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Anorexia Nervosa in RemissionNCT06000774

Therapeutic Ketogenic Diet in Anorexia Nervosa

A study testing Therapeutic Ketogenic Diet in people with Anorexia Nervosa in Remission and Bulimia Nervosa, run by University of California, San Diego at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This study will investigate the effects of therapeutic ketogenic diet (TKD) on eating behavior including drive to restrict, body dissatisfaction, mood and anxiety in individuals with anorexia nervosa who have been weight normalized (body mass index of 17.5 or greater) but continue to struggle with eating disorder… Read more about this study

Who is it for?
Ages 18 to 45 years
What is being tested?
Therapeutic Ketogenic Diet
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteUnited States
Study dates
3 Oct 2023to 30 Jun 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • All sexes
  • No healthy volunteers
  • Adult

Weight-Recovered AN Inclusion Criteria:

  1. Provision of signed and dated informed consent form
  2. Stated willingness to comply with all study procedures and availability for the duration of the study
  3. Persons, aged 18 to 45 years
  4. History of anorexia nervosa according to DSM-5 criteria
  5. Weight recovered at the time of study inclusion (body mass index > 17.5 kg/m2)
  6. Greater or equal to 2 standard deviations scores of eating disorder-relevant behaviors on the Eating Disorder Inventory-3 and Eating Disorder Examination Questionnaire
  7. The following types of psychiatric medications are allowed: antidepressant, anxiolytic, atypical antipsychotic, mood stabilizers
  8. English is primary spoken language

Weight-Recovered AN Exclusion Criteria:

  1. Pregnancy or lactation
  2. Electrolyte, blood count, kidney function or liver function abnormalities
  3. Psychosis
  4. Neurocognitive disorders including dementias or traumatic brain injury that is symptomatic
  5. Current alcohol use disorder (AUD) or substance use disorder (SUD) according to DSM-5 criteria
  6. Uncontrolled hypertension
  7. Hepatic impairment (Class-Pugh b or c)
  8. Diabetes mellitus
  9. Family history of porphyria
  10. History of recent heart attack, vascular disease, or any other current acute medical conditions as determined by the principal investigator
  11. Inability or unwillingness to adhere to the TKD diet for the duration of the study
  12. Blind or illiterate individuals

Underweight AN Sub-Study Inclusion Criteria:

  1. Provision of signed and dated informed consent form
  2. Stated willingness to comply with all study procedures and availability for the duration of the study
  3. Persons, aged 18 to 45 years
  4. Anorexia nervosa according to DSM-5 criteria
  5. Current Body Mass Index (BMI) at the time of study inclusion of 16.0 to 17.49
  6. An elevated EDE-Q global score of 2.09 or greater
  7. The following types of psychiatric medications are allowed: antidepressant, anxiolytic, atypical antipsychotic, mood stabilizers
  8. English is primary spoken language

Underweight AN Sub-Study Exclusion Criteria:

  1. Pregnancy or lactation
  2. Electrolyte, blood count, kidney function or liver function abnormalities
  3. Psychosis
  4. Neurocognitive disorders including dementias or traumatic brain injury that is symptomatic
  5. Current alcohol use disorder (AUD) or substance use disorder (SUD) according to DSM-5 criteria
  6. Uncontrolled hypertension
  7. Hepatic impairment (Class-Pugh b or c)
  8. Diabetes mellitus
  9. Family history of porphyria
  10. History of recent heart attack, vascular disease, or any other current acute medical conditions as determined by the principal investigator
  11. Inability or unwillingness to adhere to the TKD diet for the duration of the study
  12. Blind or illiterate individuals

Bulimia Nervosa Pilot Inclusion Criteria:

  1. Provision of signed and dated informed consent form
  2. Stated willingness to comply with all study procedures and availability for the duration of the study
  3. Persons, aged 18 to 45 years
  4. History of bulimia nervosa according to DSM-5 criteria
  5. An elevated EDE-Q global score of 2.09 or greater
  6. The following types of psychiatric medications are allowed: antidepressant, anxiolytic, atypical antipsychotic, mood stabilizers
  7. English is primary spoken language

Bulimia Nervosa Pilot Exclusion Criteria:

  1. Pregnancy or lactation
  2. Electrolyte, blood count, kidney function or liver function abnormalities
  3. Psychosis
  4. Neurocognitive disorders including dementias or traumatic brain injury that is symptomatic
  5. Current alcohol use disorder (AUD) or substance use disorder (SUD) according to DSM-5 criteria
  6. Uncontrolled hypertension
  7. Hepatic impairment (Class-Pugh b or c)
  8. Diabetes mellitus
  9. Family history of porphyria
  10. History of recent heart attack, vascular disease, or any other current acute medical conditions as determined by the principal investigator
  11. Inability or unwillingness to adhere to the TKD diet for the duration of the study
  12. Blind or illiterate individuals

