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You can get a fatty liver when you start dropping lots of weight, as you will once you begin running on ketones instead of glucose. For example, if a child is eating a 1500 calorie regular diet, it would be changed to a 1500 calorie ketogenic diet. When you start the ketogenic diet, it s best to keep your carb intake to 5 10 of your daily calories. Yes, you will lose a lot of weight quickly, but I am not interested in giving up bread, pasta and birthday cake for the rest of my life. The way to accurately measure if you are in ketosis is by testing blood ketones levels.