Remission of OCD and Ulcerative Colitis with a Ketogenic Diet: Case Report

Lori Calabrese ^*

• Innovative Psychiatry, South Windsor, United States

Background: There is little research describing clinical use of a ketogenic diet in obsessivecompulsive 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. Methods: A 37-year-old obese woman with longstanding OCD and ulcerative colitis was treated for 12 weeks with a personalized whole foods 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 Y-BOCS, FOCI, CGI-S/I. PHQ-9 and YFAS-2 assessed depression and food addiction. Remission of UC was assessed by PMS and 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. Results: 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 % body fat and visceral fat. Flourishing, resilience and self-compassion improved 2-to 20-fold. Conclusion: 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 meaningful positive impact on quality of life and significant improvements in flourishing, resilience, and self-compassion.