Could Ketogenic Therapy Change the Way We Treat Mental Health?
What if changing the brain's fuel source could change the experience of mental illness? That question drives my work in ketogenic therapy and mental health. I recently joined the Good Morning Harley Street podcast to talk about how I came to this field, what I see with clients in the IKRT programs, and why I believe metabolic psychiatry deserves far more attention.
How I came to this field
My journey began with psychology and a long-standing interest in food, eating behaviour
and mood.
During my undergraduate degree, I looked at how students' eating changed around exam
time. During my master's, I became interested in eating disorders and the changes in
mood that come with them. Over time, this led me to the question that now sits at the
centre of my work: could changing what the brain uses for energy influence mental
health?
From fasting to ketogenic therapy
A ketogenic diet is designed to put the body into nutritional ketosis, a metabolic state in
which ketones become an important source of energy.
The approach is not new. Ketogenic diets were developed as a therapy in the early
twentieth century, as a way to reproduce some of the metabolic effects of fasting while
still giving people food and nutrition.
My interest in applying this to psychiatry began when I came across a 1965 paper on a
ketogenic diet in women with schizophrenia. Their symptoms reportedly improved on the
diet, then returned when they went back to a standard diet. That immediately raised a
question for me: why had this line of research largely disappeared?
That question eventually became part of my research career.
Today, ketogenic therapy is being studied across a range of psychiatric conditions. The
evidence is still developing, but recent reviews point to potential benefits for mood
disorders, psychotic disorders and eating-related conditions, while stressing the need for
larger, better-controlled trials.
Why might ketosis affect the brain?
There is no single explanation. Ketosis appears to influence several biological systems at
once, including glucose and insulin metabolism, mitochondrial function, inflammation and
neurotransmitter pathways.
One particularly interesting idea is brain hypometabolism. Put simply, some brains may
struggle to use glucose efficiently for energy. Ketones offer an alternative fuel that the
brain can use.
This does not mean mental illness is simply a metabolic disorder. Depression, psychosis,
bipolar disorder and other psychiatric conditions are complex. But metabolism may be
one important piece of that complexity, and that is where ketogenic therapy becomes so
interesting.
What does this mean in simple terms?
1. It could expand the psychiatric treatment toolkit
Mental health treatment has traditionally focused on medication, psychological therapies
and psychosocial support. Ketogenic therapy introduces another possibility: that
metabolism itself could be a target for treatment.
This is not about replacing existing treatments. It is about adding another option for
people who have not recovered enough with conventional approaches.
2. It may be especially relevant for treatment-resistant illness
Many of the people I work with have already tried multiple treatments. For someone still
living with severe depression, psychosis or another debilitating condition despite
conventional care, finding another potentially effective route could be enormously
important.
The emerging research is encouraging. There is a growing body of evidence, including
randomised controlled trials, case studies and other clinical research, suggesting that
ketogenic metabolic therapy may be both feasible and beneficial for some people with
serious mental illness. But the message is not that "keto has solved depression". The message is that there isnow enough of a signal to take this question seriously. We are seeing people experience meaningful improvements and, in some cases, feel dramatically better. That does not mean it will work for everyone, or that we should get ahead of the evidence.
It means this approach deserves rigorous research, and consideration as an option for
people who may benefit from it.
3. It connects psychiatry with metabolic health
The line between "mental" and "physical" health becomes hard to defend when you
consider how much the brain depends on metabolism. Insulin resistance, metabolic
dysfunction, inflammation and mitochondrial processes can all affect how the brain
works.
Ketogenic therapy gives us a way to look at mental health from a different direction. We
can ask not only what is happening psychologically, but also what is happening
metabolically.
4. It raises new questions about who responds
Perhaps the most important scientific question is not simply whether ketogenic therapy
works. It is who it works for, how it works, and under what conditions.
Responses vary a lot. Some people notice changes fairly quickly, while others need much longer, anywhere from weeks to many months. We need research that can identify who responds, the best ketone ranges, how long treatment should last, how it works, and when it is most effective.
There is still a long way to go
Some of the observations we discussed in the interview are striking, including substantial
reductions in hallucinations, delusions and other psychiatric symptoms. But individual
client experiences are not the same as evidence from large controlled trials, and that
distinction matters to me enormously.
I am enthusiastic about ketogenic therapy precisely because I believe it deserves better
science, not because I think we already have all the answers.
For people living with persistent mental illness, though, the possibility itself matters.
When conventional approaches have not brought enough recovery, people need credible
alternatives to explore. Ketogenic therapy may eventually prove to be one of them.
We now know that changing the metabolic environment of the brain can change the
experience of mental illness, and its trajectory. This work is already under way, and people
are getting better. The next step is to find out exactly who it can work for, and why.
Useful Links
If you’d like, you can watch my full interview with Good Morning Harley Street here
For an overview of the research so far, including a timeline of key studies from the 1965
paper to the latest randomised controlled trials, see
At IKRT, we offer a range of programs designed to educate and support you in ketogenic metabolic therapy. If you are interested in learning more, please visit the link below, and claim your free Ketogenic Therapy for Mental Health Food List:
