Uploaded March 2026 | Updated September 2026, 1 day ago
Can the ketogenic diet help improve symptoms for individuals living with treatment-resistant depression?
In this conversation, Dr. Bret Scher sits down with Dr. Megan Kirk Chang, a senior researcher in metabolic psychiatry at the University of Oxford and a co-author of the recently published DIME trial.
This study represents the first randomized clinical trial to evaluate a ketogenic diet in adults with treatment-resistant depression.
Participants were assigned to either a ketogenic diet or a plant-rich comparison diet for six weeks to assess whether dietary intervention could influence depressive symptoms. Both groups experienced meaningful improvements in depression scores, with the ketogenic diet slightly outperforming the control group at 6 weeks.
While the difference between groups did not reach the threshold for statistical significance, the findings suggest a positive signal that warrants further investigation.
In this interview, Dr. Kirk Chang reflects on:
- The strengths of the study and where she sees opportunity for improvement.
- What the modest difference between diets might mean
- Why early pilot trials are designed to detect signals rather than definitive answers
- What the study revealed about adherence, cravings, and behavioral factors
- How these results will inform larger and longer clinical trials now being planned
As Dr. Kirk Chang explains, this six-week pilot trial was designed as proof-of-concept research to determine whether there is enough signal to justify larger studies in metabolic psychiatry.
At Metabolic Mind, we view studies like this as an important step in a growing scientific effort to understand how metabolism and nutrition may influence serious mental illness. Each new study contributes to the evolving evidence base that will help researchers determine who may benefit, why, and under what conditions.
đź”—Â To learn more about the available evidence for ketogenic therapy in depression and our top resources, visit our Depression Topic Page: metabolicmind.org/resources/topics/keto-for-depression
🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.
*Expert Featured:*
Dr. Megan Kirk Chang, PhD
- Senior Researcher, Department of Psychiatry, University of Oxford
- https://x.com/DrMegKirkChang
- linkedin.com/in/megankirkchang
*Resources Mentioned:*
**A Ketogenic Diet for Treatment-Resistant Depression: A Randomized Clinical Trial**
- doi.org/10.1001/jamapsychiatry.2025.4431
*Free CME Clinician Trainings:*
Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein, Dr. Mariela Glandt, Dr. Deanna Kelly, Dr. Julie Milder, Dr. Zoltan Sarnyai, and Dr. Bret Scher with more coming soon.
Our courses have been made *FREE* by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:
metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-yt
Learn more about metabolic psychiatry and find helpful resources at metabolicmind.org
*About us:*
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.
*Timestamps:*
0:00 - Introduction to Dr. Megan Kirk Chang, PhD and her new trial studying ketogenic therapy for depression, the DIME trial.
2:02 - Background of the DIME trial.
3:30 - How does Dr. Kick Chang frame the results of the DIME trial? More about the cohort studied.
7:59 - Was it a surprise to see the improved results from the control group in addition to the ketogenic therapy group? What did the control diet consist of?
10:36 - How did the keto group in the study eat? What were the implications of the setup design?
14:13 - The state of the metabolic psychiatry research community and the importance of joining psychiatrists with ketogenic researchers.
15:43 - How were ketones measured in the DIME trial and how could that have affected the study and results?
21:50 - What were some of the notable pieces of qualitative data from the participants?
27:30 - What future studies is Dr. Kirk Chang and her team working on now?
31:23 - Conclusions and where to hear more from Dr. Megan Kirk Chang
32:58 - Dr. Scher’s takeaways takeaways and final thoughts on the interview and DIME trial.
Can the ketogenic diet help improve symptoms for individuals living with treatment-resistant depression?
In this conversation, Dr. Bret Scher sits down with Dr. Megan Kirk Chang, a senior researcher in metabolic psychiatry at the University of Oxford and a co-author of the recently published DIME trial.
This study represents the first randomized clinical trial to evaluate a ketogenic diet in adults with treatment-resistant depression.
Participants were assigned to either a ketogenic diet or a plant-rich comparison diet for six weeks to assess whether dietary intervention could influence depressive symptoms. Both groups experienced meaningful improvements in depression scores, with the ketogenic diet slightly outperforming the control group at 6 weeks.
While the difference between groups did not reach the threshold for statistical significance, the findings suggest a positive signal that warrants further investigation.
In this interview, Dr. Kirk Chang reflects on:
- The strengths of the study and where she sees opportunity for improvement.
- What the modest difference between diets might mean
- Why early pilot trials are designed to detect signals rather than definitive answers
- What the study revealed about adherence, cravings, and behavioral factors
- How these results will inform larger and longer clinical trials now being planned
As Dr. Kirk Chang explains, this six-week pilot trial was designed as proof-of-concept research to determine whether there is enough signal to justify larger studies in metabolic psychiatry.
At Metabolic Mind, we view studies like this as an important step in a growing scientific effort to understand how metabolism and nutrition may influence serious mental illness. Each new study contributes to the evolving evidence base that will help researchers determine who may benefit, why, and under what conditions.
đź”—Â To learn more about the available evidence for ketogenic therapy in depression and our top resources, visit our Depression Topic Page: metabolicmind.org/resources/topics/keto-for-depression
🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.
*Expert Featured:*
Dr. Megan Kirk Chang, PhD
- Senior Researcher, Department of Psychiatry, University of Oxford
- https://x.com/DrMegKirkChang
- linkedin.com/in/megankirkchang
*Resources Mentioned:*
**A Ketogenic Diet for Treatment-Resistant Depression: A Randomized Clinical Trial**
- doi.org/10.1001/jamapsychiatry.2025.4431
*Free CME Clinician Trainings:*
Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein, Dr. Mariela Glandt, Dr. Deanna Kelly, Dr. Julie Milder, Dr. Zoltan Sarnyai, and Dr. Bret Scher with more coming soon.
Our courses have been made *FREE* by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits:
metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-yt
Learn more about metabolic psychiatry and find helpful resources at metabolicmind.org
*About us:*
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.
*Timestamps:*
0:00 - Introduction to Dr. Megan Kirk Chang, PhD and her new trial studying ketogenic therapy for depression, the DIME trial.
2:02 - Background of the DIME trial.
3:30 - How does Dr. Kick Chang frame the results of the DIME trial? More about the cohort studied.
7:59 - Was it a surprise to see the improved results from the control group in addition to the ketogenic therapy group? What did the control diet consist of?
10:36 - How did the keto group in the study eat? What were the implications of the setup design?
14:13 - The state of the metabolic psychiatry research community and the importance of joining psychiatrists with ketogenic researchers.
15:43 - How were ketones measured in the DIME trial and how could that have affected the study and results?
21:50 - What were some of the notable pieces of qualitative data from the participants?
27:30 - What future studies is Dr. Kirk Chang and her team working on now?
31:23 - Conclusions and where to hear more from Dr. Megan Kirk Chang
32:58 - Dr. Scher’s takeaways takeaways and final thoughts on the interview and DIME trial.
