Can the Keto Diet “Cure” Schizophrenia?

On Wednesday, February 4, 2026, the US Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr stated that adhering to a ketogenic (keto) diet could cure schizophrenia. The announcement is part of ongoing messaging from HHS and the US Department of Agriculture that asserts Americans should “eat real food,” a message delivered alongside the recent overhaul of federal dietary guidelines, which now emphasize protein and fats over carbohydrates.¹

“We now know that the things that you eat are driving mental illness in this country,” Kennedy said. “There are studies right now that I saw 2 days ago where people lose their bipolar diagnosis by changing their diet.”¹

Is There Any Evidence Supporting This Recommendation?

Some research—particularly small, short-term studies—that offers “very preliminary” evidence that the keto diet might be helpful in those with schizophrenia and other psychiatric disorders. Specifically, a study by Stanford University published in Psychiatry Research.⁴

The authors evaluated the potential impact of a 4-month, single-arm, keto diet intervention on both metabolic biomarker profile and psychiatric symptoms among 23 patients in the outpatient setting who were diagnosed with either schizophrenia or bipolar disorder.^4,5

For this study, participants were asked to remain adherent to their standard psychiatric treatment during the trial with no restrictions on dose adjustments with their doctor. Patients were aged 18 to 75 years with appropriate mental health diagnoses who were currently taking psychotropic medications and who were overweight (body mass index [BMI] of ≥ 25 kg/m²) and had gained more than 5% of body mass while using psychotropic medicines to manage their mental health condition. Or, they had at least 1 metabolic abnormality (eg, insulin resistance, hypertriglyceridemia, dyslipidemia, or impaired glucose tolerance).^4,5

The authors defined metabolic abnormality as a comprehensive metabolic panel result outside of the therapeutically accepted range (McPherson and Pincus, 2022). They obtained informed consent from all eligible participants. Conditions that did not allow for an individual to adhere to a diet were excluded, such as acute psychiatric instability (eg, manic episode, active suicidality requiring hospitalization) or conditions that increased medical risk (eg, anorexia, pregnancy, severe renal or hepatic insufficiency).⁴

In psychiatric measurements, participants with schizophrenia showed a 32% reduction in Brief Psychiatric Rating Scale scores, and an Overall Clinical Global Impression (CGI) severity improved by an average of 31%, with the proportion of participants that started with elevated symptomatology improved at least 1 point on CGI (79%). Additionally, psychiatric outcomes across the cohort encompassed increased life satisfaction (17%) and enhanced the quality of sleep (19%).^4,5

The study also showcased improvements in metabolic health, with no participants meeting metabolic syndrome criteria by the study’s conclusion. Individuals who remained adherent to the keto diet experienced significant reductions in weight (12%), BMI (12%), waist circumference (13%), and visceral adipose tissue (36%).⁴

Additionally, observed biomarker enhancements in this population include an approximate 27% decrease in the Homeostasis Model Assessment of Insulin Resistance and a 25% drop in triglyceride levels, both of which were primary end points.^4,5

This pilot trial underscores the potential advantages of adjunctive ketogenic dietary treatment in individuals grappling with serious mental illness.

It is crucial to note that these effects are not a substitute for medication prescribed to manage schizophrenia and psychiatric disorder-related symptoms, and instead, the keto diet can provide some additional benefits to brain health.

“For the field of psychiatry, these findings open opportunities for further research into the relationship between mental health and metabolic health. These findings underscore the importance of further exploration of evidence-based approach in neurology to individuals with serious mental illness in psychiatry,” the study authors wrote.

“Mental health and physical health are interconnected, and addressing metabolic issues can complement psychiatric treatment to enhance overall well-being. Understanding the mechanisms and potential synergies between psychiatric treatment and metabolic improvements can also inform the development of more effective interventions. The observed improvements in metabolic health among individuals with serious mental illness highlight the potential for a more comprehensive and integrated approach to psychiatric care.”⁴

What Is the Keto Diet and How Can Pharmacists Provide Support to Patients?

