{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T01:30:11Z","timestamp":1791509411530,"version":"4.3.4"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is little research describing the clinical use of a ketogenic diet in obsessive-compulsive disorder (OCD) or inflammatory bowel disease. We describe the first clinical application of a ketogenic diet in adult OCD with ulcerative colitis (UC) resulting in complete remission of OCD, clinical remission of UC, and improved metabolic health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 37-year-old obese woman with longstanding OCD and ulcerative colitis was treated for 12 weeks with a personalized whole-food ketogenic diet (KMT 1:5:1 ratio) in a specialized metabolic psychiatry clinic. Adherence was assessed by capillary beta-hydroxybutyrate (BHB) and photojournaling of food intake. Remission of OCD was assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Florida Obsessive Compulsive Inventory scale (FOCI), and Clinical Global Impression-Improvement\/Severity scale (CGI-S\/I). Patient Health Questionnaire-9 (PHQ-9) and Yale Food Addictions Scale 2.0 (YFAS 2.0) assessed depression and food addiction. Remission of UC was assessed by the Partial Mayo Score (PMS) and the Ulcerative Colitis Patient-Reported Outcome (UC-PRO). Metabolic health was assessed by laboratories and bioimpedance. Quality of life was assessed using validated scales for flourishing, resilience, self-compassion, and subjective narrative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinical remission of UC occurred within 3 weeks (PMS 0, UC-PRO 0). Progressive improvement in OCD was inversely related to oscillating BHB, with FOCI 0 at 9 weeks, and complete remission at 12 weeks (Y-BOCS 0, CGI-S 1). Body weight decreased 12.2%, with significant decreases in the percentage of body fat and visceral fat. Flourishing, resilience, and self-compassion improved 2- to 20-fold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Complete remission of OCD, clinical remission of UC, and marked improvement in metabolic health occurred within 12 weeks using a well-formulated personalized ketogenic diet (KMT ratio 1:5:1) with a meaningful positive impact on quality of life and significant improvements in flourishing, resilience, and self-compassion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1541414","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T04:19:45Z","timestamp":1743653985000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Remission of OCD and ulcerative colitis with a ketogenic diet: Case Report"],"prefix":"10.3389","volume":"16","author":[{"given":"Lori","family":"Calabrese","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.20m13398","article-title":"High prevalence and incidence of obsessive-compulsive disorder among women across pregnancy and the postpartum","volume":"82","author":"Fairbrother","year":"2021","journal-title":"J Clin Psychiatry"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.202000296","article-title":"Defining and addressing gaps in care for obsessive-compulsive disorder in the United States","volume":"72","author":"Senter","year":"2021","journal-title":"Psychiatr Serv"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.9758\/cpn.23.1075","article-title":"Clinical advances in treatment strategies for obsessive-compulsive disorder in adults","volume":"21","author":"Roh","year":"2023","journal-title":"Clin Psychopharmacol Neurosci"},{"key":"B4","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1038\/s41572-019-0102-3","article-title":"Obsessive-compulsive disorder","volume":"5","author":"Stein","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"B5","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.ajp.2016.02.001","article-title":"Adult obsessive-compulsive disorder and quality of life outcomes: A systematic review and meta-analysis","volume":"22","author":"Coluccia","year":"2016","journal-title":"Asian J Psychiatr"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-013-0056-z","article-title":"Quality of life in obsessive-compulsive disorder: impact of the disorder and of treatment","volume":"27","author":"Subramaniam","year":"2013","journal-title":"CNS Drugs"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13665","article-title":"The natural history of lifetime psychiatric disorders in patients with obsessive-compulsive disorder followed over half a century","volume":"149","author":"Klenfeldt","year":"2024","journal-title":"Acta Psychiatr Scand"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)30069-4","article-title":"Pharmacological and psychotherapeutic interventions for management of obsessive-compulsive disorder in adults: a systematic review and network meta-analysis","volume":"3","author":"Skapinakis","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2022.152352","article-title":"Treatment-resistant OCD: pharmacotherapies in adults","volume":"120","author":"van Roessel","year":"2023","journal-title":"Compr Psychiatry"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.60496","article-title":"Management and treatment of obsessive-compulsive disorder (OCD): a literature