While Secretary of Health and Human Services Robert F. Kennedy Jr. may have overstated claims about ketogenic diets, the treatments could be a hopeful new frontier in mental health.

Ten years ago, at age 19, our son Matthew experienced a manic episode that landed him in the involuntary psychiatric unit at Stanford Hospital for 10 days. He was diagnosed with bipolar 1 disorder with psychotic features, prescribed powerful antipsychotics and spent half a decade in and out of treatment while battling daily symptoms.

Then, in late 2020, we discovered the pioneering work of Harvard’s Dr. Chris Palmer, who was using therapeutic ketogenic diets to treat serious mental illness. Matthew began a medically supervised ketogenic regimen soon after — and it sent his bipolar symptoms into lasting remission.

Now, following new comments from Health and Human Services Secretary Robert F. Kennedy Jr., public discourse has erupted over whether a ketogenic diet can “cure” schizophrenia or eliminate a bipolar diagnosis. At one point, the topic was trending on X with 70,000 posts, and Dr. Palmer’s work — along with our family’s story — is at the center of the conversation.

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While Kennedy’s imprecise terminology has certainly caused confusion, what we can’t risk losing sight of, amid the viral social media threads and attention-grabbing headlines, is the science itself. While still emerging, early evidence points toward a hopeful new frontier in mental health.

A ketogenic diet — typically high in fat, very low in carbohydrates and moderate in protein — is a nutritional pattern that leads to the metabolic state of ketosis. While popular for weight loss, these diets have been used for over a century to treat epilepsy.

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Today, promising peer-reviewed pilot trials, case series and personal stories suggest ketogenic therapy can improve bipolar disorder, schizophrenia, major depressive disorder and other conditions. Two randomized controlled trials of keto for bipolar and schizophrenia have been completed, and the results will be published soon. These studies could represent a major step for the emerging field of “metabolic psychiatry,” which investigates the link between energy metabolism and brain function — a vital connection given that over 90% of Americans demonstrate suboptimal cardiometabolic health.

Our family came to try ketogenic therapy through necessity — and years of searching for answers that conventional care alone couldn’t provide.

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My husband is the founder and CEO of an online gaming platform, so we were fortunate enough to pursue the best psychiatric care for our son. I was able to set aside my writing career to focus on Matthew’s treatments and keep our three daughters on track.

Yet for five years, our son wasn’t himself. He cycled through treatment centers across the country, experienced a period of homelessness, was hospitalized three more times for mania, and ultimately, had to withdraw from UC Berkeley. He was prescribed close to 30 medications and treated by dozens of mental health care professionals.

At times, psychotropic medications offered temporary relief and were even life-saving. But long-term use posed risks to his metabolic health and didn’t fully restore his emotional well-being or cognitive capacity. 

In contrast, Matthew’s bipolar symptoms cleared within four months of being in therapeutic ketosis — and they haven’t returned after more than five years following this dietary therapy. He finished college, successfully pursued a tech career and became a mental health advocate. He lives an independent, intellectually vibrant and emotionally stable life — something we had almost given up hope was possible.

Ketogenic therapy is often used as an adjunct to conventional psychiatric care, in many cases helping to reduce medication burden and associated side effects. Under medical supervision, Matthew has been slowly, carefully tapering his medications for years. As he readily shares, he works with his clinicians to plan tapering schedules and keep as-needed medication available in case symptoms reemerge. He’s also meticulous about lifestyle strategies beyond his diet — including exercising, sleep tracking, and avoiding drugs and alcohol.

Inspired by Matthew’s progress, we have used our family’s resources to fund clinical trials of ketogenic therapy for serious mental illness at academic research institutions worldwide. We built a team of neuroscientists and experts at Baszucki Group to lead our efforts, and we recently formed the Coalition for Metabolic Health to advance research and policy in nutrition science.

Roughly 20 clinical trials are now completed or are underway testing ketogenic therapy in psychiatry, including a randomized controlled trial at Stanford led by Dr. Shebani Sethi that builds on promising pilot trial data, and studies at the University of Pittsburgh, Harvard’s McLean Hospital, the Mayo Clinic and UCLA.

Neuroscientists are pursuing a clear biological signal and clinicians are supervising the adoption of these treatments — often witnessing dramatic results. And patients are sharing their stories and strategies to help others.

Guest opinions in Open Forum and Insight are produced by writers with expertise, personal experience or original insights on a subject of interest to our readers. Their views do not necessarily reflect the opinion of The Chronicle editorial board, which is committed to providing a diversity of ideas to our readership.

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Has my son been “cured”? It’s not a term we use in our work, and it’s also not the most important question. The more pressing concern is whether we are willing to rigorously test promising new treatment approaches when conventional care has failed far too many. What is needed now is a commitment to interventional and mechanistic research — on a scale that will inevitably require public funding — that examines the critical connection between metabolic and mental health. Also needed is widespread clinical education, public awareness and informed care.

My hope is that ketogenic therapy will be examined as a biological phenomenon and medical intervention — not be reduced to a political talking point. If this moment has sparked public interest, that’s a good thing. Now it is time to apply the scientific process with care and humility to rigorously and transparently investigate promising psychiatric hypotheses and treatment modalities. For families like mine, the promise is not certainty, but the possibility of meaningful relief for those suffering from debilitating mental disorders with metabolic therapies that are already improving lives.

Jan Ellison Baszucki is president of Baszucki Group and founder of Metabolic Mind and the Coalition for Metabolic Health.

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