The Connection Between Metabolic And Mental Health

The Connection Between Metabolic And Mental Health

The Connection Between Metabolic And Mental Health

An emerging connection between metabolic and mental health can change treatment paradigms for psychiatric illness.

Bret Scher, MD

We at Metabolic Mind believe that there’s a strong connection between mental and metabolic health. But where did this belief come from? In this article, we’ll answer this by digging into what good metabolic health looks like, signs your metabolic health may be struggling, how your metabolic health influences your mental health, and how ketogenic therapies affect metabolism.

But first, let’s define what metabolic health is. 

What is Metabolic Health

Simply put, metabolic health is how effectively your body turns the food you eat into energy. Your metabolic health determines how your body balances glucose, insulin, body fat, and so much more! 

Poor metabolic health, on the other hand, is when your body doesn’t efficiently utilize or store the energy to consume, frequently presenting as weight gain, high blood pressure, increased waist size, or abnormal blood tests such as triglycerides, HDL, glucose, and insulin. 

Some mainstream doctors treat all of these health markers in isolation with prescription drugs (statins for cholesterol, hormone replacement therapy for poor sex hormone levels, GLP1 agonists for obesity, etc.). Unfortunately, prescription drug therapies aren’t healing our collective metabolism. One study reports fewer than 7% of the American population has optimal metabolic health, and it’s of little surprise with conditions such as obesity, pre-diabetes, and diabetes on the rise

But there is a promising alternative therapy for treating metabolic damage that seems to work better than the multitude of prescription drugs: lifestyle-based metabolic therapies.

What Are Lifestyle-based Metabolic Therapies?

So where did we get this idea that there’s a connection between metabolic and mental health?

Numerous studies suggest that those with poor metabolic health, such as insulin resistance, metabolic syndrome, pre-diabetes, or type 2 diabetes, have a significantly increased risk of serious mental illness such as bipolar disorder, major depression, or schizophrenia. 

And it appears the correlation holds in the opposite direction as well: those with serious mental illness have a higher likelihood of metabolic dysfunction. While this doesn’t prove causation by itself, this connection is worthy of attention and suggests metabolic therapies could improve the symptoms of mental illness.

Weight Isn’t the Only Factor

While weight gain is a red flag of metabolic illness, it isn’t the only sign.

In fact, emerging research suggests that a problem with the brain’s ability to process glucose (and create energy) can exist without someone being overweight or showing other typical signs of metabolic dysfunction. That means some individuals may have an outward appearance of good health, but inside their brain, a malfunction occurs, which results in the behavioral and cognitive changes we describe as psychiatric symptoms. 

The Good News: Nutritional Interventions Can Help

The good news is that nutritional interventions (like ketogenic therapies) can have a profound impact on both metabolic and mental health. By reducing carbohydrate intake, increasing healthy fats, and maintaining adequate protein intake, our bodies enter a state of therapeutic ketosis, promoting weight loss, improving insulin sensitivity, and reducing inflammation. These changes can lead to remarkable improvements in metabolic and mental health symptoms.

Weight Isn’t the Only Factor

In fact, emerging research suggests that a problem with the brain’s ability to process glucose (and create energy) can exist without someone being overweight or showing other typical signs of metabolic dysfunction. That means some individuals may have an outward appearance of good health, but inside their brain, a malfunction occurs, which results in the behavioral and cognitive changes we describe as psychiatric symptoms. 

A Special Case for Ketogenic Diets

What’s interesting about ketogenic therapies is that they have been used for more than a century to treat seizures in epilepsy. 

You might think, “Well, that’s interesting, but how does that relate to mental illness?” 

It turns out there may be a significant crossover in the mechanisms that contribute to seizures in your brain and the mechanisms that contribute to psychiatric conditions, which suggests that there may be an overlap in the pathways and treatments needed for both.

