Is a "keto" diet basically the Atkins? I don't want to upset anyone, but the basis behind that is nothing to do with ketoacidosis, that bit's just a mythical explanation. Iirc, the sciencey brainiac thing behind it is actually good old CICO - people on the Atkins and equivalents are actually eating less, because protein makes us feel full more quickly. We've evolved to eat protein and vegetables so that's the underpinning. I really don't want to cause a bunfight or upset anybody; it doesn't matter how it works as long as it does for you, and there's good reason behind that. There was an excellent British documentary on why the Atkins diet does actually work, if anyone is interested let me know and I'll try and search out a link.
Problem is, it doesn't work for people like Amber who don't eat for fuel and have totally lost all bodily cues telling them they are full. This is why she needs a dietician, because a super-morbidly obese person likely already has catastrophic cholesterol and, given something like Atkins will see a a no boundaries diet and load up on high-protein, high-cholesterol foods and still eat waaaaay beyond satiation.
Please don't get me wrong, I'm not knocking it and she is absolutely rude beyond belief when she dismisses genuine suggestions for a diet that actually works for well-understood reasons; people promote it because it works for them. And she's not an uncontrolled binge-eater regardless of how she tries to sell it - she simply overeats. She may binge on top of that, but we see what she eats ordinarily and we'd all be whales eating like that. An open-ended diet could do her more harm than good because she will still over-eat, it would merely be qualitatively different.
She doesn't know what hunger is and has built an enormous internal database of utter nonsense which she thinks is dietary knowledge. It's not, it's justification (ie. It's "bad" to not eat for five hours and otherwise I'd eat a carrot so....next minute, she's fully justified being face-first into her nosebag full of pizza.) Doc Now puts his patients on such a constricted diet partially so they relearn their body cues and actually start to recognise hunger and satiation. And that the very mild discomfort of hunger won't strike them dead any second now. And the fixed mealtimes break the emotional eating link.
It's hypothetical but I don't think she'd even pass screening for 600lb life. How many of us have said she doesn't really want to change, she just wants acceptance, validation and a green light. I don't know how many get turned down for that show, but screening is probably pretty brutal. And, of course, she'd not be able to put anything up on YT, so no "job." I can just imagine his face when, after gaining 20lbs at her first follow-up, she explains she hadn't eee_un for three hours and needed to do a mookboorng. But he can ask Becky, she totally stuck to the diet otherwise. Tell him, Becky!