Often when I share my story of using metabolic treatments, including ketogenic therapy, to put bipolar 1 disorder into remission, people ask me how to convince someone to try medical keto. The question typically comes from people knowledgeable about the promising science behind metabolic psychiatry, either individuals wanting to convince a loved one or clinicians wondering how to inspire their patients. 

First and foremost, it's essential to acknowledge that it is not possible to force anyone to adopt ketogenic therapy. This treatment requires willingness, open-mindedness, and commitment. My primary role as an advocate is to raise awareness that this therapy exists as an option. Patients deserve to have information on the cutting-edge science of metabolic psychiatry and what distinguishes a medical keto diet from other forms of treatment. Ultimately, the decision to pursue this form of therapy rests solely with the individual.

The more I learn about medical keto, the better I understand its potential as an effective treatment that can repair metabolism and heal many chronic conditions–psychiatric as well as physical. As someone who has experienced incredible, life-changing results from ketogenic therapy, I have also been in the difficult position of wishing I could persuade friends and family members to try it when I feel confident they could benefit. While the desire to help a loved one is natural, it's important to recognize that well-intentioned urging is not always welcome or helpful if the individual resists following a keto diet. Instead of pushing, it can be more effective to provide emotional support and share resources, like Metabolic Mind's Families and Peers page and success stories, that allow people to explore the option of medical keto and make an informed decision when they are ready. 

I was convinced my parents could benefit from keto for weight management and as a preventative strategy for physical and neurological conditions as they age. Trying to convince them to implement it felt frustrating and seemed to go nowhere. They witnessed my physical and mental transformation firsthand, and I shared many resources with them throughout my journey. However, it took a couple of years before they were ready to try it themselves. Since starting a keto diet six months ago, they have collectively lost over sixty pounds. They report feeling increased energy, mental clarity, and heightened well-being. 

This experience taught me that it is not necessarily possible to push anyone to adopt a keto diet, no matter how much you love them and are convinced it could make a dramatic difference. Eventually, I had to accept that all I could do was share resources, continue to have positive conversations about how it might help, and give them time to decide whether or not they wanted to try it. Motivational interviewing, a technique that supports individuals in discovering their intrinsic motivation for behavior change, can be used to help guide respectful and constructive conversations with loved ones or patients.   

While I have accepted I cannot convince anyone to try keto, I always openly share my lived experience and why I am so grateful that I decided to try this form of treatment. These are the five things I tell other patients who are considering trying ketogenic therapy for a psychiatric condition: 

1. This form of treatment has side benefits rather than side effects. 

Instead of side effects, ketogenic therapy offers a wide range of side benefits. While psychotropic medications often harm metabolism and worsen physical health, ketogenic therapy can improve psychiatric symptoms while simultaneously repairing metabolism. It can even counteract the negative cardiometabolic effects of some medications when used adjunctively. This approach is unique in improving both metabolism and brain function, often allowing patients to reduce or eliminate medication use altogether. This is a crucial point for those suffering from medication side effects like weight gain, brain fog, fatigue, dulled emotions, and stymied creativity. Additionally, research suggests ketogenic therapy may have a preventative effect on brain health, potentially reducing the risk of dementia, which may be a significant concern for individuals with bipolar disorder and schizophrenia who are at an increased risk. 

2. Ketogenic therapy can treat root causes and, in some cases, put serious mental illness into full remission–something no pharmaceutical treatment currently offers.

I have been using metabolic therapies as my sole form of treatment for almost three years now. I am liberated from the symptoms of bipolar illness and am living a happy, healthy life. Instead of labeling myself as having bipolar 1 disorder, I say that I am in remission from neurometabolic dysfunction. To me, the most exciting thing about ketogenic therapy is that, for at least some patients, it can mean healing a condition rather than managing one. I was told repeatedly that I had a lifelong, chronic illness, but after almost three years of using metabolic therapies as my sole form of treatment, I am completely symptom-free and very optimistic that my condition was, in reality, reversible. 

I acknowledge that I am metabolically compromised and will always need to be vigilant and do everything I can to safeguard my metabolic health, which is integral to my physical and mental well-being. There is no guarantee symptoms of my condition will never resurface, but I feel enormously grateful that I have had an invaluable few years of good health and happiness after almost a decade of physical and mental strife on medications. 

