Metabolic psychiatry was defined as the study of how metabolic dysfunction, and the central and peripheral treatments that target it, affected psychiatric outcomes as well as metabolic health outcomes, according to Shebani Sethi, MD.1 The subfield was relatively new, with scientists worldwide working in the area, and it focused on how nutritional and metabolic drivers of chronic disease intersected with psychiatry. Anti-inflammatory strategies, insulin-sensitizing agents, and nutritional interventions belonged in treatment planning alongside existing tools, not in place of them. Sethi presented this framework in an American Psychiatric Association webinar to establish the scope of the field with other experts.
Sethi described a shift in how the field regarded metabolic problems. “For decades, we’ve treated metabolic dysfunction in our field like weight gain or insulin resistance as really a side effect that needs to be monitored and not really a target to treat, but that’s really being changed,” Sethi said. She explained that “Insulin signaling in the brain or chronic low-grade inflammation or mitochondrial function, even immunity, innate and adaptive immunity being affected by the diet, are mechanistically upstream of psychiatric symptoms, not just downstream consequences of medications.”