Sometimes medications are contributing to the obesity. For example, some antidepressants (especially Mirtazapine) and even steroid nasal sprays. Diabetes medications such as insulin and the Sulfonylurea drugs (e.g. Diamicron) also cause weight gain. So it is important to reduce or stop these if possible.
If you are on insulin this is important as once the diet is started the dose will need to drop by 50% on the first day and all rapid acting insulin has to go. Believe it or not HYPOglycaemia is a side effect of the diet because of too much insulin.
If you are on a class of drug called an SGLT2 inhibitor (eg.Forxiga, Qtern and Xigduo XR) these must be stopped. These drugs mimic a ketogenic diet by increasing ketones and the 2 together have been associated with something called “normoglycemic ketoacidosis”. So thats good…. ONE LESS TABLET.