Can the ketogenic diet help improve symptoms for individuals living with treatment-resistant depression?

In this conversation, Dr. Bret Scher sits down with Dr. Megan Kirk Chang, a senior researcher in metabolic psychiatry at the University of Oxford and a co-author of the recently published DIME trial.

This study represents the first randomized clinical trial to evaluate a ketogenic diet in adults with treatment-resistant depression.

Participants were assigned to either a ketogenic diet or a plant-rich comparison diet for six weeks to assess whether dietary intervention could influence depressive symptoms. Both groups experienced meaningful improvements in depression scores, with the ketogenic diet slightly outperforming the control group at 6 weeks.

While the difference between groups did not reach the threshold for statistical significance, the findings suggest a positive signal that warrants further investigation.

In this interview, Dr. Kirk Chang reflects on:

1. The strengths of the study and where she sees opportunity for improvement.
2. What the modest difference between diets might mean
3. Why early pilot trials are designed to detect signals rather than definitive answers
4. What the study revealed about adherence, cravings, and behavioral factors
5. How these results will inform larger and longer clinical trials now being planned

As Dr. Kirk Chang explains, this six-week pilot trial was designed as proof-of-concept research to determine whether there is enough signal to justify larger studies in metabolic psychiatry.

At Metabolic Mind, we view studies like this as an important step in a growing scientific effort to understand how metabolism and nutrition may influence serious mental illness. Each new study contributes to the evolving evidence base that will help researchers determine who may benefit, why, and under what conditions.

🔗 To learn more about the available evidence for ketogenic therapy in depression and our top resources, visit our Depression Topic Page: https://www.metabolicmind.org/resources/topics/keto-for-depression/

🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.

Expert Featured:

Dr. Megan Kirk Chang, PhD

1. Senior Researcher, Department of Psychiatry, University of Oxford
2. https://x.com/DrMegKirkChang
3. https://www.linkedin.com/in/megankirkchang/

Resources Mentioned:

A Ketogenic Diet for Treatment-Resistant Depression: A Randomized Clinical Trial

1. https://doi.org/10.1001/jamapsychiatry.2025.4431

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Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.