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The following is a summary of “Pilot study of a ketogenic diet in bipolar disorder: a process evaluation,” published in the January 2025 issue of Psychiatry by Rigby et al. 

Bipolar disorder required new management strategies, and evidence suggested a ketogenic diet as a potential effective intervention. 

Researchers conducted a prospective study to evaluate the feasibility and acceptability of a ketogenic diet for bipolar disorder and the experiences of participants and clinicians. 

They conducted a mixed-methods process evaluation with semi-structured telephone interviews of 15 participants 1–2 months after a 6–8 week modified ketogenic diet intervention and 4 research clinicians. Thematic analysis was applied to the interview data, and fidelity checklists from research dietitians were analyzed using descriptive statistics. Findings were reported post-hoc, guided by the COREQ checklist. 

The results showed 5 themes from the qualitative data: ‘Encouraging entry and supporting exit,’ which emphasized managing participants’ diverse motives and expectations; ‘challenging but potentially transformational,’ reflecting the difficulties of maintaining a ketogenic diet alongside perceived benefits like weight loss and mood stability; ‘intervention facilitators,’ including behavioral, social, and technological support; ‘intervention barriers,’ such as dietary preferences and concerns about the diet’s impact; and ‘The wider context,’ where factors like cost of living influenced experiences. Overall, descriptive analyses indicated moderate-to-good fidelity to the behavior change components of the study. 

Investigators concluded that the study offered valuable insights into the experiences of individuals with bipolar disorder following a ketogenic diet and emphasized the need for improved support and understanding of social factors in future trials. 

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06479-y#Abs1