Metabolic psychiatry asks whether the way brain cells make and use energy matters in mental illness — and whether a ketogenic, animal-based way of eating has anything to offer. This site sets out what has actually been found, and what has not.
This is not a treatment for depression. If your mood has been low for weeks, please start with your GP.
One randomised trial in depression. A three-person case series. And a lot of noise.
Metabolic psychiatry — the idea that some mental illness involves how the brain produces and uses energy, and that a ketogenic diet might therefore help — is a real and active research area. Most of its more striking findings are in bipolar disorder and schizophrenia rather than in depression. For depression specifically there is now one randomised trial, in people whose antidepressants had not worked: the ketogenic group improved by about two more points on a depression questionnaire at six weeks, a difference that only just reached significance, had faded by twelve weeks, and which the authors themselves called of uncertain clinical relevance. Beside it sits a three-person case series. A review of eating only animal foods found nine human studies in all and concluded that long-term adherence cannot currently be recommended. This is a field worth watching. It is not a treatment, and nobody should read it as one.
Read every study, limitations includedNamed plainly, so you can look it up, weigh it and talk about it.
The eating pattern in this research is animal-based and very low in carbohydrate. On the plate: meat, offal, fish and shellfish, eggs, animal fats such as butter and tallow, and in some versions hard cheese and cream.
In its strictest form it excludes every plant food — grains, bread, pasta, rice and potatoes, pulses, vegetables, fruit, nuts, seeds and vegetable oils. That means very little fibre and no vitamin C from food, which is why the monitoring matters.
Restrictive, deliberately. Worth understanding before you start, not after.
Read what it involves in full
A planned course on what metabolic psychiatry proposes, what the trials found, what the food involves, and how to take the question to your doctor.
The course is in preparation at a planned price of £47. It is a separate product from the £27 guidebook and does not include it. No confirmed launch date, and no payments are being taken.
Explore the planned courseTwo resources are in preparation. Both are education about an emerging research area and about food. Neither is a treatment, and neither replaces seeing your GP.
Paid ebook
A written guide to what the research on metabolic psychiatry actually found, what an animal-based very-low-carbohydrate way of eating involves and excludes, the risks it carries, and how to discuss it with your doctor.
It is not written yet. The contents and release date have not been confirmed, and no payments are being taken.
Online video course
A planned video path through the same ground in sequence: the idea, the trials and how to read them, what is on the plate, the risks and monitoring, and the conversation with your clinician.
The course is not available yet. Its content and launch date have not been confirmed.
Both are in preparation and neither can be bought. They are separate products, bought separately — the £47 course does not include the £27 guidebook. No orders or payments are being taken, and no launch date has been set.
Four things worth settling first.
Talking therapy, medication, or both, through your GP. In England you can refer yourself to NHS talking therapies without a GP appointment. Food is not an alternative to this.
This is a restrictive way of eating that removes entire food groups. Read what it involves properly before you start, not three weeks in.
A lipid profile among them, so that any later change can be interpreted. Raised LDL cholesterol is a documented effect of this way of eating.
Some medicines need attention when carbohydrate drops sharply, and anyone with a history of disordered eating should talk to their GP before restricting anything.
Including the ones where the honest answer is no.
No. Depression is treated with talking therapy, medication, or both, arranged through your GP or an NHS talking therapies service. No diet has been shown to treat it. Anyone telling you otherwise is going well beyond what is known.
The idea that some mental illness may involve how brain cells produce and use energy, and that a ketogenic diet — which shifts the body to running on ketones made from fat — might therefore be worth studying. It is a research area, not an established treatment.
Food from animals: meat, offal, fish, eggs, animal fats, and dairy in some versions. Very little or no carbohydrate. In its strictest form it excludes all plant foods — grains, bread, rice and potatoes, pulses, vegetables, fruit, nuts and seeds. It is genuinely restrictive, and this site describes it as such.
Not clearly. One randomised trial in treatment-resistant depression found the diet group improved about two points more on a depression questionnaire at six weeks — a difference that only just reached statistical significance and had faded by twelve weeks. The authors called its clinical relevance uncertain. Beside that sits a three-person case series.
No, and this is the distinction that matters most on this site. The stronger results come from studies of bipolar disorder and schizophrenia, which are different conditions with different treatments. A finding in one is not a finding in the other, and anybody presenting it that way is misleading you.
It carries documented risks. A review of this way of eating flagged likely shortfalls in vitamin C, vitamin D, calcium, magnesium, iodine and fibre, and raised LDL and total cholesterol, and its authors concluded that long-term adherence cannot currently be recommended. Anyone considering it should talk to a doctor first and have bloods monitored.
No. Never stop, start or change prescribed medication because of something you read here or anywhere else online. Stopping antidepressants suddenly can make you unwell. If you want to come off them, that is a conversation with your prescriber, who can help you do it safely.
No, and it does not claim to be. It is an independent UK site publishing general education, written from named, cited research and from NHS and NICE guidance. No clinical review has taken place. There are no testimonials on this site of any kind.
Please speak to your GP before changing how you eat. A diet that removes entire food groups is a poor fit for anybody with that history, and eating difficulties overlap heavily with depression. Beat offers free, confidential support in the UK.
Please call the Samaritans on 116 123 — free, confidential and open at any hour. For urgent medical help that is not an emergency, call NHS 111. If you or someone else is in immediate danger, call 999.
The article this site would be dishonest without: who should not try a restrictive diet, and why restriction and low mood are a difficult combination.
Read articleHow to raise an emerging research area with a clinician, which medicines need attention first, what to ask for, and what to do if it goes badly.
Read articleIf you are going to try it: variety, offal and fish, salt and fluid, what to watch for week by week, and the signs that mean stop and see a doctor.
Read articleMetabolic psychiatry proposes that some mental illness involves how brain cells produce and use energy, and that ketones — the fuel the body makes from fat when carbohydrate is scarce — might matter. It is a hypothesis under investigation, not an established mechanism.
The more striking results come from studies of bipolar disorder and schizophrenia. Those are different conditions with different treatments, and a finding in one is not a finding in the other.
A randomised trial in treatment-resistant depression found about a two-point advantage on a depression questionnaire at six weeks. It had faded by twelve weeks, and the authors described its clinical relevance as uncertain.
Meat, fish, eggs and animal fats, with very little or no carbohydrate. The strictest version excludes all plant foods — grains, pulses, vegetables, fruit, nuts and seeds. Anyone considering it should know that from the start.
A review of this way of eating flagged likely shortfalls in vitamin C, vitamin D, calcium, magnesium, iodine and fibre, along with raised LDL and total cholesterol. Its authors concluded that long-term adherence cannot currently be recommended.
In the one randomised depression trial, fewer than one in ten participants were still following the diet once the study support ended. Whatever the biology turns out to be, this is hard to keep up without help.
General information drawn from named, cited research and from published guidance including NHS guidance on depression in adults, NICE guideline NG222 and the British Dietetic Association food fact sheet on food and mood. This page has not been independently clinically reviewed.