Live It, Then Launch It: What Clinicians Learn by Eating Keto Themselves

This week, a paper caught my attention because it studies the people on the other side of the exam table. "Pilot Evaluation of an Educational and Lived Experience Training Program on Ketogenic Metabolic Therapy in Mental Health Care for Health Care Professionals"⁽¹⁾ asked a simple question: if we teach clinicians about the ketogenic diet for mental health, and then have them live it themselves for a month, are they more ready to discuss it with their patients?

In this blog, I'll explain ketogenic metabolic therapy, review what the study found and where its limits are, share why this one is personal for me, and give you practical next steps.

What Is Ketogenic Metabolic Therapy?

First, let me explain the term. Ketogenic metabolic therapy (KMT) is a ketogenic diet used as a medical treatment. When you lower carbohydrates enough, your liver converts fat into ketones, especially beta-hydroxybutyrate (BHB). Ketones are an alternative fuel for brain cells and their mitochondria, the tiny power plants that make the energy our cells use to drive the chemistry of life. Nutritional ketosis is usually defined as a blood BHB level of 0.5 mmol/L or higher.⁽¹⁾

KMT has been used to treat epilepsy for more than a century. It is now being studied in schizophrenia, bipolar disorder, and depression. In July, I wrote about the first randomized controlled trial in psychosis, which found metabolic improvements after one month and improvements in psychiatric symptoms during a four-month extension.⁽²⁾ Earlier pilot work⁽³⁾ and a 2026 meta-analysis on depression and anxiety⁽⁴⁾ add to the signal, though much of the evidence is still early.

Why does this matter so much? People with serious mental illness die 10 to 20 years earlier than the general population, and most of those deaths come from preventable heart and metabolic disease, not suicide.⁽⁵⁾ Many psychiatric medications cause weight gain and insulin resistance. A therapy that may support both the brain and metabolism deserves serious attention.

Patients Are Asking. Clinicians Aren't Trained.

In 2026, expert clinical recommendations were published supporting the use of KMT alongside standard psychiatric care.⁽⁶⁾ But evidence alone rarely changes practice. The authors point out that effective psychiatric treatments, such as clozapine, remain underused for years,⁽⁷⁾ often because clinicians don't feel confident using them.

So this team tried something different: teach the science, then have the clinicians live it.

Study Details

This was a small, single-arm pilot study from the Maryland Psychiatric Research Center at the University of Maryland School of Medicine.(1) Forty health care professionals from across the United States enrolled: 10 psychiatrists, 10 psychiatric pharmacists, 8 psychologists or therapists, and 12 others, including nurse practitioners and physician assistants. It filled in just two weeks.

The program, called "Live It, Launch It," had two phases:

• Education: a 4-hour online course covering how glucose, ketones, and insulin work; classic versus modified ketogenic diets; how to build a nutrient-rich ketogenic diet; and how to monitor labs and manage side effects.
• Lived experience (optional): a 4-week ketogenic diet. After a consultation with a registered dietitian, participants followed a diet with about 1.5 grams of fat for every gram of protein plus carbohydrate. They tracked food in an app, checked blood ketones with a home meter, joined weekly group Q&A calls, and were advised to take a daily multivitamin.

Of the 40 clinicians, 25 started the diet phase and 21 finished it (84%). Two withdrew because of moderate side effects they believed were related to the diet: muscle soreness in one person and heart palpitations in another.

Data and Results

Clinicians rated their competence with the ketogenic diet on a 0 to 100 scale. A change of 13 to 15 points is usually considered meaningful.(1)

• Competence: 17 at the start, 68 after the course, and 87 after living the diet.
• Confidence in shared decision-making with patients: 54 at the start, 83 after the course, and 91 after the diet.
• Feedback: 28 of the 29 clinicians who answered said the program improved their ability to help patients use a ketogenic diet.

The education alone produced the biggest jump. Living the diet added meaningful gains on top of it. Participants said that eating this way showed them the real barriers their patients would face, the value of working with a dietitian, and the need to present both the benefits and the challenges honestly.

One detail stood out to me. When clinicians were asked which conditions they might consider KMT for, schizophrenia and depression topped the list. Multiple sclerosis was near the bottom.⁽¹⁾

Discussion of the Results

The authors are candid about the limits, and so should I be. This was a small study with no control group. Every outcome was self-reported confidence, not actual skill, prescribing behavior, or patient results. Several study team members, including senior authors, took part as participants. The diet phase was optional, so the people who chose it were likely already enthusiastic about ketogenic diets. The study was funded by the Baszucki Foundation, and one author owns the company that provides the course.⁽¹⁾

That doesn't make the findings worthless, but we should treat the large effects with caution until larger studies measure what clinicians actually do.

My Take

As a researcher, I see this as a promising first step. The next study must show that patients of trained clinicians actually do better.

As a physician, I have lived on both sides of this. I was a patient with progressive MS in a tilt-recline wheelchair. In the fall of 2007, I began the program that became the Wahls Protocol®, testing it first on myself. I did not learn how hard, and how worth it, a therapeutic diet is from a textbook. I learned it in my own life.

I was experiencing severe pain from trigeminal neuralgia, worsening fatigue, and brain fog. As I transitioned to a very structured ketogenic diet designed to maximize brain nutrition, along with targeted supplements and electrical stimulation of my muscles added to my physical therapy exercises, I was stunned by how rapidly I recovered. My fatigue and brain fog resolved within weeks, and I grew steadily stronger, week by week. I went from being unable to sit up for more than 10 minutes to biking 18.5 miles one year later.

