Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention: a retrospective case report
Bibliographic record
Abstract
Background: Obsessive-compulsive disorder (OCD) is a chronic and disabling condition that frequently resists standard interventions, including SSRIs and Exposure and Response Prevention (ERP). This case study explores the adjunctive use of ketogenic metabolic therapy (KMT) in conjunction with ERP for a 26-year-old man with treatment-resistant OCD characterized by the symmetry/ordering symptom dimension. The patient achieved remission of OCD symptoms and sustained improvements in mood, emotional regulation, and quality of life. Methods: A 26-year-old male with treatment-resistant OCD self-treated with a modified ketogenic diet and psychotherapy assisted ERP over 12 weeks. The diet featured a 1.5:1 macronutrient ratio (fat:protein+carbohydrates), self-monitored for nutritional ketosis (ketone levels ≥0.8 mmol/L), and included daily symptom tracking. ERP targeted symmetry/ordering-related compulsions. Symptom severity was assessed using the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Long-term outcomes were evaluated over a 95-week follow-up. Results: Within three weeks of initiating KMT and subsequent ERP, daily compulsive behaviors decreased from 3-8 hours to less than one hour. Significant reductions in DOCS symmetry/ordering subscale scores were sustained at 95 weeks. Concurrent improvements were observed in emotional distress, measured by DASS-21, with all subscale scores normalizing by week 7. Qualitative feedback highlighted enhanced emotional regulation, sleep quality, and ERP engagement, attributed to the ketogenic diet. Conclusion: This case demonstrates rapid and sustained remission of OCD symptoms with the use of KMT and ERP. The findings suggest that KMT may provide a metabolic foundation that enhances the efficacy of ERP. Further research is warranted to explore the potential role of KMT in treatment-resistant OCD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".