.png)
Across decades in clinical practice, I’ve noticed a glaring pattern: when people improve their metabolic health, their mental health often improves too. Their moods stabilize. Their anxiety eases. Their thinking becomes clearer. These changes were traditionally considered coincidental—pleasant but unrelated side benefits of treating physical disease.
Today, emerging science suggests the opposite: metabolic health and mental health are deeply intertwined. And that connection is forming the foundation of a rapidly developing field known as metabolic psychiatry.
We are facing two major public-health challenges. Rates of depression, anxiety, bipolar disorder, schizophrenia, and treatment-resistant illness continue to rise. At the same time, metabolic disorders—insulin resistance, obesity, type 2 diabetes, fatty liver disease—are skyrocketing across every demographic.
These trends are often treated as separate problems. But research now shows they are profoundly linked. Individuals with serious mental illness are far more likely to have metabolic syndrome, impaired glucose tolerance, and elevated insulin levels. Many psychiatric medications worsen these risks, creating a cycle where the treatments intended to ease emotional suffering inadvertently fuel physical decline.
Even more importantly, growing evidence suggests that metabolic dysfunction may contribute to the development or persistence of psychiatric symptoms, not just the other way around. The brain is the most energy-demanding organ in the body. When the machinery that regulates energy production—mitochondria, insulin signaling, glucose utilization—falters, brain function falters too.
This insight is reshaping how we understand mental illness and creating new opportunities for treatment.
Metabolic psychiatry is an emerging clinical and research discipline that focuses on how disturbances in metabolism affect the brain. It examines how factors like insulin resistance, mitochondrial dysfunction, and chronic inflammation influence mood, cognition, and behavior.
Rather than treating the brain as independent from the rest of the body, metabolic psychiatry recognizes that the brain’s function depends on the body’s energy systems.
The field centers on several key concepts:
Interventions in metabolic psychiatry range from nutritional strategies (including ketogenic metabolic therapy) to sleep optimization, exercise, circadian alignment, and more. Many of these approaches can be paired with standard psychiatric care, often enhancing the benefits of medication or psychotherapy.
Although the relationship between metabolism and brain function has been studied for decades, the last five years have brought an explosion of new research tools, technologies, and clinical trials that have accelerated the field.
Today, more than 75 research studies are underway worldwide, investigating metabolic interventions across a broad range of conditions:
This wave of research follows early pilot studies that showed striking results:
These studies point toward a coherent pattern: when metabolic health improves, psychiatric symptoms often improve too.
This surge in research has been matched by the rapid expansion of clinical work on the ground. Academic medical centers, outpatient psychiatric clinics, and specialized programs across the U.S. and internationally are beginning to integrate metabolic strategies into care for individuals with serious mental illness.
These include:
At the same time, professional development is accelerating. Continuing Medical Education (CME) courses, clinician handbooks, metabolic psychiatry conferences, and multidisciplinary provider networks are helping build a workforce capable of safely delivering these therapies.
Five years ago, this ecosystem didn’t exist. Today, it's taking shape rapidly—driven by clinicians seeking better outcomes and by patients looking for answers beyond traditional medication pathways.
Perhaps the most transformative aspect of metabolic psychiatry is how it reframes mental illness. Instead of viewing psychiatric symptoms purely through psychological or neurotransmitter-based models, it situates them within the broader physiology of the body.
This reframing doesn’t diminish the complexity of mental illness. It enriches it. It acknowledges that mood, cognition, energy, and resilience are deeply biological—and that biology is influenced by metabolism.
When metabolic health improves, the brain is often better able to do what we have always asked it to do: regulate emotion, focus, adapt, and recover.
The momentum in the field of metabolic psychiatry is unmistakable. With dozens of ongoing trials, expanding clinical interest, and a rapidly growing scientific foundation, the field is moving from possibility to practice.
For individuals struggling with mental illness—especially those who have exhausted traditional options—this work represents something rare: a new and evidence-based pathway for healing.
And for clinicians, researchers, and innovators, it offers an opportunity to reshape how we understand and treat mental health at the most fundamental level—the level of human metabolism.
I invite you to explore Metabolic Mind, where you’ll find accessible summaries of the science and practical resources for clinicians and innovators who want to understand this rapidly advancing field. The Science section provides an overview of the evidence, and the For Clinicians hub highlights tools and educational materials to support real-world implementation. Learn more at metabolicmind.org.
Article written by: By Bret Scher, MD, FACC, Medical Director, Baszucki Group & Metabolic Mind
.png){kind=small}
