Treating OCD with a Metabolic Tune-Up

What if the key to unlocking treatment-resistant obsessive-compulsive disorder isn’t in the psyche… but in the cells?

For decades, OCD has been viewed as a purely psychiatric condition, addressed through medication and therapy. But a new line of evidence suggests something far more fundamental:

OCD, like many other mental health issues, is a disorder of energy metabolism.

In fact, case studies in recent years show people with severe OCD finding unexpected relief through a ketogenic diet. Their stories are remarkable, not only because of the degree of improvement, but because they point to a far bigger truth about the connection between metabolism and mental health.

A Foundational Shift: Viewing Mental Illness through a Metabolic Lens

Most psychiatric treatments focus on the brain’s chemistry—neurotransmitters like serotonin, dopamine, and GABA.

But beneath the chemistry lies the machinery: the mitochondria, which generate the energy our brains need to function. When these powerhouses are under stress, cells struggle to regulate signaling, repair damage, and maintain balance. This “metabolic malfunction” may be the missing link in understanding why some mental health conditions resist treatment.

Dr. Chris Palmer of Harvard Medical School has been a leading voice in this paradigm shift, suggesting that many psychiatric illnesses—including depression, schizophrenia, and OCD—are better understood as metabolic disorders of the brain⁽¹⁾.

If the brain can’t process glucose efficiently, it runs out of fuel. But ketones—produced when carbohydrate intake is lowered and fat becomes the body’s primary fuel—offer a cleaner, steadier energy source. They bypass broken pathways, reduce oxidative stress, and restore mitochondrial resilience.

This perspective reframes the ketogenic diet from “another weight-loss diet” to a therapeutic intervention that directly targets the metabolic roots of mental illness.

Modern Breakthrough: When Keto Meets Exposure Therapy

One of the most striking cases was published in Frontiers in Psychiatry in 2025. A 26-year-old man whose OCD revolved around symmetry and ordering rituals had tried nearly every conventional tool—SSRIs, therapy, lifestyle changes—without lasting relief. His days were dominated by compulsions, taking up 3–8 hours daily.

Then he began a ketogenic diet, structured specifically to maintain therapeutic ketosis. Within three weeks, the number of hours consumed by rituals dropped dramatically, falling to less than one per day. This change occurred even before starting Exposure and Response Prevention (ERP), the gold-standard behavioral therapy for OCD. By week seven, his emotional distress scores had normalized. Two years later, he remains in remission, crediting the ketogenic diet as the cornerstone of his recovery⁽²⁾.

He reflected: “The ketogenic diet was the foundation of this recovery. I state with absolute certainty that the ketogenic diet saved my life.”

More Evidence: Three Patients, Shared Relief

This was not an isolated case. Another case series, published in Frontiers in Nutrition, documented three individuals—two women and a student at Harvard—who adopted ketogenic diets to address OCD.

Their symptoms were measured using the Yale-Brown Obsessive Compulsive Scale, the gold standard in OCD assessment. All three showed dramatic improvements, with scores dropping by an average of 21 points—translating to more than a 90% reduction in severity⁽³⁾.

Perhaps most telling, the relief lasted only as long as the diet did.

When participants returned to a standard, higher-carbohydrate diet, symptoms crept back in. When they resumed keto, the relief returned. This shows that the metabolic state itself was driving the improvement.

The Science of a Calm Mind

How does this work?

First, OCD brains often show glucose hypometabolism on brain scans. In simple terms, they struggle to use sugar for energy. Ketones bypass this bottleneck, offering a stable fuel that smooths brain activity (4).

Second, ketosis shifts the brain’s chemistry toward greater production of GABA, the neurotransmitter that calms, while reducing excessive glutamate, which fuels overactivity. This balance may interrupt the “looping” circuits that underlie obsessions and compulsions⁽⁵⁾.

Third, the ketogenic diet reduces inflammation and oxidative stress, both of which are elevated in psychiatric illness. By quieting this background noise, the brain can function more efficiently and respond better to therapy⁽⁶⁾.

Finally, the diet may act as a primer for ERP therapy. When the mind is less inflamed and better fueled, therapy is more effective. The diet creates the calm; therapy provides the map.

Nutrition as Critical Information for the Brain

Food provides far more than calories – it acts as critical information for the brain.

For both women and men, building a nutrient-dense ketogenic plan that includes organ meats, bone broth, collagen, and mineral-rich fats may provide not just fuel, but cellular healing. The gut-brain connection, too, cannot be overlooked. Fermented foods, probiotic-rich meats (like traditionally cured sausages), and glycine-rich broths may further amplify the brain’s resilience.

OCD has long been seen as a manageable condition, but rarely curable. These new findings suggest that inside the foods our ancestors ate lies a forgotten prescription for mental resilience. Ketones don’t just fuel the body. They also quiet the mind.

A big thank you to Kelley Herring for her insightful article, Treating OCD with a Metabolic Tune-Up! Her work highlights the fascinating connection between metabolism and mental health, showing how nutrition. A ketogenic approach can transform lives. Visit our Discover Blog for more inspiring articles, expert insights, and nourishing recipes to support your body and mind!

References

1. Palmer, C.M. Brain Energy: A Revolutionary Breakthrough in Understanding Mental Health—and Improving Treatment for Anxiety, Depression, OCD, PTSD, and More. BenBella Books, 2022.
2. Laurent, N. & Tague, K.A. “Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention.” Frontiers in Psychiatry, 2025.
3. MacDonald, A.J. & Palmer, C.M. “Ketogenic diet as a therapeutic intervention for obsessive-compulsive disorder: a case series of three patients.” Frontiers in Nutrition, 2025.
4. Gano, L.B., Patel, M., Rho, J.M. “Ketogenic diets, mitochondria, and neurological diseases.” J Lipid Res, 2014.
5. Stafstrom, C.E., Rho, J.M. “The ketogenic diet as a treatment paradigm for diverse neurological disorders.” Front Pharmacol, 2012.
6. Bostock, E.C., Kirkby, K.C., Taylor, B.V. “The current status of the ketogenic diet in psychiatry.” Front Psychiatry, 2017.