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Dr. Eric Smith, who has been instrumental in the sisters' progress, is likely to continue playing a key role in their care. The upcoming season may feature Tammy's skin removal surgery, a milestone in her transformation. The sisters' newfound celebrity status has brought both opportunities and challenges to their relationships. The best keto supplements provide nutritional support while you are transitioning to ketosis. "The focus of eating is on whole non-processed foods including protein and non-starchy vegetables, and not restricting fats," said Sethi, who shared keto-friendly meal ideas with the participants. On average, the participants lost 10% of their body weight; reduced their waist circumference by 11% percent; and had lower blood pressure, body mass index, triglycerides, blood sugar levels and insulin resistance. (Ketones are acids produced when the body breaks down fat - instead of glucose - for energy.) 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