A Retrospective Evaluation of an Online Group Ketogenic Metabolic Therapy Intervention on Mental Health Outcomes

Erin L Bellamy^*

• University of East London, London, United Kingdom

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 1.1mmol/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.