Can the Keto Diet Help with Bipolar Medication Weight Gain?

Yes! The research is clear. The ketogenic diet originally created for epilepsy treatment shows great promise in preventing medication weight gain caused by bipolar disorder medications. It can also help with mood management over time.

Julie’s new article from Bp Magazine shares all you need to know about this topic.


Ketogenic Metabolic Therapy Diets for Bipolar Disorder

Julie currently researches the impact of ketogenic metabolic therapy diets on bipolar disorder and psychotic disorders with an emphasis on how these diets can help prevent weight gain due to the metabolic syndrome that is common with bipolar disorder medications. To read more about her research, please read the ketogenic diet section in the second edition of Take Charge of Bipolar Disorder.

The Ketogenic Metabolic Therapy Diet for Bipolar Disorder

For most people, a balanced diet of fats, proteins, fresh vegetables, whole grains, low sugar consumption, and limited processed foods supports the immune system, balances weight, regulates blood sugar, keeps moods relatively stable, and promotes healthy aging. But as you know, you’re not most people. You have bipolar disorder and a balanced diet is rarely enough to manage mood swings or help with the weight gain and other health concerns associated with medication induced metabolic syndrome. It’s important to note that bipolar disorder mood swings, and in many cases, metabolic syndrome are not the result of a poor diet. Bipolar disorder mood swings and the side effects from bipolar disorder medications are the same all over the world, independent from a country’s cuisine or the size of the people who have the diagnosis. Research suggests that bipolar disorder symptoms and metabolic syndrome are connected to a condition called insulin resistance. Insulin is a hormone produced by the pancreas that is used to metabolize food and regulate glucose in the body. Insulin is also an important element in managing your mood. Any diet used to manage bipolar disorder and at the same time prevent metabolic syndrome needs to address the role of insulin in the bipolar brain. Luckily, a diet originally created to help manage epilepsy called the ketogenic metabolic therapy diet shows great promise in helping people with bipolar disorder.

What is the Ketogenic Metabolic Therapy Diet?

The ketogenic metabolic therapy diet was created in the 1920s to help children manage epilepsy. This medical intervention diet uses food science to balance brain chemistry by carefully monitoring the ratio of fat to the amount of carbohydrates and protein in a person’s diet. There is a direct connection between epilepsy and bipolar disorder as the medications used to treat epilepsy also work for the bipolar brain. Thus, a diet that helps manage epilepsy by mimicking the brain chemistry changes from medications could work for bipolar disorder as well. Before exploring how the diet could help with bipolar disorder mood swings and metabolic syndrome, it helps to understand the food science behind the diet.

Julie recently interviewed Dr. Chris Palmer, the author of the bestselling book Brain Energy: A Revolutionary Breakthrough in Understanding Mental Health—and Improving Treatment for Anxiety, Depression, OCD, PTSD, and More

He kindly shared an explanation of his research into the metabolic nature of bipolar disorder including the impact of insulin resistance on bipolar disorder symptoms and how ketogenic metabolic therapies used in epilepsy management may be one of the healthiest and most cost effective ways to prevent metabolic syndrome and management bipolar disorder symptoms. Brain Energy also includes his research into how mitochondria and the gut microbiome may affect people with bipolar disorder and psychotic disorders.

Ketogenic Metabolic Therapies for Bipolar Disorder

By Dr. Chris Palmer

The ketogenic therapeutic diet is an evidence-based treatment for epilepsy and diabetes. Most people think these have nothing to do with bipolar disorder, but in fact, they have a lot to do with the illness.

First, many medication treatments for bipolar disorder were originally developed for epilepsy. This suggests some overlap in what might be happening in the brains of people with epilepsy and bipolar disorder, and in fact, metabolic problems such as insulin resistance have been identified in both.

Bipolar disorder also overlaps with diabetes. They often run in the same families. It’s even proposed that people with bipolar disorder are more likely to have insulin resistance even before taking any psychiatric medications or eating an unhealthy diet. In one study, children with the highest levels of insulin resistance beginning at age 9 were 5 times more likely to be at risk for bipolar disorder. While this could be attributed to a poor diet and subsequent weight gain, other studies found that people in a first episode who were not overweight or showing signs of diabetes also had signs of insulin resistance. Insulin resistance is not a marker of someone necessarily being obviously unhealthy or overweight. When people come in the hospital with their first manic or psychotic episode, they often show signs of insulin resistance even before we give them one pill. It turns out that insulin is very important to brain function, and this might be playing a role in bipolar disorder. Finding a way to manage this potential insulin resistance through the food you eat is a breakthrough therapy that is changing the lives of people with neurochemical disorders.

Mechanisms of  Ketogenic Diet Therapies

How does the ketogenic diet work? We know that it balances neurotransmitters, reduces inflammation, improves insulin resistance, changes the gut microbiome, and even changes gene expression through epigenetics (the theory that genes can be latent and then turned on by the environment later in life). These are all thought to play a role in bipolar disorder. But is there any evidence that it actually works for bipolar symptoms? Yes, but this research is just getting started.

If you are considering trying this diet as part of your treatment, I urge you to work with your healthcare professional and a ketogenic metabolic therapy nutritionist. Although it’s called a “diet,” it is actually a very powerful medical intervention. If you’re taking medications, your prescriber needs to be a part of this ketogenic therapy. There are also some risks, such as insomnia while starting the diet. These types of risks need to be safely managed. There are many case reports of people with bipolar disorder improving dramatically on this diet and it is something I hope that all people with bipolar disorder will explore.

For more information on Dr. Palmer’s research, please visit his website.

His media interviews are hopeful and filled with important information on the role changes in lifestyle and especially diet can help manage bipolar disorder, anxiety, ADD and psychotic disorders.


What is the latest research on the metabolic theory of bipolar disorder? The following article explains how abnormal glucose metabolism, mitochondrial dysfunction, and insulin resistance may be underlying factors in bipolar disorder mood swings.

Glucose metabolism and its regulatory mechanisms play a central role in energy (ATP) production in the body and brain by providing fuel for oxidative phosphorylation in mitochondria. Metabolic dysfunction characterized by abnormal glucose metabolism, mitochondrial dysfunction, and insulin resistance (IR) are increasingly recognized as important features in the pathophysiology of bipolar disorder.


Julie highly recommends the work of ketogenic metabolic therapy diet nutritionist Denise Potter.

Julie has worked with Denise for the past year with her own ketogenic diet journey. Denise has experience in working with clients who have bipolar disorder as well as their family members and partners. 

Denise explains her ketogenic metabolic therapy classes in the following video:

Play Video

Click here to read more about Advanced Ketogenic Therapy Services.

A Note

From Julie A. Fast

I believe the ketogenic metabolic therapy diets are the future of bipolar disorder and psychotic disorder management. Start with the basic keto information in Take Charge of Bipolar Disorder and then explore the work of other researchers and professionals in this field. I trust the work of Chris Palmer and Denise Potter as well as the amazing books and services from Beth Zupec Kania. For more information on the origins of the ketogenic diet’s use in epilepsy, please visit the Charlie Foundation. For updates on my keto research, please join me on The Bipolar Belly on Instagram.