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Megan Shott, BS contact

848-246-5272

mshott@health.ucsd.edu

United States1 site, 1 recruiting
  • University of California San Diego

    San Diego, California, 92121

    Megan E Shott, BS, 858-246-5272, mshott@health.ucsd.edu

    Guido Frank, MD, gfrank@health.ucsd.edu

    Recruiting

Other trials in United States

About this study

Official title: Ketogenic Diet in Eating Disorders to Target Metabolism and Normalize Persistent Eating Disorder Psychopathology

This study will investigate the effects of therapeutic ketogenic diet (TKD) on eating behavior including drive to restrict, body dissatisfaction, mood and anxiety in individuals with anorexia nervosa who have been weight normalized (body mass index of 17.5 or greater) but continue to struggle with eating disorder behaviors including a high drive for thinness and body dissatisfaction.

The Underweight Anorexia Nervosa (AN) Sub-Study will investigate the effects of TKD on eating behavior including drive to restrict, body dissatisfaction, mood and anxiety in individuals with anorexia nervosa who are currently underweight (body mass index between 16.0 and 17.49) and continue to struggle with eating disorder behaviors including a high drive for thinness and body dissatisfaction.

The Bulimia Nervosa Pilot will will investigate the effects of TKD on eating behavior including drive to binge and purge, body dissatisfaction, mood and anxiety in individuals with bulimia nervosa.

Read the detailed description

For this 14-week study, the investigator will recruit twenty individuals with anorexia nervosa who have been weight normalized but continue to have high impairment from the illness with a high (2 standard deviations above average) drive for thinness and body dissatisfaction and a high drive for food restriction and thus are at high risk for full relapse. Study participants will be carefully assessed and oriented to the ketogenic diet according to the procedures in our small previous trial (Calabrese, et al., 2022). The study will be conducted in a university medical environment, showing feasibility and safety in a typical medical setting. A commercial supplier will provide the ketogenic diet. After ketosis induction over two weeks, study participants will be assessed weekly for ketosis and mood, anxiety, and eating disorder symptoms.

For the BN Pillot study we will also complete a small pilot in 5 individuals with bulimia nervosa.

For the Underweight Anorexia Nervosa (AN) Sub-Study we will also recruit 30 individuals with anorexia nervosa who are mild to moderately underweight and have a body mass index of between 16.0 to 17.49.

Primary Objective 1 is to test the effects of ketogenic diet in individuals with anorexia nervosa who are weight recovered but continue to suffer severely from drive for thinness and are at very high relapse risk. Participants will be evaluated for tolerability of the study and weight trajectory. Primary Objective 2 is to assess improvement in AN symptoms and behaviors in relation to the ketogenic diet over a 12-week course. Participants will be assessed for specific symptoms such as drive for thinness and body dissatisfaction, fear of eating and weight gain. Primary Objective 3 is to assess the underlying genetic basis for the treatment effect of the ketogenic diet.

Bulimia Nervosa Pilot Objective 1: To test the effects of ketogenic diet in individuals with bulimia nervosa.

Bulimia Nervosa Pilot Objective 2: To assess improvement in BN symptoms and behaviors in relation to the ketogenic diet over a 2-week induction period followed by a 12-week course of the intervention. We expect especially a reduction in binge eating episodes and associated purging episodes in response to the treatment and in addition to improvement of the cognitive emotional symptoms.

Underweight AN Sub-Study Objective 1: To test the effects of ketogenic diet in individuals with anorexia nervosa who are currently mildly underweight and assess how the intervention impacts weight normalization in this population.

Underweight AN Sub-Study Objective 2: To assess improvement in AN symptoms and behaviors in relation to the ketogenic diet over a 2-week induction period followed by a 12-week course of the intervention.

Underweight AN Sub-Study Objective 3: To assess the underlying genetic basis for the treatment effect of the ketogenic diet.

Being tested
Therapeutic Ketogenic Diet
Medical subject headings
Bulimia Nervosa, Anorexia Nervosa

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Therapeutic Ketogenic DietOther

    therapeutic ketogenic diet

Study groups in NCT06000774
Study groupRoleWhat they receive
Therapeutic Ketogenic DietExperimentalA 2-week therapeutic ketogenic diet (TKD) induction will be implemented to establish nutritional ketosis (the goal are BHB blood levels of 0.5-3.0 millimoles per liter [mmol/L]). After establishing the ketotic state, study participants will continue TKD for 12 weeks.
Receives: Other: Therapeutic Ketogenic Diet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. To assess the safety and tolerability in individuals with anorexia nervosa who are weight recovered, individuals with anorexia nervosa who are currently underweight, and individuals with bulimia nervosa using weekly body weight measurements.