review","volume":"16","author":"Elsouri","year":"2024","journal-title":"Cureus"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2017.12.003","article-title":"Metabolic and cardiovascular complications in obsessive-compulsive disorder: a total population, sibling comparison study with long-term follow-up","volume":"84","author":"Isomura","year":"2018","journal-title":"Biol Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1164750","article-title":"Metabolic syndrome in patients with obsessive-compulsive disorder","volume":"14","author":"Khalkhali","year":"2023","journal-title":"Front Psychiatry"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2022.152329","article-title":"Obsessive-compulsive disorder, insulin signaling and diabetes - a novel form of physical health comorbidity: the sweet compulsive brain","volume":"117","author":"Grassi","year":"2022","journal-title":"Compr Psychiatry"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00966-2","article-title":"Ulcerative colitis","volume":"402","author":"Le Berre","year":"2023","journal-title":"Lancet"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12317","article-title":"Implications of the changing epidemiology of inflammatory bowel disease in a changing world","volume":"10","author":"Agrawal","year":"2022","journal-title":"United Eur Gastroenterol J"},{"key":"B16","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/s11894-019-0705-6","article-title":"Evolving epidemiology of IBD","volume":"21","author":"Windsor","year":"2019","journal-title":"Curr Gastroenterol Rep"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjac167","article-title":"Intake of ultra-processed foods is associated with an increased risk of Crohn's disease: a cross-sectional and prospective analysis of 187 154 participants in the UK Biobank","volume":"17","author":"Chen","year":"2023","journal-title":"J Crohns Colitis"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1554","article-title":"Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study","volume":"374","author":"Narula","year":"2021","journal-title":"BMJ"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1080\/17474124.2021.1911644","article-title":"Burden of comorbid anxiety and depression in patients with inflammatory bowel disease: a systematic literature review","volume":"15","author":"Dubinsky","year":"2021","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.15389","article-title":"Ulcerative colitis in adults: a review","volume":"330","author":"Gros","year":"2023","journal-title":"JAMA"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD015084.pub2","article-title":"Prebiotics for induction and maintenance of remission in ulcerative colitis","volume":"3","author":"Sinopoulou","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"B22","doi-asserted-by":"publisher","first-page":"2508","DOI":"10.1016\/j.cgh.2022.11.026","article-title":"Dietary interventions for the treatment of inflammatory bowel diseases: an updated systematic review and meta-analysis","volume":"21","author":"Limketkai","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60071068","article-title":"A comprehensive review of dietary approaches in maintaining remission of inflammatory bowel diseases in adults","volume":"60","author":"Istratescu","year":"2024","journal-title":"Medicina (Kaunas)"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.12.031","article-title":"STRIDE-II: un update on the selecting therapeutic targets in inflammatory bowel disease (STRIDE) initiative of the International Organization for the Study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD","volume":"160","author":"Turner","year":"2021","journal-title":"Gastroenterology"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25179695","article-title":"Navigating the neuroimmunomodulation frontier: pioneering approaches and promising horizons-a comprehensive review","volume":"25","author":"Krsek","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1396685","article-title":"Complete remission of depression and anxiety using a ketogenic diet: case series","volume":"11","author":"Calabrese","year":"2024","journal-title":"Front Nutr"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2018-000898","article-title":"Omega-6 vegetable oils as a driver of coronary heart disease: the oxidized linoleic acid hypothesis","volume":"5","author":"DiNicolantonio","year":"2018","journal-title":"Open Heart"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.tifs.2021.12.020","article-title":"Food proteins from animals and plants: difference in the nutritional and functional properties","volume":"199","author":"Day","year":"2022","journal-title":"Trends Food Sci Technol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.951376","article-title":"The ketogenic diet for refractory mental illness: A retrospective analysis of 31 inpatients","volume":"13","author":"Danan","year":"2022","journal-title":"Front Psychiatry"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2019.49","article-title":"Ketosis and bipolar disorder: controlled analytic study of online reports","volume":"5","author":"Campbell","year":"2019","journal-title":"BJPsych