A new study from the UC San Diego School of Medicine suggests that the ketogenic diet could significantly improve symptoms in people recovering from anorexia nervosa.

The research, published in the journal Nature, involved 22 women aged 18 to 45 who had a history of anorexia and a body mass index above 17.5.

Participants followed a tightly structured ketogenic plan for 14 weeks, consisting of 70% fat, 20% protein and 10% carbohydrates.

The aim was to maintain their weight while producing nutritional ketosis, a state in which the body uses ketones for energy as carbohydrate levels drop.

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Researchers tracked their progress through weekly weight checks, ketone monitoring, psychiatric support and food intake assessments.

Of the participants, 18 completed the program. Results showed notable improvements in several areas, including dietary restraint, depression levels and feelings about eating, body shape and weight.

According to the study, 72% of participants recorded “recovered or normal” scores on the Eating Disorder Examination Questionnaire by the end of the 14 weeks.

Importantly, their body weights remained stable, and no participant’s BMI dropped below 17.5.

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Those who continued following the ketogenic therapy for three months after the main intervention retained slightly better scores on the same standardized evaluation.

Researchers concluded that the ketogenic therapy was “well-tolerated” and displayed “potential efficacy” in reducing anorexia symptoms for adults who were mildly underweight or weight-restored.

At the same time, the authors cautioned that the small group size, limited diversity and focus on women narrowed the study’s scope.

They recommended larger follow-up studies that include a wider mix of participants and consider advanced imaging tools such as metabolic PET scans.

Lead author Guido Frank, MD, professor of psychiatry at UC San Diego School of Medicine, said the research reflects an effort to find fresh approaches for treating anorexia nervosa.

Frank, who has worked with anorexia patients for more than 25 years, said in a statement that new treatment strategies are “urgently” needed.

“Our work with ketogenic therapy looks beyond standard therapies and potentially at the underlying physiology of the disorder,” he wrote.

He added that increasing evidence points toward “neurometabolic dysfunction” in anorexia nervosa.

The study, he said, may indicate that “direct metabolic intervention can regulate neural function and address the psychological symptoms patients experience.”

The findings suggest that metabolic and nutritional strategies could have a role alongside traditional psychiatric care, although more evidence will be required before any broad conclusions can be drawn.


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