    Weekly weights will be obtained to assess whether subjects remain within a normal weight range.

    Measured: Weekly for the duration of the study intervention (14 weeks)

  2. To assess the safety and tolerability in individuals with anorexia nervosa (AN) who are weight recovered, AN individuals who are currently underweight, and Bulimia Nervosa individuals using the Committee of Clinical Investigations UKU-Side Effect Scale

    The UKU assesses psychiatric, neurologic, autonomic, and other side effects.

    Measured: At weeks 4, 8, 12, 14

  3. Measurement of drive for weight loss, fear of weight gain and body image distortion using the Eating Disorder Examination Questionnaire (EDEQ) Global Score, EDEQ Eating Restraint Score, and EDEQ Weight Concern

    The Eating Disorders Examination Questionnaire a self report assessment that measures core eating disorder symptoms. Subjects will complete this measure at the beginning and end of the study and weekly throughout the 14-week intervention and the investigator will measure the change in scores. The EDE Global, Eating Restraint, and Weight Concern scales have a range of 0 to 6 where higher scores mean worse outcome.

    Measured: At baseline, Week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 3 month follow-up

  4. Measurement of the relationship between genotype and improvement of eating disorder symptoms

    In order to identify potential genetic signatures that may predict response to treatment, Whole Exome Sequencing will be conducted on participants.

    Measured: At baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Aug 2023
  2. Study start3 Oct 2023
  3. Primary completionJun 2027 (estimated)
  4. Study completion30 Jun 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Subjects will complete a 14-week therapeutic ketogenic diet (TKD)
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06000774
Sponsor's protocol ID
807674
Status last verified
Aug 2025
First submitted
14 Aug 2023
Last updated
5 Sep 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Scolnick B, Zupec-Kania B, Calabrese L, Aoki C, Hildebrandt T. Remission from Chronic Anorexia Nervosa With Ketogenic Diet and Ketamine: Case Report. Front Psychiatry. 2020 Jul 30;11:763. doi: 10.3389/fpsyt.2020.00763. eCollection 2020.

    PubMed 32848935
  • Frank GKW, Shott ME, DeGuzman MC. The Neurobiology of Eating Disorders. Child Adolesc Psychiatr Clin N Am. 2019 Oct;28(4):629-640. doi: 10.1016/j.chc.2019.05.007. Epub 2019 Jul 4.

    PubMed 31443880
  • Frank GKW, Shott ME, Stoddard J, Swindle S, Pryor TL. Association of Brain Reward Response With Body Mass Index and Ventral Striatal-Hypothalamic Circuitry Among Young Women With Eating Disorders. JAMA Psychiatry. 2021 Oct 1;78(10):1123-1133. doi: 10.1001/jamapsychiatry.2021.1580.

    PubMed 34190963
  • Dignon A, Beardsmore A, Spain S, Kuan A. 'Why I won't eat': patient testimony from 15 anorexics concerning the causes of their disorder. J Health Psychol. 2006 Nov;11(6):942-56. doi: 10.1177/1359105306069097.

    PubMed 17035265
  • Calabrese L, Scolnick B, Zupec-Kania B, Beckwith C, Costello K, Frank GKW. Ketogenic diet and ketamine infusion treatment to target chronic persistent eating disorder psychopathology in anorexia nervosa: a pilot study. Eat Weight Disord. 2022 Dec;27(8):3751-3757. doi: 10.1007/s40519-022-01455-x. Epub 2022 Aug 23.

    PubMed 35997954
  • Frank GKW, Scolnick B, Beckwith C, Shott ME, Kilty S, Swindle S, Lutter M, Rho JM. Symptom impact and safety of ketogenic therapy in adults with anorexia nervosa: a feasibility trial. Commun Med (Lond). 2026 Jun 3;6(1):315. doi: 10.1038/s43856-026-01644-0.

    PubMed 42236862

Questions about this trial

What is this clinical trial studying?

A study testing Therapeutic Ketogenic Diet in people with Anorexia Nervosa in Remission and Bulimia Nervosa, run by University of California, San Diego at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 5 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Megan Shott, BS (848-246-5272, mshott@health.ucsd.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

To assess the safety and tolerability in individuals with anorexia nervosa who are weight recovered, individuals with anorexia nervosa who are currently underweight, and individuals with bulimia nervosa using weekly body weight measurements. (time frame: Weekly for the duration of the study intervention (14 weeks)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06000774, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Sep 2025.

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