I’ve never received more press attention than I have over the past two weeks—thanks, in part, to comments from the U.S. Secretary of Health and Human Services, Robert F. Kennedy, Jr., about the ketogenic diet and serious mental illness. I’ve been interviewed by the New York Times, Washington Post, USA Today, Scientific American, The Guardian, and other media outlets.
Let me say this upfront: I welcome the attention and appreciate the Secretary’s interest in this work.
For far too long, people with conditions like schizophrenia and bipolar disorder have had limited treatment options, and progress has been slow. If this moment sparks broader awareness, more research funding, and more curiosity about metabolic approaches to mental illness, that’s a good thing.
At the same time, we need to be precise about what the science does—and does not—show.
The Claim: Can Keto “Cure” Schizophrenia?
The word cure is powerful. It’s also, at this point, not supported by scientific evidence.
We do not yet have definitive proof that the ketogenic diet can cure schizophrenia or bipolar disorder. What we do have is a growing body of evidence suggesting that metabolic interventions—including ketogenic therapies—may play a meaningful role in treatment for some individuals, even resulting in remission of longstanding illness for some. But remission isn’t the same thing as a cure.
This distinction matters. Not because we want to downplay hope, but because credibility is essential if this field is going to move forward.
Additionally, suggesting that the ketogenic diet can cure schizophrenia may lead some patients to try the diet on their own and stop medications—an approach that, in some cases, could have devastating consequences.
A Signal That’s Been There for Decades
Interest in ketogenic diets for psychiatric conditions is not new.
One of the earliest reports dates back to 1965, when Pacheco and colleagues described improvements in patients with schizophrenia treated with a ketogenic diet. At the time, the findings were largely overlooked—perhaps because the field lacked a framework to understand why or how a dietary intervention might matter for severe mental illness.
Today, that framework is emerging.
Modern Evidence: Small Studies, Big Implications
Over the past several years, my colleagues and I have published clinical work demonstrating that ketogenic diets can lead to improvements in both metabolic health and psychiatric symptoms in patients with serious mental illness. Dr. Shebani Sethi and colleagues from Stanford published a pilot trial of the ketogenic diet in patients with schizophrenia and bipolar disorder. Dr. Albert Danan and colleagues conducted a similar trial in France.
These studies are not definitive. Most are small, uncontrolled, or observational. But the consistency of the signal—across mood symptoms, psychosis, and metabolic markers—is difficult to ignore.
And importantly, these interventions are targeting something fundamentally different: brain energy metabolism.
The Next Phase: Randomized Controlled Trials
We are now entering a new era—one that will provide much more rigorous answers.
Two randomized controlled trials of ketogenic therapy for schizophrenia have recently been completed and are expected to be published soon. These studies, led by Professor Zoltan Sarnyai in Australia and Dr. Judy Ford at UCSF, will offer some of the first controlled data in this space.
At McLean Hospital, my colleague Dr. Virginie-Anne Chouinard is leading a randomized controlled trial examining ketogenic therapy in bipolar disorder and schizoaffective disorder.
And Professor Daniel Smith, Dr. Iain Campbell, and their colleagues have just received £7.9M (GBP) from the Wellcome Trust to conduct one of the largest ketogenic dietary trials ever undertaken in the mental health field—ENERGISE-BD—which will compare a ketogenic diet to the UK’s standard healthy diet in patients with bipolar depression.
This is exactly what the field needs: rigorous, well-funded, large-scale studies.
Why This Matters
For decades, psychiatry has focused on neurotransmitters, trauma, and psychosocial factors. Each captures part of the truth—but none captures the whole.
Metabolism—particularly the central role of mitochondria—may be the missing link that connects them. This is not a replacement for the biopsychosocial model; it is a way to unify it.
If the Brain Energy theory is ultimately validated, it could mark a turning point for the field—and open up new, urgently needed treatment pathways for millions of people still struggling despite receiving the best possible care.
Moving Forward: Hope With Rigor
Moments like this—when public figures make bold claims—can be uncomfortable for scientists. But they can also create opportunities.
The opportunity is not to defend or attack any individual.
It is to do what science does best:
- Ask better questions
- Conduct better studies
- And follow the data wherever it leads
Ketogenic therapies may ultimately prove to be transformative for some patients with serious mental illness.
Or they may prove to be helpful for a subset of patients, in combination with other treatments.
We don’t yet know.
But for the first time in decades, we are finally in a position to find out.
And that, in itself, is something worth paying attention to.
Dr. Christopher Palmer is a Harvard psychiatrist and researcher working at the interface of metabolism and mental health. He is the Founder and Director of the Metabolic and Mental Health Program and the Director of the Department of Postgraduate and Continuing Education at McLean Hospital and an Assistant Professor of Psychiatry at Harvard Medical School. For almost 30 years, he has held administrative, educational, research, and clinical roles in psychiatry at McLean and Harvard. He has been pioneering the use of the medical ketogenic diet in the treatment of psychiatric disorders—conducting research in this area, treating patients, writing, and speaking around the world on this topic. Most recently, he has proposed that mental disorders can be understood as metabolic disorders affecting the brain, which has received widespread recognition in both national and international media outlets.
