Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention: a retrospective case report
BackgroundObsessive-compulsive disorder (OCD) is a chronic and disabling condition that frequently resists standard interventions, including SSRIs and Exposure and Response Prevention (ERP). This case study explores the adjunctive use of ketogenic metabolic therapy (KMT) in conjunction with ERP for...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Psychiatry |
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| author | Nicole Laurent Katherine A. Tague |
| author_facet | Nicole Laurent Katherine A. Tague |
| author_sort | Nicole Laurent |
| collection | DOAJ |
| description | BackgroundObsessive-compulsive disorder (OCD) is a chronic and disabling condition that frequently resists standard interventions, including SSRIs and Exposure and Response Prevention (ERP). This case study explores the adjunctive use of ketogenic metabolic therapy (KMT) in conjunction with ERP for a 26-year-old man with treatment-resistant OCD characterized by the symmetry/ordering symptom dimension. The patient achieved remission of OCD symptoms and sustained improvements in mood, emotional regulation, and quality of life.MethodsA 26-year-old male with treatment-resistant OCD self-treated with a modified ketogenic diet and psychotherapy assisted ERP over 12 weeks. The diet featured a 1.5:1 macronutrient ratio (fat:protein+carbohydrates), self-monitored for nutritional ketosis (ketone levels ≥0.8 mmol/L), and included daily symptom tracking. ERP targeted symmetry/ordering-related compulsions. Symptom severity was assessed using the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Long-term outcomes were evaluated over a 95-week follow-up.ResultsWithin three weeks of initiating KMT and subsequent ERP, daily compulsive behaviors decreased from 3–8 hours to less than one hour. Significant reductions in DOCS symmetry/ordering subscale scores were sustained at 95 weeks. Concurrent improvements were observed in emotional distress, measured by DASS-21, with all subscale scores normalizing by week 7. Qualitative feedback highlighted enhanced emotional regulation, sleep quality, and ERP engagement, attributed to the ketogenic diet.ConclusionThis case demonstrates rapid and sustained remission of OCD symptoms with the use of KMT and ERP. The findings suggest that KMT may provide a metabolic foundation that enhances the efficacy of ERP. Further research is warranted to explore the potential role of KMT in treatment-resistant OCD. |
| format | Article |
| id | doaj-art-47eab107d12148aa9def49da44f8b7ac |
| institution | DOAJ |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj-art-47eab107d12148aa9def49da44f8b7ac2025-08-20T03:22:18ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-06-011610.3389/fpsyt.2025.15555911555591Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention: a retrospective case reportNicole Laurent0Katherine A. Tague1Family Renewal, Inc., Vancouver, WA, United StatesWell Supported Behavioral Health, PLLC, Greenwich, CT, United StatesBackgroundObsessive-compulsive disorder (OCD) is a chronic and disabling condition that frequently resists standard interventions, including SSRIs and Exposure and Response Prevention (ERP). This case study explores the adjunctive use of ketogenic metabolic therapy (KMT) in conjunction with ERP for a 26-year-old man with treatment-resistant OCD characterized by the symmetry/ordering symptom dimension. The patient achieved remission of OCD symptoms and sustained improvements in mood, emotional regulation, and quality of life.MethodsA 26-year-old male with treatment-resistant OCD self-treated with a modified ketogenic diet and psychotherapy assisted ERP over 12 weeks. The diet featured a 1.5:1 macronutrient ratio (fat:protein+carbohydrates), self-monitored for nutritional ketosis (ketone levels ≥0.8 mmol/L), and included daily symptom tracking. ERP targeted symmetry/ordering-related compulsions. Symptom severity was assessed using the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Long-term outcomes were evaluated over a 95-week follow-up.ResultsWithin three weeks of initiating KMT and subsequent ERP, daily compulsive behaviors decreased from 3–8 hours to less than one hour. Significant reductions in DOCS symmetry/ordering subscale scores were sustained at 95 weeks. Concurrent improvements were observed in emotional distress, measured by DASS-21, with all subscale scores normalizing by week 7. Qualitative feedback highlighted enhanced emotional regulation, sleep quality, and ERP engagement, attributed to the ketogenic diet.ConclusionThis case demonstrates rapid and sustained remission of OCD symptoms with the use of KMT and ERP. The findings suggest that KMT may provide a metabolic foundation that enhances the efficacy of ERP. Further research is warranted to explore the potential role of KMT in treatment-resistant OCD.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1555591/fullketogenic metabolic therapyketogenic dietobsessive-compulsive disorderOCDexposure and response preventionERP |
| spellingShingle | Nicole Laurent Katherine A. Tague Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention: a retrospective case report Frontiers in Psychiatry ketogenic metabolic therapy ketogenic diet obsessive-compulsive disorder OCD exposure and response prevention ERP |
| title | Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention: a retrospective case report |
| title_full | Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention: a retrospective case report |
| title_fullStr | Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention: a retrospective case report |
| title_full_unstemmed | Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention: a retrospective case report |
| title_short | Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention: a retrospective case report |
| title_sort | remission of obsessive compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention a retrospective case report |
| topic | ketogenic metabolic therapy ketogenic diet obsessive-compulsive disorder OCD exposure and response prevention ERP |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1555591/full |
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