Ongoing rigorous research funded by Baszucki Group and others is investigating what makes this therapy effective. I am optimistic that someday there will be scientific evidence that illuminates the underlying mechanisms of this therapy and explains how it treats the root cause of psychiatric conditions and can lead to long-term healing and remission. In Brain Energy, Harvard psychiatrist Dr. Christopher Palmer hypothesizes that ketogenic therapy can heal dysfunctional mitochondria incrementally over time, repairing metabolism and fully restoring brain function. I benefited immediately from my brain fuel source switching from glucose to ketones, but I was in awe as my physical and mental state continued to improve gradually, peeking around a year into medical keto. From my lived experience, the idea that there is an underlying mechanism of ketogenic therapy, likely mitochondrial repair, that happens over an extended period, resonates. 

3. We know from more than a century of research using medical keto to treat epilepsy that it is a safe intervention. The promising research and numerous testimonials indicate a significant potential upside relative to risk. 

I recently heard from a patient with bipolar 1 disorder who, after being a bit hesitant, decided to devote himself to ketogenic therapy after seeing the promising results of Dr. Shebhani Sethi’s recent pilot trial. The study demonstrated substantial improvements in both mental and metabolic health for patients with schizophrenia and bipolar disorder. Scientific research is critical to getting clinician buy-in–it is often equally important to patients considering this treatment. 

Individual responses to metabolic strategies may vary, with some experiencing immediate, dramatic improvements and others seeing more gradual progress. Dr. Christopher Palmer recommends a trial period of at least four to six months for the ketogenic diet before assessing effectiveness. Current Randomized Controlled Trials are investigating mechanisms and corresponding biomarkers. In the future, it may be feasible to predict in advance the patients most likely to respond to this intervention. 

I understand why some patients are hesitant to try keto when efficacy is not guaranteed. I am optimistic that this form of treatment has the potential to benefit a large percentage of patients, but rigorous science has yet to make this determination. Personally, after a little cost-benefit analysis, I was willing to try it despite the uncertainty: more than a hundred years of research in epilepsy has shown that it is a safe, very low-risk intervention, and emerging science and testimonials highlight that there is an enormous potential return on investment. Reducing carbs for six months felt like a small price to pay for potentially game-changing results. 

4. I would choose metabolic therapies over a pill any day. Willpower is a muscle that can be strengthened. 

The strongest oak in the forest is not the one protected from the storm and hidden from the sun. It's the one that stands in the open, compelled to struggle for its existence against the winds, rains, and scorching sun. 

-Napoleon Hill 

For individuals with mental illness, ketogenic therapy provides a powerful way to restore one's sense of agency and cultivate lifelong tools that build strength and resilience. Self-discipline is a tool that can be utilized beyond treating mental illness to empower individuals in all areas of their lives after healing and give them compounding returns as they pursue new dreams post-remission.

If someone offered me a pill that would have the equivalent effect of all my metabolic therapies, including a keto diet, fasting, exercise, and meditation, I wouldn't take it. Mental illness made me feel weak and powerless; having the agency to make lifestyle changes that restored my health gave me back my sense of self and the feeling that I was in the driver's seat of my life. I see this as my most valuable asset and something I will never take for granted. 

5. There are helpful mindsets that can assist with adhering to keto in order to see the benefits 

When I first started jogging, I sometimes found it challenging to get going. I used to play a mental trick and tell myself that I only needed to run for five minutes, and if I still didn't feel like it, I could stop. Almost without fail, I would keep going once I got started. Similarly, it might be helpful for some patients to focus on the thought that a medical keto diet does not need to be a lifelong undertaking. If someone feels an aversion to loss in terms of not having the ability to enjoy carb-rich foods, it might be comforting, psychologically, to think of it as a six-month experiment, with a finite commitment. 

I love keto meals, which I now find highly satiating and pleasurable. So much of what humans think they need to be happy is just habituated and can change entirely with time. If patients are willing to commit for a given time frame, they may find the upsides so incredible that the original perceived sacrifice of changing their diets quickly melts away. And, like me, many report beginning to love the diet and no longer crave carb-rich foods. At that point, the idea of following a keto diet indefinitely becomes welcome, rather than fear-inducing. 

Igniting a metabolic revolution 

My hope is to see ketogenic therapy and metabolic strategies transform lives. As an advocate, I'm driven to spread awareness of this cutting-edge treatment, especially for those who yearn for a better life. Each person I reach has the potential to not only heal themselves but to inspire others and ignite a metabolic revolution.