Yes, as part of the treatment. Diet shapes mood, weight and seizures. Ketogenic diets have treated epilepsy since the 1920s. Low-carb diets take off more weight in the first 3 to 6 months than balanced diets. And many of my patients have tapered their anxiety and depression medicines with weight loss and a better diet.
The idea of food as medicine is credited to Hippocrates. “Let thy food be thy medicine, and thy medicine be thy food.” But in today’s world, can food be medicine?
Many mainstream doctors are quick to judge other clinicians who claim that food can “improve the symptoms of mental health disorders,” or who say that a good diet can “reverse” or even “cure” disease.
Let’s look at some of the research to see what the “evidence” tells us.
Does food/glycemia/nutrition affect mood, including depression or anxiety?
Quite a few studies tie several nutrition problems to mental illness. These include B-12 deficiency, diabetes, and high-glycemic diets (diets that spike blood sugar).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3317401/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532289/
https://www.ncbi.nlm.nih.gov/pubmed/11375373
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022608/
https://www.nature.com/articles/s41598-017-05649-7
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3856388/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515860/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5154680/
https://www.ncbi.nlm.nih.gov/pubmed/29189904
What about Food Quality and Food Security?
It seems that food quality and steady access to good food play a close role in anxiety and depression.
https://www.ncbi.nlm.nih.gov/pubmed/30588894
https://www.ncbi.nlm.nih.gov/pubmed/30269866
Is there any evidence that a well-constructed, ketogenic diet could be beneficial?
I can tell you that many of my patients have been able to taper their anxiolytics (anxiety medicines) and antidepressants with weight loss and a better diet. There does seem to be some early evidence that a well-built ketogenic diet can help.
Since the 1920s, very-low-carbohydrate ketogenic diets (VLCKD) have been used to treat epilepsy. They can reduce or end the need for medicine. In fact, a recent Cochrane review showed a 30–40% drop in seizures compared with controls, “comparable to modern antiepileptic drug” therapy.
Since the 1960s and 1970s, VLCKD has been widely promoted to treat obesity and for weight loss. It is now better known as the “Atkins Diet.”
Ketogenic diets cut carbohydrates (usually to less than 50 g/day). In turn, protein and fat make up a larger share of the diet.
Insulin switches on the pathways that store energy from carbohydrates. That causes lipogenesis (making fat) and fat storage, and it lowers blood glucose. In a VLCKD, there are very few carbs in the diet. That leads to a lower insulin level, and in turn less lipogenesis and less fat buildup.
Ketone bodies (acetoacetate, β-hydroxybutyric acid and acetone) are made mainly by the mitochondria in the liver. This process is called ketogenesis. It happens when insulin is low and the diet is very-low carbohydrate. Cells then burn ketones for energy. They do this through a pathway that turns β-hydroxybutyrate into acetyl CoA.
Ketosis is a normal body process. Biochemist Hans Krebs described it. He used the term physiological ketosis to set it apart from the dangerous ketoacidosis seen in type 1 diabetes. In physiological ketosis (which occurs during very-low-carbohydrate ketogenic diets), blood ketones peak at 7-8 mmol/l, with no change in pH. In uncontrolled diabetic ketoacidosis, they can top 20 mmol/l, and blood pH drops at the same time.
In people with insulin resistance, muscle cells have a harder time taking up glucose from the blood. So a person with insulin resistance sends more of the carbs they eat to the liver. There, much of it is turned into fat (that is, de novo lipogenesis), instead of being burned for energy in skeletal muscle.
There is strong evidence that ketogenic diets work for weight loss. Most ad-libitum studies (where people eat as much as they want) show the same thing. People on a low-carbohydrate diet lose more weight during the first 3–6 months than people on balanced diets. Weight loss appears to improve for several reasons. Ketosis directly curbs appetite. Gluconeogenesis and the thermic effect of proteins raise the body’s energy costs, approximately a 25% conversion cost. Proteins are more filling (you feel full longer). And lower insulin means less lipogenesis and more lipolysis (fat burning).
Ketone bodies send signals that control gene expression, inflammation, and metabolism. They do this through specific signaling pathways:
- HDACs: insulin sensitivity
- HDAC3: gluconeogenesis
- BHBylation: fat metabolism genes
- HCAR2: fatty acids, inflammation
- NLRP3: adipose inflammation
Satiety is the feeling of fullness that lasts for a while after a meal. Different foods give different satiety. It comes from a complex back-and-forth between the Enteric Nervous System (the gut’s nervous system) and the Central Nervous System.
The food choices we make set our satiety, our sense of fullness and satisfaction with a meal. Satiety drives how we eat later (how hungry we get and how soon we are likely to eat after a meal). Processed foods lack long-term satiety. The enteric nervous system holds most of the body’s serotonin. It talks directly to the central nervous system through the vagus nerve. The gut and how it handles the food we give it is the basis of our “gut feeling.”
Satiety cuts decision fatigue, while cravings feed on decision fatigue.
When you are hungry or short on sleep, your brain reacts more to pictures of high-calorie food. Hungry people buy more calories when they go grocery shopping. You are more sensitive to sweet and salty tastes when you are hungry. If you are going somewhere like a bar or a party where you know there will be junk food, don’t go hungry. Fill up on protein first to cut decision fatigue.
Lack of sleep also makes the brain more sensitive to pictures of high-calorie foods. It also lowers activity in the brain areas that let you consciously control what you eat. Lack of sleep weakens impulse control. In experiments, teenagers kept short on sleep eat more refined carbs, especially desserts and sweets. If you know you will face tempting food, a nap to reset your brain may also cut decision fatigue.
https://www.ncbi.nlm.nih.gov/pubmed/30075165
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357645/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5863039/
https://www.ncbi.nlm.nih.gov/pubmed/28808808
Is diet a cure for any of these diseases? It is only possibly a part of the cure. But a bad diet can certainly make symptoms worse.
Can a well-constructed diet erase trauma, abuse or neglect?
It’s not likely, but it may help you cope. A nutrient-dense diet seems to be associated with fewer mental health problems. It also seems to ease symptoms of depression and anxiety. There is plenty of strong evidence that iron excess, copper excess, folate deficiency, and other nutrition problems are implicated in psychiatric and mental health.
Related reading
Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP
Interventional pain physician, addiction medicine specialist and obesity medicine diplomate.
Licensed in Missouri and Illinois.
Last reviewed June 17, 2026