Interestingly, many medications used to treat seizures are often the same medications used to treat mental illness. This, again, suggests a significant overlap between the brain pathways in epilepsy and mental disorders. 

These facts point to why a nutrition plan helpful for seizures might also be helpful for mental illness. While we don’t have published evidence from randomized controlled trials proving this yet, five pilot trials are underway, with their initial results set to arrive in 2023.

Healing Your Metabolism Helps Your Mental Health

There are times when clinical experience is ahead of research simply because the research hasn’t been done yet. We at Metabolic Mind feel that’s the case for using ketogenic therapies as a treatment option for mental illness.

Thankfully, the research for both dietary interventions and medications is starting to catch up. One study using Metformin, a medication used to manage type-2 diabetes, showed significant improvement in bipolar symptoms for those with insulin resistance. 

Metformin is not known to have effects on the brain, but it does improve metabolic health by reducing insulin resistance. This study showed that Metformin healed the blood-brain barrier, which could be one mechanism of action for bipolar disorder.

What’s revolutionary about this study is that the researchers showed that treating insulin resistance directly improved psychiatric symptoms.

Now, this doesn’t mean everybody struggling with their mental health should be on Metformin or ketogenic therapy, and it certainly doesn’t mean that people should go off their medications. In fact, nutritional interventions like ketogenic therapies are typically initiated while keeping medication regimens the same, at least for some amount of time.

Work with your healthcare and psychiatric team to discuss any treatments you feel might be effective for your circumstance. Nutritional interventions and therapeutic nutritional ketosis are best used in conjunction with medical treatment and, of course, with the support of your treating clinician. This is an important point we’re going to emphasize over and over again: ketogenic therapies are serious medical interventions and should be undertaken in conjunction with your healthcare provider.

Wrapping It Up

At Metabolic Mind, we’re passionate about exploring the connection between metabolic health and mental well-being. By sharing the latest research, actionable tips, and insights from experts, we hope to empower you with information that will lead you closer to health and happiness. In case you’re curious, we’ll explore the metabolic therapies mentioned here in future articles so you can better understand if these interventions could be effective for you, either now or at a future point in your journey.


We at Metabolic Mind believe that there’s a strong connection between mental and metabolic health. But where did this belief come from? In this article, we’ll answer this by digging into what good metabolic health looks like, signs your metabolic health may be struggling, how your metabolic health influences your mental health, and how ketogenic therapies affect metabolism.

But first, let’s define what metabolic health is. 

What is Metabolic Health

Simply put, metabolic health is how effectively your body turns the food you eat into energy. Your metabolic health determines how your body balances glucose, insulin, body fat, and so much more! 

Poor metabolic health, on the other hand, is when your body doesn’t efficiently utilize or store the energy to consume, frequently presenting as weight gain, high blood pressure, increased waist size, or abnormal blood tests such as triglycerides, HDL, glucose, and insulin. 

Some mainstream doctors treat all of these health markers in isolation with prescription drugs (statins for cholesterol, hormone replacement therapy for poor sex hormone levels, GLP1 agonists for obesity, etc.). Unfortunately, prescription drug therapies aren’t healing our collective metabolism. One study reports fewer than 7% of the American population has optimal metabolic health, and it’s of little surprise with conditions such as obesity, pre-diabetes, and diabetes on the rise

But there is a promising alternative therapy for treating metabolic damage that seems to work better than the multitude of prescription drugs: lifestyle-based metabolic therapies.

What Are Lifestyle-based Metabolic Therapies?

So where did we get this idea that there’s a connection between metabolic and mental health?

Numerous studies suggest that those with poor metabolic health, such as insulin resistance, metabolic syndrome, pre-diabetes, or type 2 diabetes, have a significantly increased risk of serious mental illness such as bipolar disorder, major depression, or schizophrenia. 

And it appears the correlation holds in the opposite direction as well: those with serious mental illness have a higher likelihood of metabolic dysfunction. While this doesn’t prove causation by itself, this connection is worthy of attention and suggests metabolic therapies could improve the symptoms of mental illness.

