Please don’t call ketogenic therapy a “diet”

Embracing a body-positive approach to metabolic mental health.

Updated 11/10/2023

When you look at pictures of me at the beginning of my ketogenic therapy versus today, more than two years in, my radical physical transformation is evident. Focusing on “before and after” pictures, though, is not the story I want to tell. Not only is it the least interesting part of my journey, but as a mental health advocate, I do not wish to contribute to the diet culture noise that, if anything, exacerbates the mental health crisis. 

After a severe psychotic break at the age of 28, I was diagnosed with bipolar 1 disorder. Clinicians told me that I had a chronic condition and would need to take medication for the rest of my life to maintain mental stability. When I began taking antipsychotics, my brain and body changed rapidly. I gained more than seventy pounds in less than six months. I experienced impaired cognition; thinking creatively and focusing deeply became a struggle. After seven years of coping with these side effects, I discovered the pioneering science of metabolic interventions through the work of Dr. Christopher Palmer, author of Brain Energy. Compelling evidence suggests that mental illnesses are a result of neurometabolic dysfunction, opening up the possibility of more effective, comprehensive treatments that address root causes and could potentially lead to complete remission and recovery. 

Ketogenic therapy entails following a specific way of eating, the ketogenic diet—high in fat, low in carbohydrates, and moderate in protein—to induce a state of ketosis. However, it is essential to emphasize that ketogenic therapy should not be understood as “dieting,” defined narrowly as restricting food intake merely to lose weight. It is a complex physiological process that promotes healing at the cellular level.

The brain energy theory explains how fasting and a “fasting-mimicking” ketogenic diet helped me get better. I was able to promote mitophagy and mitochondrial biogenesis, thereby addressing the likely underlying cause of my bipolar symptoms: mitochondrial dysfunction. This metabolic treatment enabled me to get completely off medication. I regained my mental acuity and eventually lost all the weight I had put on. Despite the challenges of battling a mental illness, I am glad I went through this experience because it taught me so much about myself: body, mind, and the complex interplay between the two that shape my identity. 

A fascinating shift happened the minute I started to reap the cognitive benefits of ketogenic therapy. No camera could capture the staggering beauty of this internal “after-picture” which occurred in my brain long before any external changes. The fog completely lifted; my mind and body started to heal in tandem. 

The quality of my thoughts improved, my senses sharpened–likely from heightened neuroplasticity and neurogenesis–and I began to enjoy life again. A ketogenic diet may positively affect the brain through increased neurogenesis, the process by which new neurons are generated, and neuroplasticity, the formation of new neural connections. These benefits result from complex, interconnected processes involving epigenetics, reduced inflammation, and improved metabolic function. 

My metabolic treatment includes not only ketogenic therapy but also meditation and exercise. For the past two years, I’ve been diligently working on my mindset and loving my body more and more—not because I’ve shed weight, but because I experience the world in a new way through my improved mental and physical health. Sometimes while indulging in satiating, powerfully medicinal food, or taking a glorious sunrise jog, or swimming in a beautifully mucky Midwestern lake, a recurring phrase will pop into my head: “I love subjectifying myself.” 

I define this as a conscious shift away from external ideals toward my unique experience of internal embodiment. After years of feeling broken and depleted from severe mental illness, the science of metabolic treatments has empowered me. Being equipped with the knowledge to make lifestyle choices that heal my brain has restored my sense of agency. I can finally love my body because it allows me to experience the world mentally and physically in a newly elevated way that is its own reward. 

I am wildly alive and finally happy. I savor the endorphins I feel after a vigorous workout. I soak up the sunrise on exhilarating morning jogs. I indulge in meditative yoga that induces a blissful feeling of focused calm. We are constantly bombarded by images and messages that objectify us. Instead of enjoying how our body allows us to experience the world, many people fall into a culturally reinforced trap of chasing an unattainable ideal. For most, measuring ourselves against those standards, we will never feel “good enough.”

At the beginning of my journey, I was unwell, sluggish, and constantly fatigued. Now, I am revitalized and full of energy. Losing the seventy pounds I gained primarily as a result of antipsychotic medications was a welcome side effect of my life-enhancing metabolic therapies, not the end goal. I do not want anyone to interpret pictures documenting my before and after experience of metabolic therapies as a diet ad. If I had tried to adhere to keto (which, for me, is even more restrictive as a dairy-free vegetarian) solely to attain some superficial beauty standard, there is no way I would have stuck with it. I am motivated to continue my ketogenic therapy because it has transformed my mind and restored my health, allowing me to enjoy daily life in invigorating new ways. 

Diet culture and fat shaming will not help the mental health crisis. Spreading awareness of the intersection between metabolic and mental health from a body-positive perspective will. While I leave the contentious debate about exactly how BMI correlates with health to doctors and scientists, I do feel an obligation to share the power of metabolic therapies in my own life. I want people to know that there are alternatives to solely using sedating psychiatric medications. I do this while honoring each individual’s subjectivity above all.

A powerful first step for those working toward implementing metabolic treatments is recognizing the bidirectional relationship between our bodies and minds, and cultivating a mindset of self-love. The latter can be particularly challenging for anyone who struggles with severe mental illness. With emerging science bringing awareness to the metabolic root causes of mental disorders, choosing to consciously, lovingly “subjectify” oneself can be an empowering tool, helping positively reinforce lifestyle changes that provide healing and hope for a better future.