The keto diet is a high-fat, very low-carbohydrate nutritional pattern that promotes a metabolic shift from glucose utilization to ketone production, which supports energy needs during carbohydrate restriction. The diet reduces circulating insulin levels, enhances fat oxidation, and induces ketosis, which then creates physiologic conditions that may benefit individuals who have epilepsy, obesity, type 2 diabetes, and certain metabolic disorders.

The diet was originally developed as a therapy for refractory epilepsy in pediatric patients, but it is now incorporated into broader clinical practice as evidence accumulates regarding its metabolic, neurologic, and endocrine effects.

The diet’s physiologic impact includes alterations in mitochondrial function, modulation of neuronal excitability, and changes in gut microbiota—all of which contribute to its therapeutic potential. According to the National Library of Medicine, health care professionals frequently encounter challenges related to patient selection, monitoring requirements, safety considerations, and long-term adherence. This reveals the need for a structured understanding of its mechanisms and clinical applications necessary to effectively optimize patient care.³

The pharmacist’s role in helping patients maintain safe, optimal outcomes from a keto diet is significant, as the diet can directly affect blood sugar, blood pressure, electrolytes, and kidney function. Keto diet can even affect the medications patients take.

Pharmacists can help identify patients who are at high risk for hypoglycemia, since carbohydrate restriction can rapidly lower glucose levels—particularly in patients taking insulin, sulfonylureas, or meglitinides. They can also monitor for dehydration and low blood pressure, which are common early effects of keto because of fluid and sodium losses, and review medications that may increase or exacerbate these risks.

Additionally, pharmacists are well positioned to screen for kidney- and heart-related concerns, as keto may require extra caution in patients with chronic kidney disease, a history of kidney stones, or significant cardiovascular disease.

Beyond medication safety, pharmacists can counsel patients on common nutrient gaps that may occur with keto, including low fiber intake and potential electrolyte deficiencies (eg, magnesium, potassium, and sodium), alongside helping patients choose supplements appropriately—especially when comorbidities are present.

Pharmacists serve as a critical safeguard against misinformation by helping patients interpret online keto advice, avoid unsafe supplement use, and recognize symptoms that require medical attention. Long-term success can be supported by counseling patients on realistic expectations, managing gastrointestinal adverse effects, and helping tailor dietary approaches to fit the patient’s lifestyle and medical needs. Collaboration with other health care professionals and specialists is also necessary and crucial to successful treatment.

REFERENCES

1. Stolberg SG. Kennedy Makes Unfounded Claim That Keto Diet Can ‘Cure’ Schizophrenia. The New York Times. February 5, 2026. Accessed February 9, 2026. https://www.nytimes.com/2026/02/05/us/politics/kennedy-keto-diet-schizophrenia.html?unlocked_article_code=1.KFA.RIbR.A0nyZMjwy9xC&smid=url-share

2. Valletti D. New Federal Dietary Guidelines Emphasize Protein and Real Foods While Cutting Sugar. Pharmacy Times. January 8, 2026. Accessed February 9, 2026. https://www.pharmacytimes.com/view/new-federal-dietary-guidelines-emphasize-protein-and-real-foods-while-cutting-sugar

3. Daley SF, Masood W, Annamaraju P, Khan Suhed MZ. The Ketogenic Diet: Clinical Applications, Evidence-based Indications, and Implementation. National Library of Medicine – National Center for Biotechnology Information. Updated December 13, 2025. Accessed February 9, 2026. https://www.ncbi.nlm.nih.gov/books/NBK499830/

4. Sethi S, Wakeham D, Ketter T, et al. Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial. Psychiatry Res. 2024;335:115866. doi:10.1016/j.psychres.2024.115866

5. Impact of a Ketogenic Diet on Metabolic and Psychiatric Health in Patients With Bipolar or Schizophrenia Illness. ClinicalTrials.gov identifier: NCT03935854. Updated December 17, 2024. Accessed February 9, 2026. https://clinicaltrials.gov/study/NCT03935854

6. Bai N. Pilot study shows ketogenic diet improves severe mental illness. News release Stanford Medicine. April 1, 2024. Accessed February 9, 2026. https://med.stanford.edu/news/all-news/2024/04/keto-diet-mental-illness.html