{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:03:26Z","timestamp":1791835406728,"version":"4.3.4"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T00:00:00Z","timestamp":1661212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T00:00:00Z","timestamp":1661212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Homeostasis Therapeutics"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eat Weight Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Anorexia nervosa (AN) is a severe psychiatric disorder, and shape and weight concerns are often chronic despite weight normalization. No specific treatments exist for those preoccupations that interfere with recovery and trigger relapse. A case study using a ketogenic diet followed by ketamine infusions led to sustained remission in one patient with chronic AN. Here we conducted an open-label trial to test whether this response could be replicated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five adults weight recovered from AN but with persistent eating disorder thoughts and behaviors adopted a therapeutic ketogenic diet (TKD) aimed at maintaining weight. After sustaining nutritional ketosis, participants received six ketamine infusions and were followed over 6\u00a0months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All participants completed the study protocol without significant adverse effects. Two participants maintained TKD for 8\u00a0weeks prior to ketamine infusions due to good behavioral response and remained on TKD. Three participants received TKD for 4\u00a0weeks prior to and during ketamine, then tapered off after the final infusion. The group showed significant improvements on the Clinical Impairment Assessment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), Eating Disorder Examination Questionnaire (EDEQ) Global score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), EDEQ-Eating Concerns (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), EDEQ-Shape Concerns (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016), EDEQ-Weight Concerns (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032), Eating Disorders Recovery Questionnaire (EDRQ) Acceptance of Self and Body (0.027) and EDRQ-Social and Emotional Connection (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Weight remained stable, except for one participant who relapsed 4 months after treatment and off TKD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This novel treatment appears to be safe and effective for adults with chronic AN-related psychopathology. The results from this open trial support that there are specific neurobiological underpinnings of AN that can be normalized using TKD and ketamine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level IV, multiple time series with intervention<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40519-022-01455-x","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T04:02:31Z","timestamp":1661227351000},"page":"3751-3757","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Ketogenic diet and ketamine infusion\u00a0treatment to target chronic persistent eating disorder psychopathology\u00a0in anorexia nervosa: a pilot study"],"prefix":"10.1007","volume":"27","author":[{"given":"Lori","family":"Calabrese","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Scolnick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Zupec-Kania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Beckwith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Costello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6590-3441","authenticated-orcid":false,"given":"Guido K. W.","family":"Frank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"1455_CR1","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/s40337-015-0065-z","volume":"3","author":"S Touyz","year":"2015","unstructured":"Touyz S, Hay P (2015) Severe and enduring anorexia nervosa (SE-AN): in search of a new paradigm. J Eat Disord 3:26. https:\/\/doi.org\/10.1186\/s40337-015-0065-z","journal-title":"J Eat Disord"},{"key":"1455_CR2","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1038\/s41588-019-0439-2","volume":"51","author":"HJ Watson","year":"2019","unstructured":"Watson HJ, Yilmaz Z, Thornton LM et al (2019) Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa. Nat Genet 51:1207\u20131214. https:\/\/doi.org\/10.1038\/s41588-019-0439-2","journal-title":"Nat Genet"},{"key":"1455_CR3","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/s40337-021-00481-x","volume":"9","author":"S Spadini","year":"2021","unstructured":"Spadini S, Ferro M, Lamanna J, Malgaroli A (2021) Activity-based anorexia animal model: a review of the main neurobiological findings. J Eat Disord 9:123. https:\/\/doi.org\/10.1186\/s40337-021-00481-x","journal-title":"J Eat Disord"},{"key":"1455_CR4","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1093\/qjmed\/91.7.493","volume":"91","author":"IH Mills","year":"1998","unstructured":"Mills IH, Park GR, Manara AR, Merriman RJ (1998) Treatment of compulsive behaviour in eating disorders with intermittent ketamine infusions. QJM 91:493\u2013503. https:\/\/doi.org\/10.1093\/qjmed\/91.7.493","journal-title":"QJM"},{"key":"1455_CR5","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1001\/jamapsychiatry.2021.1580","volume":"78","author":"GKW Frank","year":"2021","unstructured":"Frank GKW, Shott ME, Stoddard J, Swindle S, Pryor TL (2021) Association of brain reward response with body mass index and ventral striatal-hypothalamic circuitry among young women with eating disorders. JAMA Psychiat 78:1123\u20131133. https:\/\/doi.org\/10.1001\/jamapsychiatry.2021.1580","journal-title":"JAMA Psychiat"},{"key":"1455_CR6","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.brainres.2009.06.060","volume":"1286","author":"B Cheng","year":"2009","unstructured":"Cheng B, Yang X, An L, Gao B, Liu X, Liu S (2009) Ketogenic diet protects dopaminergic neurons against 6-OHDA neurotoxicity via up-regulating glutathione in a rat model of Parkinson\u2019s disease. Brain Res 1286:25\u201331. https:\/\/doi.org\/10.1016\/j.brainres.2009.06.060","journal-title":"Brain Res"},{"key":"1455_CR7","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1038\/mp.2017.190","volume":"23","author":"M Kokkinou","year":"2018","unstructured":"Kokkinou M, Ashok AH, Howes OD (2018) The effects of ketamine on dopaminergic function: meta-analysis and review of the implications for neuropsychiatric disorders. Mol Psychiatry 23:59\u201369. https:\/\/doi.org\/10.1038\/mp.2017.190","journal-title":"Mol Psychiatry"},{"key":"1455_CR8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.neubiorev.2018.07.020","volume":"94","author":"E Brietzke","year":"2018","unstructured":"Brietzke E, Mansur RB, Subramaniapillai M, Balanza-Martinez V, Vinberg M, Gonzalez-Pinto A, Rosenblat JD, Ho R, McIntyre RS (2018) Ketogenic diet as a metabolic therapy for mood disorders: evidence and developments. Neurosci Biobehav Rev 94:11\u201316. https:\/\/doi.org\/10.1016\/j.neubiorev.2018.07.020","journal-title":"Neurosci Biobehav Rev"},{"key":"1455_CR9","doi-asserted-by":"publisher","first-page":"763","DOI":"10.3389\/fpsyt.2020.00763","volume":"11","author":"B Scolnick","year":"2020","unstructured":"Scolnick B, Zupec-Kania B, Calabrese L, Aoki C, Hildebrandt T (2020) Remission from chronic anorexia nervosa with ketogenic diet and ketamine: case report. Front Psychiatry 11:763. https:\/\/doi.org\/10.3389\/fpsyt.2020.00763","journal-title":"Front Psychiatry"},{"key":"1455_CR10","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.brainres.2018.05.049","volume":"1703","author":"SA Masino","year":"2019","unstructured":"Masino SA, Rho JM (2019) Metabolism and epilepsy: ketogenic diets as a homeostatic link. Brain Res 1703:26\u201330. https:\/\/doi.org\/10.1016\/j.brainres.2018.05.049","journal-title":"Brain Res"}],"container-title":["Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40519-022-01455-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40519-022-01455-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40519-022-01455-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T05:51:12Z","timestamp":1672379472000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40519-022-01455-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,23]]},"references-count":10,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1455"],"URL":"https:\/\/doi.org\/10.1007\/s40519-022-01455-x","relation":{},"ISSN":["1590-1262"],"issn-type":[{"value":"1590-1262","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,23]]},"assertion":[{"value":"26 May 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 July 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No author reports any conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}},{"value":"The study was approved by the IntegReview Institutional Review Board, Texas, USA.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants were adults and provided written, informed consent to participate in this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the data gathered in this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}]}}