I am not a doctor and this is not to be taken, interpreted or construed as medical advice. If you have poor liver or gallbladder function, it can be a good idea to take care of that prior to a high fat diet, yes. But a healthy high fat diet would not cause liver issues per se. These are just my own personal thoughts and not a prescription or a diagnosis or any form of health care whatsoever.
The bulk of research suggests that the ketogenic diet is more effective than conventional diets in helping you lose weight and shed body fat. One of the reasons why the ketogenic diet provides such reliable weight loss results is because it consists primarily of highly-satiating whole foods like meat, high-fat dairy, and low-carb vegetables while removing all carb-rich, sugar-laden processed foods from the diet. By eating in this way, you will feel full while eating fewer calories and losing weight.
I am so glad that I never went full board on the keto diet. I work from home. Because of this, I have the option to eat my bigger meal at lunch time rather than dinner/supper. What I noticed for me personally is that when I go to bed on a fully carbed meal, I am less likely to want to eat breakfast in the morning. So, I have moved my carbs to lunchtime and then a dinner that is lighter and less carbed out. I also go to the gym in the evening and just don’t care for a heavy meal sitting on my stomach because I feel like I have to work out just to burn that meal off.
"Growing up, I was always sick to my stomach and doctors couldn’t see anything wrong. After going keto, all those symptoms went away, until I have a cheat meal. For the first year, I didn’t have any cheats. Now, 95 percent of the time it’s keto, but if we go on vacation or have an anniversary, I’ll have a cheat meal. I usually don’t feel good after cheating and I remember why I don't like to do it."  

Eggs and dairy. If you think there’s nothing better than butter and cheese, you’re in luck! Eggs, butter and cheese are all a big part of eating Keto. You’ll want to make sure your items are as unprocessed as possible, so stick to cheeses like cheddar, mozzarella and blue, and look for butter and egg products that are organic or come from free-range animals.
Wondering what fits into a keto diet — and what doesn’t? “It’s so important to know what foods you’ll be eating before you start, and how to incorporate more fats into your diet,” says Kristen Mancinelli, RD, author of The Ketogenic Diet: A Scientifically Proven Approach to Fast, Healthy Weight Loss, who is based in New York City. We asked her for some guidelines.
Frankly, the results of my foray into ketosis and eventually keto-adaptation were astounding. I had the best Ironman triathlon season of my life and shocking levels of mental focus and physical ease, especially for races and workouts that lasted longer than two hours. Without experiencing muscle loss, hunger pangs or brain fog, I found I could go the entire day without eating, which was enormously helpful for business and personal productivity. My gas, bloating, fermentation and GI “issues” disappeared. My blood levels of inflammatory markers like HS-CRP and cytokines dropped to rock-bottom, while my levels of good cholesterol, vitamin D, and anti-inflammatory fatty acids skyrocketed.
So why did Atkins fall out of favor? Well, the diet’s delightful side effects could include fatigue, constipation, excessive thirst, bad breath, the dreaded meat sweats, and worst, the look your friends would give you when you said you were on Atkins. There was also the fact that the diet wasn’t really sustainable (kinda like most diets, funnily enough). In 2003, a pair of studies in the New England Journal of Medicine found that most of the weight one initially lost while following Atkins was water weight; and subjects who followed the diet typically gained back any lost weight in six months.
A reduced availability of dietary carbohydrates leads to an increased liver production of KBs. The liver cannot utilize KBs because it lacks the mitochondrial enzyme succinyl-CoA: 3-ketoacid (oxoacid) CoA transferase (SCOT) necessary for activation of acetoacetate to acetoacetyl CoA. KBs are utilized by tissues, in particularly by brain. KBs enter the citric acid cycle after being converted to acetyl CoA by hydroxybutyrate dehydrogenase (HBD), succinyl-CoA: 3–CoA transferase (SCOT), and methylacetoacetyl CoA thiolase (MAT). Modified from Owen (2005), Paoli et al. (2014).

Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.
Since originally publishing this article, I’ve been asked whether elevating blood ketones with exogenous sources could trigger a ketone-induced release of insulin that would theoretically reduce hepatic ketogenesis and perhaps slow fat mobilization. This makes sense since you are putting more energy into the system in general (from exogenous ketones), so there would be less need to draw off your own fat stores.
Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[18] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[3]
Other kinesiologists think the keto diet could have dangerous effects on athletic performance, and it's tough to know what potential side effects a long-term high-fat diet might have for a healthy person, since we don't have any solid study results yet. Low-carb diets like keto can make it easy to neglect key nutrients like magnesium, calcium, and potassium found in fresh, high-carb foods like beans, bananas, and oats.
Gut health is extremely important for anyone looking to lose weight and increase overall health[*][*]. It is not uncommon for those who shift to a ketogenic diet to have a change in the production of bacteria in their colon (although not necessarily a bad thing – just a change)[*]. To help support this change and increase the healthy bacteria in your gut, try consuming more fermented foods such as sauerkraut, kimchi or kefir and/or supplement with a high-quality probiotic[*][*].
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