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If you wish to follow a ketogenic diet whilst taking Wegovy, healthcare professionals typically recommend: Comprehensive medical assessment before starting, including baseline blood tests (renal function, liver function, lipid profile, HbA1c) Regular monitoring of blood glucose, particularly if you have diabetes Medication review to adjust doses of any diabetes medications and prevent hypoglycaemia Nutritional counselling with a registered dietitian to ensure adequate nutrient intake Hydration and electrolyte management , as both interventions can affect fluid balance Gradual implementation rather than abrupt dietary changes Monitoring for gallbladder disease , as rapid weight loss increases risk of gallstones Diabetes UK and other professional organisations emphasise that very low-carbohydrate diets should be undertaken with medical supervision, particularly in patients taking glucose-lowering medications