Weight Isn’t the Only Factor

While weight gain is a red flag of metabolic illness, it isn’t the only sign.

In fact, emerging research suggests that a problem with the brain’s ability to process glucose (and create energy) can exist without someone being overweight or showing other typical signs of metabolic dysfunction. That means some individuals may have an outward appearance of good health, but inside their brain, a malfunction occurs, which results in the behavioral and cognitive changes we describe as psychiatric symptoms. 

The Good News: Nutritional Interventions Can Help

The good news is that nutritional interventions (like ketogenic therapies) can have a profound impact on both metabolic and mental health. By reducing carbohydrate intake, increasing healthy fats, and maintaining adequate protein intake, our bodies enter a state of therapeutic ketosis, promoting weight loss, improving insulin sensitivity, and reducing inflammation. These changes can lead to remarkable improvements in metabolic and mental health symptoms.

Weight Isn’t the Only Factor

In fact, emerging research suggests that a problem with the brain’s ability to process glucose (and create energy) can exist without someone being overweight or showing other typical signs of metabolic dysfunction. That means some individuals may have an outward appearance of good health, but inside their brain, a malfunction occurs, which results in the behavioral and cognitive changes we describe as psychiatric symptoms. 

A Special Case for Ketogenic Diets

What’s interesting about ketogenic therapies is that they have been used for more than a century to treat seizures in epilepsy. 

You might think, “Well, that’s interesting, but how does that relate to mental illness?” 

It turns out there may be a significant crossover in the mechanisms that contribute to seizures in your brain and the mechanisms that contribute to psychiatric conditions, which suggests that there may be an overlap in the pathways and treatments needed for both.

Interestingly, many medications used to treat seizures are often the same medications used to treat mental illness. This, again, suggests a significant overlap between the brain pathways in epilepsy and mental disorders. 

These facts point to why a nutrition plan helpful for seizures might also be helpful for mental illness. While we don’t have published evidence from randomized controlled trials proving this yet, five pilot trials are underway, with their initial results set to arrive in 2023.

Healing Your Metabolism Helps Your Mental Health

There are times when clinical experience is ahead of research simply because the research hasn’t been done yet. We at Metabolic Mind feel that’s the case for using ketogenic therapies as a treatment option for mental illness.

Thankfully, the research for both dietary interventions and medications is starting to catch up. One study using Metformin, a medication used to manage type-2 diabetes, showed significant improvement in bipolar symptoms for those with insulin resistance. 

Metformin is not known to have effects on the brain, but it does improve metabolic health by reducing insulin resistance. This study showed that Metformin healed the blood-brain barrier, which could be one mechanism of action for bipolar disorder.

What’s revolutionary about this study is that the researchers showed that treating insulin resistance directly improved psychiatric symptoms.

Now, this doesn’t mean everybody struggling with their mental health should be on Metformin or ketogenic therapy, and it certainly doesn’t mean that people should go off their medications. In fact, nutritional interventions like ketogenic therapies are typically initiated while keeping medication regimens the same, at least for some amount of time.

Work with your healthcare and psychiatric team to discuss any treatments you feel might be effective for your circumstance. Nutritional interventions and therapeutic nutritional ketosis are best used in conjunction with medical treatment and, of course, with the support of your treating clinician. This is an important point we’re going to emphasize over and over again: ketogenic therapies are serious medical interventions and should be undertaken in conjunction with your healthcare provider.

Wrapping It Up

At Metabolic Mind, we’re passionate about exploring the connection between metabolic health and mental well-being. By sharing the latest research, actionable tips, and insights from experts, we hope to empower you with information that will lead you closer to health and happiness. In case you’re curious, we’ll explore the metabolic therapies mentioned here in future articles so you can better understand if these interventions could be effective for you, either now or at a future point in your journey.


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