-carb lifestyle; it is essential to it. By prioritizing strength training and adequate protein, you transform your muscles into powerful allies that dispose of blood sugar, enhance insulin sensitivity, and protect your long-term metabolic health. Shifting your mindset to view muscle as a vital organ—not just for aesthetics—is the key to successfully combining a ketogenic diet with your fitness goals.