The study examined whether a ketogenic diet could ease lingering symptoms of anorexia nervosa in adults who were lightly underweight or weight-restored, reporting promising improvements on standard measures without major weight loss and highlighting limits tied to a small, mostly White sample.
Researchers enrolled 22 women aged 18 to 45 with a history of anorexia nervosa and a BMI above 17.5 to test a targeted nutritional approach over 14 weeks. The diet aimed for roughly 70% of calories from fat, 20% from protein and 10% from carbohydrates to induce nutritional ketosis while keeping body weight stable. Participants were followed with ketone testing, weekly weight checks, symptom questionnaires and ongoing psychiatric support to watch both metabolic and psychological responses. This combination of monitoring helped the team track tolerability and symptom changes in real time.
KETO DIET HAS SURPRISING IMPACT ON MENTAL HEALTH, RESEARCHERS DISCOVER
By the study’s end, 18 participants remained and several measures of disordered eating shifted in a positive direction. Scores for dietary restraint, depressive symptoms and preoccupation with eating, shape and weight all showed improvement on the Eating Disorder Examination Questionnaire. Overall, 72% of those who completed the study scored in the recovered or normal range on that instrument, a notable signal for a small, controlled trial. Importantly, body weight stayed steady and no participant dropped below the BMI threshold of 17.5 during the intervention.
Some participants continued the ketogenic approach after the 14-week protocol, and those who did demonstrated slightly better questionnaire scores at three months. The authors framed ketogenic dietary therapy as “well-tolerated” and said it showed “potential efficacy” for reducing core anorexia nervosa symptoms in this narrow adult group. These cautious conclusions reflect that metabolic shifts can be measured and might influence the psychological patterns that keep the disorder locked in. Still, the effect sizes and persistence of benefit need more tracking in larger samples.
The investigators noted important limitations tied to the study design and demographics. They described the work as “sufficiently powered” for initial signals, but the small sample and its lack of diversity limit how confidently the findings can be generalized beyond predominantly White females. The authors recommended repeating the study in more diverse populations and adding objective brain measures, because self-report scales and weight checks only capture part of the picture. Tools like metabolic PET imaging were suggested to test whether changes in brain glucose use line up with clinical improvements.
Lead author Guido Frank, MD, a psychiatry professor with decades of experience treating anorexia, said new options are needed now more than ever. He explicitly called for action, writing that new approaches to anorexia nervosa are “urgently” needed. He framed the ketogenic approach as a way to move past standard therapies and probe the disorder’s physiological roots rather than treating only behavior. That stance opens a different line of inquiry that pairs psychiatric care with targeted metabolic interventions.
The study sits at a rough intersection of nutrition science and psychiatry, where biological signals and psychological patterns interact. Growing evidence links anorexia nervosa to neurometabolic dysfunction, and the investigators expressed hope that changing metabolic fuel use could help regulate neural circuits involved in the disorder. If metabolic therapies can alter the brain environment in ways that reduce fear of eating or obsession with shape and weight, they could become a useful adjunct to psychotherapy and medical support. Still, translation to clinical practice will demand replication and careful safety monitoring, especially across ages and backgrounds.
This trial does not settle whether ketogenic therapy belongs in standard anorexia treatment yet, but it does push the conversation toward metabolic targets. The data invite larger, more diverse trials and objective imaging to test mechanisms, while clinicians and patients weigh risks and benefits in the meantime. The findings are a prompt to broaden research beyond traditional models and to examine how fuel sources shape brain function in serious psychiatric disorders.
