Rethinking Mental Health: The Promise of Ketogenic Metabolic Therapy (KMT)

May is Mental Health Awareness Month – and a powerful reminder that it’s time to rethink our approach to mental health. As the field of metabolic psychiatry gains momentum, Ketogenic Metabolic Therapy (KMT) continues to emerge as a promising, evidence-based intervention for conditions like schizophrenia, bipolar disorder, major depression, and anxiety.

It is often overwhelming for those suffering from mental health issues to make significant dietary and lifestyle changes. As such, I have decided to launch a 12-week group coaching program to explore how nutrition can support brain health and to support the implementation of a therapeutic ketogenic diet for cognitive and mental health.

In an editorial titled “Ketogenic Metabolic Therapy as a Treatment for Mental Health Disorders” published in April 2025 in Frontiers in Nutrition, Ede et al., look at some of the latest research. I have listed just some of the papers they refer to:

1. Calabrese et al. present a case series of 3 adults who achieved complete remission from both treatment-resistant major depressive disorder and generalized anxiety disorder after engaging in a 12–16 week ketogenic diet.

2. Edwards et al. presents the first pilot trial of diet-induced ketosis with exogenous ketone supplementation in PTSD, documenting clinical benefits in two of the three individuals who completed the 4-week protocol.

3. Laurent details the case of a woman with bipolar disorder whose depression had responded only minimally to weekly ketamine treatments. KMT led to measurable improvements not only in depression, but also in anxiety and PTSD symptoms.

4. A review paper by Frank and Scolnick presents emerging evidence suggesting that properly formulated ketogenic diets, despite commonly being viewed as weight loss interventions, may support people in their recovery from anorexia nervosa, a condition with a high fatality rate and no approved biological treatment.

5. Gertler and Blackford highlight the underexplored potential of KMT in the management of paediatric mental and metabolic health disorders, particularly those that often coexist in children with epilepsy such as ADHD, autism spectrum disorder, and childhood obesity.

In addition to these, there have been a number of earlier studies (there are many more studies, these are just a handful that I have picked):

1. In a May 2024 pilot trial, Sethi et al. showed that individuals with schizophrenia or bipolar disorder showed improvements in psychiatric symptoms, metabolic health, and overall functioning.
2. In a narrative review, Brietzke et al., discuss the underlying metabolic mechanisms of bipolar disorder and look at the impact KMT can have on mitochondrial function, inflammation and neurotransmitter balance.

3. In a case series, Calabrese et al. report on three adults with major depression and generalized anxiety disorder who achieved complete remission within 7–12 weeks of initiating a personalized ketogenic diet. Improvements were also noted in metabolic health and psychological well-being.

 

Together, this handful of studies underscore a growing shift in psychiatry – toward metabolic therapies that target core drivers of mental illness, including brain energy deficits, inflammation, and oxidative stress. While making significant dietary and lifestyle changes can feel overwhelming, a well-formulated ketogenic diet is generally safe to try and offers meaningful potential for improving mental health. That said, expert guidance and coaching are essential to ensure the diet is implemented correctly and sustainably – greatly increasing the likelihood of long-term success.