It radically changed the way I think about disease and health, the way I practice medicine, and the research that I conduct.

In my lab at the University of Iowa, our diet studies have taught me how much coaching, cooking help, and peer support people need to succeed.(8,9) This paper confirms what I have long believed: clinicians who have lived the diet are better guides.

I also noticed what the study revealed about fit. Even among motivated health professionals with dietitian support, 14 chose not to try the diet, and 4 of the 25 who started did not finish. Ketosis is a powerful tool, but it is not the right first step for everyone. That is exactly why I wrote my new book.

Next Steps for You

If you are struggling with your mental health right now, confidential support is available through crisis lines. Call or text 988 for the national suicide and crisis lifeline.

Food First

• Eliminate added sugar and white flour foods. They are stripped of nutrients and feed the wrong microbes.
• Work toward nine cups of vegetables and fruit a day: three cups leafy greens, three cups sulfur-rich (cabbage family, onion family, mushrooms), and three cups deeply colored.
• Eat adequate protein, omega-3 rich fish, and fermented foods like sauerkraut or kimchi.

If You Are Considering a Ketogenic Diet

• Don't start alone. Medications for mood, psychosis, blood sugar, and blood pressure may need adjustment as your diet changes, so involve your prescribing clinician first.
• Ask for a referral to a registered dietitian experienced in ketogenic therapy.
• Consider bringing this paper to your next appointment. Shared decision-making works best when you both have the same information.
• Wahls Paleo Plus™ is my nutrient-dense ketogenic diet: 35 grams of net carbs or less per day, plenty of non-starchy vegetables, ½ cup or less of berries per day, and olive oil as a key fat.

Targeted Supplements for Brain Health

The clinicians in this study were advised to take a daily multivitamin, and I agree. I suggest a good multivitamin/multimineral (Advanced Multi), vitamin D3 with K2 (D3K2 5000iu), fish oil (MindFuel Omega), and magnesium (Better Brain Mag) to support your mitochondria and brain cells. I have included all of these, plus lithium orotate, in the Peace of Mind Essentials Kit.

Move Every Day

Exercise daily, and ask for a physical therapy consult to design a program that fits your body.
Do this alongside your medical team, not instead of them.

Find the Diet That Fits You: The Wahls Spectrum

This study shows that even trained clinicians found a ketogenic diet demanding. Some thrived. Some decided it wasn't for them. It means no one diet is perfect for everyone.

My new book, The Wahls Spectrum: Optimize Your Cellular Health to Prevent and Reverse Chronic Disease, written with Eve Adamson, helps you find the diet that best fits your symptoms and your specific medical issues, your personality, your cultural values, and your household preferences. It walks you through the spectrum of options, including Mediterranean, the Wahls™ Diet, Wahls Paleo™, Wahls Paleo Plus™ (my version of a ketogenic diet), low-fat vegan, fasting patterns, and carnivore, so you can determine which diet is best for you and bring a clear plan to your care team.
The Wahls Spectrum comes out March 16, 2027. Preorder now wherever books are sold, and learn more at terrywahls.com.

Closing Thoughts

One small study cannot tell you what will happen for you. But the medical community is beginning to take food seriously as brain medicine, and clinicians who live the change become better partners. Start the conversation with your care team today.

References

1. Murray SL, Potter D, Zisman-Ilani Y, Lee H, Chen S, Roche DJO, et al. Pilot evaluation of an educational and lived experience training program on ketogenic metabolic therapy in mental health care for health care professionals. Front Psychiatry. 2026;17:1913325.
2. Abram SV, Kyner JM, Vu A, Naeem Z, Sethi S, Jacob MS, et al. Metabolic improvements with a ketogenic diet correlate with symptom improvement in psychosis: a randomized controlled trial. Schizophr Bull. 2026;52(4).
3. Sethi S, Wakeham D, Ketter T, Hooshmand F, Bjornstad J, Richards B, et al. Ketogenic diet intervention on metabolic and psychiatric health in bipolar and schizophrenia: a pilot trial. Psychiatry Res. 2024;335:115866.
4. Janssen-Aguilar R, Vije T, Peera M, Al-Shamali HF, Meshkat S, Lin Q, et al. Ketogenic diets and depression and anxiety: a systematic review and meta-analysis. JAMA Psychiatry. 2026;83:13-22.
5. Chan JKN, Correll CU, Wong CSM, Chu RST, Fung VSC, Wong GHS, et al. Life expectancy and years of potential life lost in people with mental disorders: a systematic review and meta-analysis. EClinicalMedicine. 2023;65:102294.
6. Ede G, Bernstein M, Calabrese L, Campbell IH, Laurent N, Palmer CM, et al. Awareness and best practices in using ketogenic therapy to treat serious mental illness: a modified Delphi consensus. Front Nutr. 2026;13:1749406.
7. Kelly DL, Freudenreich O, Sayer MA, Love RC. Addressing barriers to clozapine underutilization: a national effort. Psychiatr Serv. 2018;69:224-7.
8. Bisht B, et al. A multimodal intervention for patients with secondary progressive multiple sclerosis: feasibility and effect on fatigue. J Altern Complement Med. 2014;20(5):347-55.
9. Irish AK, et al. Randomized control trial evaluation of a modified Paleolithic dietary intervention in the treatment of relapsing-remitting multiple sclerosis: a pilot study. Degener Neurol Neuromuscul Dis. 2017;7:1-18.