Posted on 09/03/2025 1:49:25 PM PDT by nickcarraway
Glucagon-like peptide-1 (GLP-1) agonist medications such as semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound, Mounjaro) have taken the world by storm over the past few years. People are losing tremendous amounts of weight and improving certain chronic medical conditions when all else has failed to help. Yet, it was an accident that GLP-1s were rediscovered as a toolopens in a new tab or window for weight loss.
We have had GLP-1 medications on the market for a long time now, such as in the form of liraglutide (Saxenda). Liraglutide was first approved by the FDA in 2010 to improve blood glucose in patients with type 2 diabetes, but studies of the drug hinted at the weight loss potential offered by GLP-1s via its 5 and 10% weight lossopens in a new tab or window compared with placebo. However, only more recently was that potential taken seriously as an intervention in and of itself. Today, GLP-1s are seen as a game-changer for the world's growing obesity problem.
This brings us to the ketogenic, or "keto" diet, which has traditionally been used for weight loss and fitnessopens in a new tab or window. It has taken the health and fitness sector by storm in waves over the years, and routinely stirs controversyopens in a new tab or window. The keto diet is highest in fats, moderate in protein, and extremely low in carbohydrates. While exact amounts of each macronutrient can differ and there are multiple variations, a general rule is to keep carbohydrate intake extremely low (as low as 20 grams of net carbohydrate intakeopens in a new tab or window daily in some cases).
What is less well-known are the promising results of the keto diet in the medical literature across a variety of specialties. Beyond its effectiveness in weight loss, it has also shown risk reduction benefits for heart health, canceropens in a new tab or window, and even epilepsy. Even less well known is that in psychiatry, there is emerging research showing its impact on schizophrenia and bipolar disorderopens in a new tab or window, and more recently in obsessive-compulsive disorderopens in a new tab or window. Remarkably, some patients even claim the diet has brought to complete remissionopens in a new tab or window cases of the most treatment-resistant psychiatric conditions -- a claim actively sought by pharmaceutical companies for their drugs.
One case series showed success of the ketogenic diet for patients with a serious treatment-resistant psychiatric condition: anorexia nervosa. This is a condition in which patients will restrict eating for prolonged periods of time, which leads to it being the deadliest psychiatric conditionopens in a new tab or window. Patients with severe anorexia nervosa can routinely spend years pursuing treatments in inpatient medical and psychiatric units, eating disorder-specific units, structured outpatient group programs for eating disorders, and outpatient care with multiple individual specialists from various specialties, including psychiatry and adolescent medicine.
Published in the Journal of Metabolic Healthopens in a new tab or window, the case series follows three patients with anorexia nervosa who developed sustained improvements in their condition over the course of multiple years after starting the keto diet intervention. Over 1, 2, and 5 years, these three patients each ultimately gained at least 20 kilograms (about 44 pounds) of weight, with sustained weight restoration over those time frames. It is important to note that these were severe, treatment-resistant cases -- they suffered with anorexia for many years, and because of their conditions, these patients had developed multiple medical problems that directly resulted from food restriction, including osteoporosis, hypogonadism, and multiple organ prolapses treated with surgical interventions.
As a psychiatry resident, I am naturally fascinated by this promising potential of the keto diet. This may be a true disease-modifying interventionopens in a new tab or window -- perhaps comparable to the likes of a medication such as lithium for bipolar disorderopens in a new tab or window. Despite this, keto has long been overlooked.
So, how does it work? Theories point toopens in a new tab or window ketones' effects in improving the health and functioningopens in a new tab or window of mitochondriaopens in a new tab or window, brain neural energy metabolism, and immune response throughout the body.
However, we will need more than case reports and series in order to determine true efficacyopens in a new tab or window and for this intervention to gain traction. Some groups are already working on clinical trialsopens in a new tab or window.
I believe the keto diet has the potential to become one of the most serious breakthrough treatments in psychiatry. It could entirely redefine psychiatric "treatment-resistance" as we know it. Of course, there are certainly weaknesses to the keto diet, such as with stigma, lifestyle change, and long-term adherence -- especially within populations that face significant socioeconomic barriers. But I believe the keto diet can completely change lives if it were to be adopted more readilyopens in a new tab or window in psychiatric practice.
It is only a matter of time before the keto diet takes the world by storm as GLP-1s recently have, to potentially spur a new revolution as the "Ozempic" or "Zepbound" of psychiatry.
Zane Kaleem, MD,opens in a new tab or window is a fourth-year psychiatry resident at Penn State Milton S. Hershey Medical Center in Hershey, Pennsylvania. He can be reached on X @ZaneKaleemopens in a new tab or window.
“...opens in a new tab or window...”
20 times.
Sorry, it’s not on the original page, it must come up on words that are linked.
I believe they should immediately apply the possible benefits of the Keto Diet to an emerging psychiatric phenomenon.
Too many people in the Federal legal system, Boasbergers Syndrome is spreading far too much. A heavy dose (1-3 years) of the Hillsdale College United States Constitution classes, combined with a Ketogenic program, would be the best practice for effective medical treatment and psychiatric care.
Diets don’t work period.
Drugs to make you think, may make you think but I’m guessing the long term results will be worse.
If your fat, you made yourself fat. It’s on you no one else.
Self control and responsibility is where it’s at and F’ those who say otherwise.
I had an A1C of 6.5 and my doctor diagnosed me as pre-Type II diabetic and prescribed Metformin. Got off it after a couple weeks of problems. Started keto, got a glucose monitor and have lost 20 lbs, lowered my A1C by 0.9 to 5.8 and my glucose by 25 points.
Luckily you have a very progressive doctor. Most would have declared you diabetic for life.
Got off it after a couple weeks of problems. Started keto, got a glucose monitor and have lost 20 lbs, lowered my A1C by 0.9 to 5.8 and my glucose by 25 points.
Good job! You might want to check out Dr. Jason Fung's book. and videos by Dr. Sarah Hallberg.
Thank you for the suggestions! His nurse said essentially the same thing but said he likes to go through a process before final diagnosis. I’ve had some diabetes type symptoms but had an eye appt today and doctor said no changes.
Had a friend who was a Type I and he died waiting for a kidney transplant after having gone blind. At the end, he knows it was his choices that he had weaponized his disease and wouldn’t let anyone in his family donate a kidney.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.