A 2026 feasibility trial found that a ketogenic diet helped 72% of adults with anorexia nervosa achieve normal-range eating disorder and depression scores within 14 weeks. Participants reported significant reductions in food anxiety, body image concerns, and dietary restraint, with no dangerous weight loss or symptom worsening. According to Gram Research analysis, ketogenic therapy appears safe and potentially effective for weight-restored adults with anorexia nervosa, though larger studies are needed to confirm these promising early findings.
Researchers tested whether a special high-fat, low-carb diet called ketogenic therapy could help adults with anorexia nervosa reduce their eating disorder symptoms. In this 14-week study, 22 participants followed the ketogenic diet while maintaining a healthy weight. The results were encouraging: 82% of participants completed the trial, and by the end, 72% had eating disorder and depression scores that fell within the normal range. Participants reported less anxiety about food and body image, and the diet was well-tolerated with no serious side effects. According to Gram Research analysis, these findings suggest ketogenic therapy may be a promising new treatment option for people struggling with anorexia nervosa.
Key Statistics
A 2026 feasibility trial of 22 adults with anorexia nervosa found that 72% achieved eating disorder and depression scores within the normal range after 14 weeks of ketogenic dietary therapy, compared to baseline measurements.
In the same 2026 study, 82% of participants (18 of 22) completed the full 14-week ketogenic therapy trial, indicating high tolerability and adherence to the dietary intervention.
Among 2026 trial participants who continued ketogenic therapy at three-month follow-up, only 28% showed increased eating disorder symptoms, while 64% of those who discontinued the diet showed symptom increases.
The 2026 ketogenic therapy trial demonstrated significant reductions across all measured eating disorder domains: restraint, eating concern, shape concern, and weight concern, with no clinically significant weight loss or safety concerns reported.
The Quick Take
- What they studied: Whether a ketogenic diet (a diet high in fat and very low in carbohydrates) could safely reduce eating disorder symptoms in adults with anorexia nervosa who were either slightly underweight or at a healthy weight.
- Who participated: Twenty-two adults with anorexia nervosa who were either mildly underweight or had already restored their weight to a healthy level. Eighteen participants (82%) completed the full 14-week study.
- Key finding: By the end of the 14-week study, 72% of participants had eating disorder and depression scores that fell within the normal range. Participants showed significant improvements in food anxiety, body image concerns, and mood, with no worsening of symptoms or dangerous weight loss.
- What it means for you: If you or someone you know has anorexia nervosa, this research suggests a ketogenic diet might be worth exploring with a healthcare team as part of treatment. However, this is early-stage research with a small group, so it should only be pursued under medical supervision. This is not a replacement for traditional eating disorder treatment like therapy and counseling.
The Research Details
This was a feasibility trial, which means researchers were testing whether a new treatment approach is practical and safe to use. Twenty-two adults with anorexia nervosa followed a ketogenic diet (high in fat, very low in carbohydrates) for 14 weeks while maintaining a healthy body weight. Researchers measured eating disorder symptoms using a standard questionnaire called the Eating Disorder Examination Questionnaire (EDE-Q) and also tracked depression symptoms and overall well-being.
Participants were assessed at the beginning of the study, at the end of the 14 weeks, and again three months later to see if improvements lasted. The researchers used statistical methods to account for other factors that might affect results, like whether participants were taking medications or had other mental health conditions.
This type of study is important because it helps researchers determine if a new treatment is worth studying in larger, more rigorous trials. By carefully monitoring safety and early signs of effectiveness in a small group, researchers can decide whether to invest in bigger studies.
Anorexia nervosa is one of the most serious eating disorders, with high rates of relapse even after people reach a healthy weight. Many people continue struggling with intense fear of eating, obsessive thoughts about body shape and weight, and depression long after their weight is restored. Finding new treatments that address these lingering psychological symptoms is critically important. This study matters because it explores a completely different approach—using diet composition rather than traditional therapy alone—to reduce these core symptoms.
This study has both strengths and limitations. Strengths include: it was registered in advance (a sign of good research practices), it used validated measurement tools, it tracked participants after the study ended, and it carefully monitored for safety. Limitations include: the sample size was small (only 22 people), there was no control group for comparison, and it was conducted at a single research center. These limitations mean the findings are promising but preliminary and need confirmation in larger studies.
What the Results Show
The most important finding was that 72% of participants had eating disorder and depression scores within the normal range by the end of the 14-week study. This is significant because it means most participants no longer met criteria for an eating disorder on standard psychological measures.
Participants showed meaningful improvements across multiple areas: they reported less dietary restraint (obsessive control over food), fewer concerns about eating, reduced preoccupation with body shape and weight, and improved mood. These improvements happened without any participants experiencing dangerous weight loss or worsening of their eating disorder symptoms.
The diet was well-tolerated, meaning participants could stick with it and didn’t experience serious side effects. Eighteen of 22 participants (82%) completed the full 14-week trial, which is a high completion rate for eating disorder research.
At the three-month follow-up, participants who continued the ketogenic diet maintained their improvements better than those who stopped. Among people who kept following the diet, only 28% showed an increase in eating disorder symptoms, while 64% of those who stopped the diet showed symptom increases. This suggests the diet’s benefits may depend on continuing it.
Depression scores improved significantly alongside eating disorder symptoms, which is important because depression and eating disorders often occur together. The study found no evidence of clinically significant weight loss or other safety concerns, which was a major goal since safety is paramount in treating eating disorders. The fact that the diet could be maintained at a stable weight (rather than causing weight loss) is reassuring for this population.
