KETOGENIC DIET AND KETAMINE INFUSION TREATMENT TO TARGET CHRONIC PERSISTENT EATING DISORDER PSYCHOPATHOLOGY IN ANOREXIA NERVOSA; A PILOT STUDY
B Scolnick¹, L Calabrese², B Zupek-Kania³, C Beckwith⁴, G Frank^5
1Internal & Addiction Medicine, Waban, MA, United States/²Innovative Psychiatry, So Windsor, CT, United States/³Ketogenic Therapy, Milwaukee, WI, United States/⁴Peer Counseling, New York, NY, United States/⁵University California San Diego, San Diego, CA, United States

Purpose Shape and weight concerns are often chronic despite weight normalization in patients with anorexia nervosa (AN). A case study using a ketogenic diet followed by ketamine infusions led to sustained remission in one patient with chronic AN. We conducted an open-label trial to test whether this response could be replicated. Methods Five adults, weight recovered from AN but with persistent eating disorder thoughts and behaviors adopted a therapeutic ketogenic diet (TKD). After sustaining nutritional ketosis, participants received six ketamine infusions and were followed over 6 months. Results All participants completed the study protocol without significant adverse effects. Two participants maintained TKD for 8 weeks prior to ketamine infusions due to good behavioral response and remained on TKD. Three participants received TKD for 4 weeks prior to and during ketamine, then tapered off. The group showed significant improvements on the Clinical Impairment Assessment (p = 0.008), Eating Disorder Examination Questionnaire (EDEQ) Global score (p = 0.006), Eating Disorders Recovery Questionnaire (EDRQ) Acceptance of Self and Body (0.027). Weight remained stable, except for one participant who relapsed 4 months after treatment and off TKD. Conclusion This novel treatment appears to be safe and effective for adults with chronic AN-related psychopathology and merits further study.  

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Medical Factors