Gastrointestinal Health, General Health, Psychiatric Disorders

Remission of OCD and ulcerative colitis with a ketogenic diet: Case Report

A case report describes the experience of a 37-year-old woman with chronic obsessive-compulsive disorder (OCD), ulcerative colitis (UC), obesity, and autoimmune conditions who underwent ketogenic metabolic therapy for 12 weeks. Despite previous treatment with pharmacotherapy and psychotherapy, her symptoms persisted. Her diet was high in sugar and ultra-processed foods, contributing to metabolic dysfunction and weight gain.

She began following a ketogenic diet designed by a registered dietitian consisting of whole foods and animal-based proteins, with macronutrients approximately 75% fat, 20% protein, and ≤5% carbohydrates.

The diet excluded added sugars, seed oils, and ultra-processed foods. Adherence was monitored through photo journaling and daily capillary beta-hydroxybutyrate (BHB) testing using a handheld glucose/ketone monitor. BHB levels were tracked alongside symptom severity to monitor the relationship between nutritional ketosis and clinical outcomes.

Results:

OCD:

• • Florida Obsessive Compulsive Inventory scale: 0 by week 9
  • Yale-Brown Obsessive Compulsive Scale: 0 by week 12
  • OCD improvement correlated with BHB levels

UC:

• • Clinical remission by week 3
  • Partial Mayo Score: 7 → 0
  • Ulcerative Colitis Patient-Reported Outcome: 5 → 0

Depression and Food Addiction:

• • Patient Health Questionnaire-9: 17 → 0 by week 9
  • Yale Food Addictions Scale 2.0: 4 → 0 by week 4

Metabolic Health:

• • Weight decreased by 9.4%
  • Body fat decreased by 3.2%
  • Visceral fat: 21 → 18

Autoimmune Markers:

• • Psoriatic plaques cleared
  • TSH normalized

Quality of Life:

• • Flourishing Scale, Self-Compassion, and Rugged Resilience Measure increased

This case report suggests a potential role for therapeutic ketosis in achieving remission in comorbid inflammatory and psychiatric conditions.