This is one of the first studies to examine ketogenic therapy specifically for anorexia nervosa in adults. Previous research has explored ketogenic diets for other psychiatric conditions like depression and anxiety with mixed results. This study is novel because it applies this dietary approach to the core symptoms of eating disorders. The improvement rates (72% achieving normal-range scores) are comparable to or better than some traditional eating disorder treatments, though direct comparisons aren’t possible without a control group.
The study had several important limitations. First, it was small with only 22 participants, so results may not apply to everyone with anorexia nervosa. Second, there was no control group—researchers didn’t compare the ketogenic diet to standard treatment or a placebo diet, so they can’t be completely certain the diet itself caused the improvements rather than other factors like increased medical attention. Third, the study only lasted 14 weeks, so we don’t know if benefits persist long-term. Fourth, participants were selected to be either mildly underweight or weight-restored, so results may not apply to people who are severely underweight. Finally, the study was conducted at one research center, so results may not generalize to other settings or populations.
The Bottom Line
Based on this early-stage research, ketogenic therapy shows promise as a potential additional tool for treating anorexia nervosa in adults who are at or near a healthy weight. However, confidence in this recommendation is moderate because the study was small and lacked a comparison group. If you have anorexia nervosa, discuss this approach with your treatment team (psychiatrist, therapist, and dietitian) before considering it. This should complement, not replace, evidence-based treatments like cognitive behavioral therapy and family-based therapy. Do not attempt a ketogenic diet for an eating disorder without professional medical supervision.
This research is most relevant to: adults with anorexia nervosa who have reached or nearly reached a healthy weight but continue struggling with eating disorder thoughts and behaviors; mental health professionals treating eating disorders who want to know about emerging treatment options; and people researching new approaches to eating disorder treatment. This research is NOT appropriate for people who are severely underweight, pregnant, have liver or kidney disease, or have a history of disordered eating patterns that could be triggered by dietary restriction.
In this study, participants showed measurable improvements within 14 weeks, with 72% reaching normal-range symptom scores by the end. However, individual results vary. Some people may see benefits sooner, while others may need the full 14 weeks or longer. The three-month follow-up data suggest that continuing the diet helps maintain improvements, so this isn’t a quick fix but rather an ongoing dietary approach.
Frequently Asked Questions
Can a ketogenic diet treat anorexia nervosa?
Early research suggests ketogenic diet may help reduce eating disorder symptoms in weight-restored adults with anorexia nervosa. A 2026 trial found 72% of participants achieved normal symptom scores within 14 weeks. However, this should only be pursued under medical supervision as part of comprehensive treatment, not as a standalone cure.
Is a ketogenic diet safe for people with eating disorders?
In this 2026 study of 22 adults with anorexia nervosa, the ketogenic diet was well-tolerated with no dangerous weight loss or symptom worsening. However, safety depends on medical supervision, stable weight maintenance, and individual health factors. Anyone with an eating disorder should consult their treatment team before dietary changes.
How long does it take to see improvements from ketogenic therapy for anorexia?
In the 2026 trial, participants showed measurable improvements within 14 weeks, with 72% reaching normal symptom scores by completion. Individual timelines vary. Continuing the diet appeared important for maintaining benefits, as 64% of participants who stopped showed symptom increases at follow-up.
Who should not try a ketogenic diet for eating disorders?
This approach is not appropriate for people who are severely underweight, pregnant, have liver or kidney disease, or have medical conditions requiring carbohydrate intake. It should only be considered for weight-restored or mildly underweight adults under professional medical supervision as part of comprehensive eating disorder treatment.
Does ketogenic therapy replace traditional eating disorder treatment?
No. The 2026 research suggests ketogenic therapy may complement traditional treatments like therapy and counseling, not replace them. This dietary approach should be used alongside evidence-based psychological treatments, medical monitoring, and nutritional counseling for optimal outcomes.
Want to Apply This Research?
- Track daily eating disorder thoughts and behaviors using a simple 1-10 scale (where 1 = minimal symptoms and 10 = severe symptoms). Log this daily along with what you ate and whether you followed your ketogenic meal plan. Over 2-4 weeks, look for patterns in how your symptom severity correlates with diet adherence.
- Start by working with a registered dietitian to create a personalized ketogenic meal plan that maintains your current healthy weight. Use the app to log meals, track macronutrient ratios (fat, protein, carbs), and record your mood and anxiety levels before and after eating. Set a weekly goal to complete 80% of planned meals without restriction or binge episodes.
- Use the app to track four key metrics weekly: (1) frequency of food-related anxiety thoughts, (2) body image satisfaction on a 1-10 scale, (3) dietary restraint behaviors, and (4) overall mood. Create a dashboard showing 4-week trends. Share these trends with your treatment team monthly to assess whether the ketogenic approach is helping and to make adjustments as needed.
This research represents early-stage findings from a small feasibility trial and should not be considered definitive treatment guidance. Anorexia nervosa is a serious psychiatric disorder requiring comprehensive professional treatment. Any dietary intervention for eating disorders must be pursued under the direct supervision of a qualified healthcare team including a psychiatrist, therapist, and registered dietitian. This article is for informational purposes only and does not constitute medical advice. Do not attempt ketogenic therapy or any dietary change for an eating disorder without explicit approval and monitoring from your treatment team. If you or someone you know is struggling with an eating disorder, contact the National Eating Disorders Association (NEDA) helpline at 1-800-931-2237 or visit nationaleatingdisorders.org for support.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.