The history of keto
It started as a medical treatment for epilepsy. The weight loss came a century later.
Ancient roots: fasting and seizures
The connection between food and epilepsy is old. Hippocrates wrote in the 5th century BCE about a man whose seizures stopped after he abstained from food and drink. Across cultures for the next two thousand years, fasting was one of the few things that consistently seemed to help people with seizure disorders, even though no one understood why.
1921: the ketogenic diet is born
Modern keto traces to two researchers in the early 1920s. At Harvard, Dr. Rollin Woodyatt observed that the same ketones produced during starvation could also be produced by a diet very high in fat and very low in carbohydrates. The body didn't actually need to starve — it just needed to be deprived of carbs.
That same year, at the Mayo Clinic, Dr. Russell Wilder built on the finding and coined the term "ketogenic diet." He used it to treat children with epilepsy who weren't responding to anything else. The results were striking: many of his patients saw seizures drop dramatically or stop entirely. For the next two decades it became the standard medical treatment for childhood epilepsy.
The pharmaceutical era pushes it aside
In 1938, the first effective anti-seizure drug — phenytoin — was discovered. Through the 1940s and 50s, more anticonvulsants followed. A pill was easier than a strict diet, and the ketogenic approach faded from mainstream use. It survived only in a handful of specialized epilepsy clinics for patients who didn't respond to medication.
1972: Atkins enters the chat
Dr. Robert Atkins published Dr. Atkins' Diet Revolution, reframing carb restriction as a weight-loss tool rather than a medical treatment. It was wildly popular and just as wildly controversial — mainstream nutrition at the time was firmly in the low-fat camp, blaming dietary fat for heart disease. Atkins was treated as a fringe figure for decades. His diet wasn't strict keto (it allowed more protein and gradual carb reintroduction) but it planted the cultural seed.
1994: the Charlie Foundation
The medical use of keto roared back into public view through a single family's story. Hollywood producer Jim Abrahams had a two-year-old son, Charlie, whose severe epilepsy wasn't responding to any drug or surgery. Out of options, Abrahams discovered the ketogenic diet in an old medical text, took Charlie to Johns Hopkins for treatment, and saw his seizures stop within days.
Abrahams founded The Charlie Foundation in 1994 to spread awareness, then directed a 1997 made-for-TV film, …First Do No Harm, starring Meryl Streep as a mother fighting to get the diet for her son. The story restored credibility to keto in medical circles and pushed research funding back into the space.
2000s–2010s: from clinic to kitchen
As the low-fat consensus weakened — large studies began questioning the link between dietary fat and heart disease — interest in carb restriction grew. Researchers like Dr. Stephen Phinney and Dr. Jeff Volek published work on athletic performance, metabolic health, and type 2 diabetes reversal using ketogenic protocols. The diet started moving out of epilepsy clinics into broader use:
- Weight loss — high satiety from fat and protein makes calorie restriction easier.
- Type 2 diabetes — cutting carbs directly lowers blood sugar and insulin needs.
- Metabolic syndrome — improvements in triglycerides, HDL, and blood pressure.
- Athletic performance — endurance athletes exploring fat-adapted fueling.
- Neurological research — early studies on Alzheimer's, Parkinson's, and migraine.
Today
Keto is one of the most-searched diets in the world. The science is no longer fringe — hundreds of clinical studies are published each year. It's still the gold-standard treatment for drug-resistant pediatric epilepsy, and it's increasingly used as a tool for weight management, blood sugar control, and metabolic health.
The core idea hasn't changed since 1921: deprive the body of carbohydrates long enough, and it switches fuel sources from glucose to fat-derived ketones. What's changed is who's using it and why — from a few hundred epileptic children in a Minnesota clinic to millions of people trying to feel better.