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People commonly adopt ketogenic diets with the goal of losing weight, but what about the other side of this: can keto help people – particularly those with anorexia – gain needed, healthy weight? Emerging research suggests that keto has the potential to be effective for correcting some of the brain energetics that may be contributing to the condition.
A paper published recently in Frontiers in Nutrition notes that there are currently no effective biological treatments for anorexia nervosa (AN) and makes the case that keto may be helpful for improving this condition by addressing “brain neural energy metabolism and neurotransmitter function.”
The authors noted that “individuals with AN often report that food restriction reduces anxiety and improves mood,” and that “individuals with AN may have a metabolic reason why it is so desirable for them to pursue the starvation state.” It’s not known for certain what’s responsible for this reported improved sense of wellbeing, but possible contributors include increased synthesis of ketones and greater ketone uptake and use by the brain, increased GABA production, and more stable blood glucose levels (with less likelihood for hypoglycemia and its associated mood changes). Each of these effects is achievable via a ketogenic diet with adequate energy and nutrient intake. As the authors wrote, replacing “starvation ketosis” with “nutritional ketosis” eliminates the need to induce ketosis via starvation and can help support weight gain in AN as well as maintenance of a healthier weight in those with AN after weight recovery.
Supporting research in humans is limited, research is in its early days, as this is a new frontier for clinical applications of ketogenic diets. A case series published last year reported on three subjects with AN refractory to standard therapies. Each subject achieved remission of between 1-5 years (at the time of publication) via a ketogenic diet consisting primarily of animal foods. Each subject had gained over 20 kg each and each reported decreased anxiety and enhanced overall mental wellbeing.
Interestingly, keto is also beginning to show promise as a treatment for binge eating disorder as well. A paper in the Journal of Eating Disorders reported a case series of three subjects who experienced remarkable improvements in binge eating and food addiction symptoms while following a keto diet. As more research is conducted in the use of keto for mental health, perhaps this very-low-carb way of eating will emerge as a novel way to treat a variety of otherwise intractable eating disorders.
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