Low carbohydrate ketogenic therapy as a metabolic treatment for binge eating and ultraprocessed food addiction

Curr Opin Endocrinol Diabetes Obes. 2020 Oct;27(5):275-282. doi: 10.1097/MED.0000000000000571.


Purpose of review: The aim of this study was to highlight the recent advancements and future directions for potential use of a low carbohydrate ketogenic dietary approach to treat binge eating and ultraprocessed food addiction. Herein, we explore proposed mechanisms of why a diet low in refined carbohydrates, processed sugar and higher fat content may be helpful in alleviating symptoms.

Recent findings: Emerging evidence suggests there may be a metabolic role in development of maladaptive eating. These findings broaden our understanding of eating psychopathology causes. Ultraprocessed, refined or high glycemic index carbohydrates are a possible trigger mediating neurochemical responses similar to addiction. The carbohydrate-insulin model of obesity supports observations of these foods triggering abnormal blood sugar and insulin spikes subsequently leading to changes in metabolic and neurobiological signaling. This results in overeating symptoms and hunger exacerbation, which differs from observed effects of healthy fat consumption and lack of similar insulin spikes. As supported in recent case series, significantly reducing or abstaining from these addictive-like ultraprocessed foods and highly refined carbohydrates could be considered a treatment approach.

Summary: The current review highlights recent and pertinent evidence with respect to theoretical and practical application of low carbohydrate ketogenic therapeutic approaches for ultraprocessed food addiction and binge eating symptoms. VIDEO ABSTRACT:.

Publication types

  • Review

MeSH terms

  • Binge-Eating Disorder / complications
  • Binge-Eating Disorder / diet therapy*
  • Binge-Eating Disorder / epidemiology
  • Binge-Eating Disorder / metabolism
  • Diet, Carbohydrate-Restricted* / methods
  • Diet, Ketogenic* / methods
  • Dietary Carbohydrates / adverse effects
  • Food Addiction / complications
  • Food Addiction / diet therapy*
  • Food Addiction / epidemiology
  • Food Addiction / metabolism
  • Food Handling
  • Food Preferences / psychology
  • Humans
  • Insulin / metabolism
  • Obesity / diet therapy
  • Obesity / epidemiology
  • Obesity / etiology
  • Obesity / metabolism


  • Dietary Carbohydrates
  • Insulin