Fix Your Brain by Fixing Your Body: Metabolic Psychiatry Explained by Dr. Shebani Sethi

Mark Hyman

Sep 24, 2025

Episode description

For too long, psychiatry has treated mental illness as if it lives only in the brain. But what if the real story begins in the body? My guest today, Dr. Shebani Sethi, is a Clinical Associate Professor at Stanford and founding director of the Metabolic Psychiatry Program, the first clinic to unite psychiatry with nutrition and metabolism. On this revealing episode of The Dr. Hyman Show, we explore how shifts in metabolism affect the brain and why this whole-body lens could transform how we prevent, understand, and treat mental health. Watch the full conversation on YouTube, or listen wherever you get your podcasts.

We discuss:

• How to recognize metabolic red flags behind mood and focus

• Tests you can ask for to uncover hidden drivers of mental health

• Everyday steps to restore brain energy and resilience

• Foods and nutrients that calm inflammation and support cognition

Dr. Shebani Sethi coined the term Metabolic Psychiatry, capturing what I’ve long believed and explored: that mental health begins in the body. Embracing this shift could reshape how we treat the mind and how we live each day.

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Mindsip insights from this episode:

Implement ketogenic diet to reverse metabolic syndrome and improve mental health

In a pilot study, a ketogenic diet for bipolar and schizophrenia patients reversed 100% of metabolic syndrome cases and dramatically reduced psychiatric symptoms in four months.

#keto

#mental-health

Address insulin resistance to reduce depression risk

Having insulin resistance doubles your risk of developing depression, even if you have had no previous psychiatric history.

#depression

#insulin

Address cerebral glucose hypometabolism in mental health conditions

In conditions like schizophrenia and bipolar disorder, the brain can't use glucose for energy even when it's available, a state called cerebral glucose hypometabolism.

#cognition

#glucose

Combat insulin resistance to protect brain health

Insulin resistance in your body can lead to the degeneration and atrophy of brain neurons, structurally altering your brain over time.

#brain

#insulin

Address four pillars of metabolic disease: plasticity, inflammation, oxidative stress, mitochondrial dysfunction

Metabolic disease operates through four main mechanisms: loss of plasticity, inflammation, oxidative stress, and mitochondrial dysfunction.

#metabolism

#oxidative-stress

Leverage Metformin for neuroprotection and enhanced psychiatric treatment

The diabetes drug Metformin crosses the blood-brain barrier, where it has a neuroprotective effect and can help psychiatric medications work better.

#cognition

#metformin

Monitor triglyceride-to-HDL ratio to assess depression severity

The triglyceride-to-HDL ratio is a biomarker strongly associated with both the severity and chronicity of depression.

#blood-test

#depression

Protect brain health by managing energy consumption

The brain makes up only 2% of our body weight but consumes 20% of our energy, making it extremely vulnerable to metabolic problems.

#brain

#metabolism

Utilize ketogenic diet to improve eating disorders

Contrary to conventional wisdom, a ketogenic diet is being studied for anorexia and has shown preliminary improvements in binge eating by changing neurocognition.