ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
This article is part of the Research TopicKetogenic Metabolic Therapies in Prevention & Treatment of Non-communicable Diseases: Volume IIView all 5 articles
Awareness and Best Practices in using Ketogenic Therapy to Treat Serious Mental Illness: A Modified Delphi Consensus
Provisionally accepted
Georgia Ede1*
Matthew Bernstein2
Lori Calabrese3
Iain Campbell4
Nicole Laurent5
Christopher M Palmer6Shebani Sethi7
Beth Ann Zupec-Kania8- 1Georgia Ede MD PLLC, Newburyport, Massachusetts, United States
- 2Ellenhorn/Accord Mental Health, Arlington, Massachusetts, United States
- 3Innovative Psychiatry, South Windsor, Connecticut, United States
- 4The University of Edinburgh, Edinburgh, United Kingdom
- 5Family Renewal, Inc, Vancouver, Washington, United States
- 6Harvard Medical School, Boston, United States
- 7Stanford University, Stanford, United States
- 8Ketogenic Therapies LLC, Elm Grove, Wisconsin, United States
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Background: Metabolic dysfunction is emerging as an important contributor to the pathophysiology of major depressive disorder, bipolar disorder, and schizophrenia, fueling interest in ketogenic metabolic therapy (KMT) as a potentially beneficial clinical intervention for serious mental illness. KMT has been used successfully for decades in treating epilepsy, but evidence for treating mental illness has yet to mature. This study aimed to produce expert-informed guidance for the implementation of KMT in adults with serious mood and psychotic disorders. Aims: This study aimed to produce expert-informed guidance for the implementation of KMT in adults with serious mood and psychotic disorders. Method: A modified Delphi methodology was used to examine the opinions of KMT-experienced mental health experts. A steering group of 8 such experts convened to develop an online survey comprising 33 statements regarding 1) the definition of KMT in the context of serious mood and psychotic illness; 2) identification of eligible candidates; 3) monitoring and measurement standards; and 4) best practices in employing KMT. This survey was distributed to clinician peers to examine opinions. The threshold for consensus agreement was set a priori at 75%. Result: Consensus was reached for all 33 statements (100%); therefore, the steering group approved the complete series of recommendations. Conclusions: This consensus provides expert-informed guidance to support the use of KMT in adults with major depressive disorder, bipolar disorder, and schizophrenia.
Keywords: Bipolar Disorder, Ketogenic Diet, Major Depressive Disorder, Schizophrenia, serious mental illness
Received: 19 Nov 2025; Accepted: 19 Jan 2026.
Copyright: © 2026 Ede, Bernstein, Calabrese, Campbell, Laurent, Palmer, Sethi and Zupec-Kania. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Georgia Ede
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