International advocacy for ketogenic diet research in schizophrenia: insights from a public petition

Schizophrenia is associated with substantial disability, persistent symptoms, and significant unmet treatment needs. The ketogenic diet has emerged as a metabolic intervention of growing interest for serious mental illness. This study reports quantitative and qualitative findings from a large international Change.org petition advocating for the resumption of a halted randomized blinded inpatient study investigating a ketogenic diet intervention for individuals with schizophrenia. The petition received 21,637 signatures and 1,105 comments from individuals across 151 countries. Participant comments were analyzed using top-down theme consensus coding and Latent Dirichlet Allocation (LDA) topic modeling. Results revealed widespread interest in nutritional and metabolic approaches to mental health, concerns regarding the limitations of current treatment options, and support for further investigation of ketogenic interventions in schizophrenia. Many petitioners described personal or observed experiences with ketogenic diets and emphasized the need for additional research. As this was a self-selected advocacy-driven sample, findings may overrepresent individuals supportive of ketogenic diet research and are not representative of the broader population. These findings provide insight into the perspectives and experiences of petitioners and highlight interest in expanding research on novel treatment approaches for schizophrenia, such as ketogenic dietary interventions.