Metabolic Psychiatry: Can Ketones Transform Mental Health Treatment?

Explore the emerging field of metabolic psychiatry and its potential to revolutionize mental health treatment. Discover the inspiring story of the Baszucki family and how a ketogenic diet helped their son overcome severe bipolar disorder. Learn about the science behind the gut-brain connection and the mechanisms by which the ketogenic diet can improve brain health. Gain insights from leading experts Dr. Georgia Ede and Dr. Bret Scher on implementing metabolic psychiatry in clinical practice, including how to assess metabolic health, collaborate with nutrition professionals, and address objections from traditional psychiatry and insurers. Finally, explore practical considerations for patient empowerment and learn how you can get involved in the growing metabolic psychiatry movement to help shape a brighter future for mental health care.

Psychiatry Tomorrow Podcast Show Notes

00:00:00 - Introduction

- Over 50% of U.S. adults have insulin resistance, which affects blood sugar levels and impairs the brain's ability to process glucose

- Interview with Dr. Georgia Ede, a psychiatrist specializing in nutritional and metabolic approaches to mental health, and Dr. Bret Scher, a cardiologist and director of Metabolic Mind

- Ketogenic diet can fundamentally improve brain health by providing an alternate fuel source

00:02:00 - Introductions and background

- Dr. Bret Scher's journey from cardiology to metabolic health and involvement with the Bazouki family and metabolic psychiatry

- Dr. Georgia Ede's background and gradual incorporation of nutrition principles into her psychiatric practice

00:05:00 - Defining metabolic psychiatry

- Understanding and addressing the metabolic root causes of mental health conditions, often through nutritional strategies

00:06:00 - The Baszucki family story

- Matt Bazouki's struggle with bipolar disorder and remarkable improvement on a ketogenic diet under the guidance of Dr. Chris Palmer

- The Baszuki family's commitment to advancing metabolic psychiatry research and education

00:10:00 - Research in metabolic psychiatry

- Explosion of research in the field across a wide spectrum of psychiatric conditions

- Dr. Albert Danan's study on the ketogenic diet in treatment-resistant patients with serious mental illness

00:14:00 - Ongoing and upcoming studies

- Completed pilot studies by Dr. Shabani Sethi and Dr. Ian Campbell

- New randomized controlled trials at McLean and University of Pittsburgh

- Metabolic Mind's role in bringing together the scientific community

00:16:00 - Balancing the need for more research with helping patients today

- Relying on clinical experience while working to speed up research and randomized controlled trials

00:17:00 - Metabolic psychiatry in mainstream psychiatric education

- Lack of programming in traditional psychiatric training

- McLean and Stanford now have formal programs

00:18:00 - Resources for psychiatrists to learn about metabolic psychiatry

- Metabolic Mind website, Dr. Ede's book "Change Your Diet, Change Your Mind," clinician training programs, and literature

00:19:00 - Including a simple metabolic evaluation in psychiatric intake

- Testing fasting insulin, triglycerides, HDL cholesterol, and waist circumference

- Encouraging patients to improve overall metabolic health

00:21:00 - Metabolic assessment details

- Problems with relying solely on fasting blood sugar and hemoglobin A1c

- Importance of testing fasting insulin levels and other markers of metabolic health

00:24:00 - Scaling the ketogenic diet for the average person

- Strategies for making the ketogenic diet affordable and accessible

- Adapting the diet to various preferences, including vegetarian and vegan approaches

00:28:00 - GLP-1 agonists and their role in metabolic health

- Dr. Ede's preference for food-first, lifestyle approaches

- Limitations of medication-based solutions for the metabolic health crisis

00:31:00 - Empowering patients to improve their mental and metabolic health

- The role of psychiatrists in supporting and encouraging patients while emphasizing the importance of patient ownership and self-efficacy

00:32:00 - Working with nutritionists and dietitians

- Dr. Ede's unique experience incorporating nutrition principles into her practice without a dietitian

- The value of collaborating with nutrition professionals for most psychiatrists

00:34:00 - Helping patients get started with metabolic psychiatry

- Working with dietitians, therapists, or health coaches when doctors are not available or knowledgeable

- Dr. Ede's clinician training course and directory

00:36:00 - Addressing polarization and myths on social media

- Countering the perception that metabolic psychiatry is an alternative to conventional care

- Emphasizing the importance of combining metabolic interventions with medication, psychotherapy, and other evidence-based treatments

00:38:00 - The role of ketogenic diets in mitigating the adverse effects of psychiatric medications

- Metabolic damage caused by antipsychotics and certain anticonvulsants

- The ketogenic diet as a powerful add-on treatment to improve metabolic health

00:41:00 - Mechanisms of action: how ketosis helps various psychiatric disorders

- Multiple mechanisms, including lowering blood glucose levels, reducing inflammation, oxidative stress, and glutamate excitotoxicity

- Providing an alternative fuel source in the form of ketones for those with insulin resistance

00:46:00 - Addressing the drug paradigm and the complexity of metabolic interventions

- The ketogenic diet changes whole-body physiology, which may be off-putting to some physicians accustomed to the drug paradigm

00:47:00 - Insurance reimbursement and advocacy

- The need for research demonstrating both efficacy and cost savings for insurance coverage

- Precedents set by companies like Virta Health for type 2 diabetes treatment

- The long-term cost-saving potential of metabolic interventions compared to lifelong medication use

00:50:00 - Getting involved in the metabolic psychiatry movement

- Metabolic Mind's advocacy efforts led by Hannah Warren

- The growing mainstream media coverage of metabolic psychiatry

00:51:00 - Resources for further learning and support

- Metabolic Mind website, podcast, YouTube channel, and social media presence

- Dr. Ede's website, DiagnosisDiet.com, offering trainings, a clinician directory, and articles

00:52:00 - Conclusion and final thoughts

- The power of dietary interventions for mental health concerns

- The potential for metabolic psychiatry to transform clinical practice and improve patient outcomes

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