Summary:
Current treatments for depression include antidepressant medication, psychotherapy, or both, but they are not effective for everyone. Side effects and poor tolerance can also limit long-term use. Access to care is another major limitation, as increasing demand has led to long waiting times and reduced continuity of care. These gaps highlight the need for more accessible, scalable, and effective interventions that can be implemented early. Ketogenic metabolic therapy (KMT), which can be explained as a dietary intervention that restricts carbohydrates alongside education, monitoring, and safety management, has emerged as a potential approach. The proposed mechanisms include improvements in brain energy use, inflammation, and neurotransmitter balance. This study (a retrospective evaluation) examined an online, group-based KMT intervention combining mental health education, professional support, and peer engagement. Nineteen adults with elevated depression and anxiety symptoms completed a 12-week program. Depression scores decreased by 62% and anxiety scores decreased by 46%, with most participants achieving clinically meaningful improvement and several reaching remission. Adherence was high, and no serious adverse events were reported. These findings suggest that KMT delivered online is feasible and associated with meaningful improvements in mental health outcomes. It may offer a scalable addition to existing care, particularly when supported by structured education and ongoing support. Further research with larger samples and longer follow-up is needed.
Abstract:
Background: Conventional treatments for depression and anxiety, including pharmacotherapy and psychotherapy, often fail to achieve long-term symptom remission and are associated with side effects, limited accessibility, and high attrition. Ketogenic metabolic therapy (KMT) has emerged as a potential adjunctive intervention, with studies showing improvements in metabolic and mental health outcomes. However, research on remotely delivered, group-based KMT remains limited. This study evaluates the feasibility of an online, group-based KMT program integrating psychoeducation, professional guidance, and community support on symptoms of depression and anxiety in adults with varying mental health conditions.Methods: A retrospective evaluation of 19 self-referred participants with baseline PHQ-9 and GAD-7 scores > 4. Participants followed a ketogenic diet tailored to individual macronutrient targets. Depression (PHQ-9) and anxiety (GAD-7) were assessed at baseline, 4, 8, and 12 weeks.Results: Mean PHQ-9 scores decreased from 13 to 5 over 12 weeks, representing a 62% reduction, with 71% achieving clinically meaningful improvement. Mean GAD-7 scores decreased from 13 to 7, a 46% reduction, with 79% achieving clinically meaningful improvement. Eight participants reached remission for depression and nine for anxiety. Participants achieved blood ketone levels > 0.5 mmol/L 85% of the time, indicating high adherence with mean ketone levels of 1.1 mmol/L. No serious adverse events were reported, and all participants completed the intervention.Conclusion: This remotely delivered, group-based KMT appears feasible and was associated with clinically meaningful reductions in depression and anxiety over 12 weeks. These findings support the potential of KMT as a scalable, transdiagnostic approach to conventional psychiatric care. Future research should evaluate larger samples and longer-term outcomes.
Article Publication Date: 04/03/2026
DOI: 10.3389/fnut.2026.1751564