Open"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2023.568","article-title":"Pilot study of a ketogenic diet in bipolar disorder","volume":"9","author":"Needham","year":"2023","journal-title":"BJPsych Open"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2024.115866","article-title":"Ketogenic diet intervention on metabolic and psychiatric health in bipolar and schizophrenia: A pilot trial","volume":"335","author":"Sethi","year":"2024","journal-title":"Psychiatry Res"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2019.03.019","article-title":"The ketogenic diet and remission of psychotic symptoms in schizophrenia: Two case studies","volume":"208","author":"Palmer","year":"2019","journal-title":"Schizophr Res"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13102819","article-title":"The potential role of the ketogenic diet in serious mental illness: current evidence, safety, and practical advice","volume":"13","author":"Rog","year":"2024","journal-title":"J Clin Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1007\/s40501-024-00339-4","article-title":"The ketogenic diet as a transdiagnostic treatment for neuropsychiatric disorders: mechanisms and clinical outcomes","volume":"12","author":"Anderson","year":"2025","journal-title":"Curr Treat Options Psych"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1192\/bja.2024.74","article-title":"Beyond comorbidities: metabolic dysfunction as a root cause of neuropsychiatric disorders","author":"Palmer","year":"2025","journal-title":"BJPsych Adv"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1177\/08830738030180020501","article-title":"Application of a ketogenic diet in children with autistic behavior: pilot study","volume":"18","author":"Evangeliou","year":"2003","journal-title":"J Child Neurol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-022-01455-x","article-title":"Ketogenic diet and ketamine infusion treatment to target chronic persistent eating disorder psychopathology in anorexia nervosa: a pilot study","volume":"27","author":"Calabrese","year":"2022","journal-title":"Eat Weight Disord"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1467475","article-title":"Case report: carnivore-ketogenic diet for the treatment of inflammatory bowel disease: a case series of 10 patients","volume":"11","author":"Norwitz","year":"2024","journal-title":"Front Nutr"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3390\/ijms241511978","article-title":"Microbial reprogramming in obsessive-compulsive disorders: a review of gut-brain communication and emerging evidence","volume":"24","author":"Bendriss","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3389\/fncel.2021.661838","article-title":"Blood-brain barrier dysfunction amplifies the development of neuroinflammation: understanding of cellular events in brain microvascular endothelial cells for prevention and treatment of BBB dysfunction","volume":"15","author":"Takata","year":"2021","journal-title":"Front Cell Neurosci"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnutbio.2024.109693","article-title":"Therapeutic potential of the ketogenic diet: A metabolic switch with implications for neurological disorders, the gut-brain axis, and cardiovascular diseases","volume":"132","author":"Shahpasand","year":"2024","journal-title":"J Nutr Biochem"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2024.114891","article-title":"A diet-dependent host metabolite shapes the gut microbiota to protect from autoimmunity","volume":"43","author":"Alexander","year":"2024","journal-title":"Cell Rep"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.339\/nu16091348","article-title":"Ketogenic diet protects from experimental colitis in a mouse model regardless of dietary fat source","volume":"16","author":"Luiskari","year":"2024","journal-title":"Nutrients"},{"key":"B45","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1038\/s41398-019-0570-y","article-title":"Inflammation-related biomarkers in major psychiatric disorders: a cross-disorder assessment of reproducibility and specificity in 43 meta-analyses","volume":"9","author":"Yuan","year":"2019","journal-title":"Transl Psychiatry"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuad175","article-title":"The effect of a ketogenic diet on inflammation-related markers: a systematic review and meta-analysis of randomized controlled trials","volume":"83","author":"Ji","year":"2025","journal-title":"Nutr Rev"},{"key":"B47","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.neuron.2010.09.002","article-title":"Metabolic control of vesicular glutamate transport and release","volume":"68","author":"Juge","year":"2010","journal-title":"Neuron"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1541414\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T04:19:46Z","timestamp":1743653986000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1541414\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,3]]},"references-count":47,"alternative-id":["10.3389\/fpsyt.2025.1541414"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2025.1541414","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,3]]},"article-number":"1541414"}}