Person sitting with a mental health counselor

For many people, hiring one of the many “Keto Coaches” or low-carbohydrate informed Dieticians out there is going to be life-changing and all they need to lose weight, feel better, and improve their mental health. These professionals can help answer a lot of important questions.

  • How do you track macros and decide how many carbohydrates to eat?
  • What low-carb foods can you pack with you while traveling or on a busy day?
  • How do you make your low-carb meals delicious?

However, for many people, difficulty adhering to the ketogenic diet is about deeply engrained emotional and thinking patterns. Some people have lifelong difficulties implementing self-care and self-love strategies. Being able to say no and have boundaries for one’s own emotional and in this case, physical well-being can feel insurmountable. There is a lot of psychotherapy, sometimes subtle and sometimes blatant, that goes on in the successful and enduring implementation of dietary therapy for mental health. And in our very processed food and carbohydrate-rich world, even more so for a ketogenic diet.

What people may need more support in adopting a ketogenic diet?

People who don’t know the answers to the following questions or who suspect they will have difficulty figuring those answers out, and then following them up with behavior change, will be the people who need and DESERVE additional support from a therapist in adopting a ketogenic diet.

What will you do when they have cravings and how will you manage them?

The managing of cravings is something mental health professionals who work with addiction often encounter. However, not surprisingly, there is in fact a large body of empirical evidence to support the condition of processed food addiction as its own disorder. Knowing how to manage cravings is also an important consideration in some eating disorders like Binge Eating Disorder and Bulimia. Or even in just anyone who has problems effectively managing their emotions. There are countless mental health conditions where a major symptom is problems with Emotion Regulation. Just telling them to “not give in to cravings” is not a sufficient intervention for these individuals. This is where you need a mental health counselor to help them increase their coping and emotion regulation skills, so they are up for the challenge!

What are you going to do when you are encouraged (or even feel bullied) into eating carbs at social situations, holidays, and family gatherings?

If someone struggles with boundaries this can be a very difficult situation to manage and continue to be successful with. The person on a low-carbohydrate or ketogenic diet may be concerned they will hurt someone’s feelings if they say no to a sweet someone has baked. They may be fearful of being made fun of or being ostracized in future social situations. They know that some people will take their food choices personally and decide they are being judged by the low-carb adherent.

Sometimes there are social or family dynamics in which the entire system is threatened by someone making a healthy decision for themselves because it goes against unspoken norms. These people need support and help in identifying their enmeshment with these systems. They need skills in how to assert themselves while staying emotionally open and loving to the people around them. Sometimes they need psychotherapy in order to learn to build a sense of identity that is both connected to the group and still individual. This is no small task. And requires a level of support that one can not often find in Keto Coach or a Registered Dietician.

How will you assert yourself with wait staff or while ordering at a restaurant?

Again, many people struggle with “being a bother” or with what I like to call “taking up space”. They feel like the wait staff sees them as a problem or a difficult customer. They feel shy or have crippling social anxiety they are dealing with and need evidence-based treatments such as CBT in order to combat a certain level of social anxiety before they can successfully ask questions about ingredients and make choices that will support what they are doing for their mental and long-term health.

What will you do when you encounter unsupportive medical or academic authority figures who may not be aware of the research literature of a ketogenic diet for mental health as a possible intervention?

This is an important issue when working with other medical professionals (e.g., Dieticians, Doctors, etc.) that want you to try different treatments or want you to stop something that you are finding is helpful. Does the client have the developed sense of self and assertiveness skills to determine what is best for them in the presence of someone with medical authority that has an alternative opinion? Many of us do, and many of us do not. And this is another area in which it may be helpful or even necessary to work with a mental health professional to not only facilitate your treatment but to help you handle the feelings that come up when you disagree with or do not feel heard by authorities, whether institutional (e.g., National Dietary Guidelines) or individual (e.g., your doctor).

Conclusion

There are a lot of psychological factors that go into making big lifestyle changes. Big lifestyle changes are influenced by how we think, what we feel, and our current behavioral habits. These all feed into our sense of self, our relationships, and even how we interact in society. Sometimes evaluating these factors with a mental health professional can increase our chances of success when wanting to use a dietary therapy like the ketogenic diet as a treatment for our mental health.

If you found this blog post helpful you may also find the following to be useful in your mental health journey.

You may also want to hear other people’s experiences: Ketogenic Diet Case Studies

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