He has tried a ketogenic diet, and he did not enter ketosis
Options:
Ketosis Resistance
Too many carbs? Did the diet wrong?
Didn't stay on the diet for a long enough? Less than a month?
Drank lots of water, diluted urine test?
If he can rule out the other options, and he didn't lose any weight, it might be ketosis resistance.
By the way, metabolic disorders are usually a sign that a person will get diabetes at some point.
There is this thing called Ketosis Resistant Diabetes Mellitus. At least one person has fixed it using diet.. I'm pretty sure that this paper is describing a previously known diet-based insulin sensitivity improving procedure, although it's hard to tell without access to the full paper.
I'm not sure whether the ketosis resistance and the diabetes are linked, or whether both ketosis resistant and ketosis susceptible people both acquire high insulin resistance at equal rates, but the interaction matters if you want to use ketosis for weight loss.
I doubt Eliezer Y. has full blown diabetes yet, since it would have been diagnosed already, but since metabolic syndrome is usually a diabetes precurser and a sign of insulin resistance I consider it worth looking into. Diabetes type-2 proper is just the extreme end of the insulin resistance spectrum coupled with the pancreas not compensating properly.
(Disclaimer: my field is neuroscience, not medicine. I just idly read about metabolism sometimes because it's important for brain things, and because people I care about have diabetes.)
Eliezer and I have put together this first pass at a recipe for DIY ketogenic soylent--or, as he prefers to call it,The Mildly Surprising Super Ketonic Dietary Replacement Weight-Loss Fluid - It's Not Food, It's Dietary Replacement Fluid!(R) (I am not in full support of this particular preference...)
So let's play Make a Prediction. It seems more likely to be useful than "free associate with why soylent/ketosis is awesome/stupid". Imagine that Eliezer has around a week's worth of infinite willpower (that can only be spent on resisting food cravings etc.). Further, imagine your crystal ball shows you that a month from now, he hasn't lost any weight. What does it tell you about why?
Ketogenic Soylent v1
1 scoop Gold Standard whey protein
1½ tsp calcium citrate powder
1 tsp creatine
½ cup+1 tbsp ground flax
4 tbsp Hershey’s Special Dark cocoa powder
2 tbsp lecithin
⅗ tsp potassium citrate on day 1, increase gradually to 1tsp by day 5, don’t exceed 2tsp
½ tsp iodized salt
⅛ packet Emergen-C
⅕ cup olive oil
1¼ tbsp flaxseed oil
⅗ cup MCT oil
Sucralose to taste
We might need to add water to get the consistency right.
Pills
1 capsule vitamin D supplement/day
2 Opti-Women vitamins per day
1 capsule MSM
Totals Per Day
Calories: 1866
Fats: 193.5g
Carbs: 12g
Protein: 54g
Fiber: 25g
Biotin 250mcg
Calcium 150mg
Chromium 120mcg
Copper 2mg
Folic Acid 600mcg
Iodine 200mcg
Iron 18mg
Magnesium 75mg
Manganese 5mg
Methyl-Sulfonyl-Methane 1000mg
Molybdenum 70mcg
Niacin 20mg
Pantothenic Acid 20mg
Potassium: 5g
Riboflavin 20mg
Selenium 70mcg
Sodium 3g
Thiamin 20mg
Vitamin A 5,000IU
Vitamin B6 20mg
Vitamin B12 100mcg
Vitamin C 250mg
Vitamin D 1600IU
Vitamin E 100IU
Vitamin K 80mcg
Zinc 15mg