First Keto Trial for Anorexia Nervosa: 72% Showed Recovery

A new study demonstrates that ketogenic therapy could be an option for individuals living with weight-normalized anorexia nervosa.

One of the primary goals of anorexia nervosa treatment is restoring weight, and while this is an important milestone, many individuals continue to experience psychological symptoms.

Dr. Guido Frank, Professor of Psychiatry at UC San Diego, has spent more than 25 years researching and treating eating disorders. For much of his career, the lack of effective biological treatments for anorexia nervosa has been one of his greatest frustrations.

That changed when he began investigating ketogenic therapy.

In this video, Dr. Frank shares results from the first-ever clinical trial of ketogenic therapy in anorexia nervosa, published in Communications Medicine.

This 14-week outpatient feasibility trial enrolled adults living with weight-normalized anorexia nervosa who, despite weight restoration, continued to struggle with persistent eating disorder symptoms.

Of the 22 individuals enrolled in the study, 82% completed the trial. Among those who completed, 40% experienced mild early side effects, all of which resolved by study end, providing early evidence that ketogenic therapy may be a well-tolerated option in this weight-normalized population.

Among the study completers:

✅ 72% no longer met the criteria for an anorexia nervosa diagnosis

✅ All showed improvement in depression scores, with 72% reaching the normal range

✅ Participants also showed improvements in self-esteem, anxiety, and clinical impairment

One of the most common concerns about keto in this population is whether it will cause weight loss.

For this reason, weight was closely monitored and participants did not experience significant weight change during the study. These findings suggest that under clinical supervision, ketogenic therapy can be implemented in a way that supports weight maintenance, while also delivering far-reaching effects on brain function and psychiatric symptoms.

These results are encouraging early evidence of feasibility, but larger, controlled studies are needed to further evaluate efficacy.

The outcomes should not be generalized to severely underweight patients, who were not included in this trial. Dr. Frank's team is now actively studying whether ketogenic therapy can be applied at lower weights.

This intervention was conducted under close supervision by a licensed eating disorder specialist, with weekly check-ins, ketone monitoring, and regular psychiatric assessments. Anyone interested in exploring this approach should only do so under close medical supervision and in partnership with their care team. If you or someone you care for is living with anorexia nervosa, please speak with your healthcare provider before making any changes.

👉 Learn more about this study: https://www.metabolicmind.org/trials/featured-post/ketogenic-therapy-feasibility-trial-in-anorexia-nervosa-shows-promise-in-weight-normalized-adults/

Expert Featured:

Dr. Guido Frank

• https://x.com/GuidoFrank?s=20
• linkedin.com/in/guido-k-w-frank-b7b42172
• https://profiles.ucsd.edu/guido.frank

Resources Mentioned:

Study:

• DOI Link: https://doi.org/10.1038/s43856-026-01644-0

UC San Diego Website:

• https://clinicaltrials.ucsd.edu/ketogenic-diet

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.