Anorexia nervosa is a severe illness that has one of the highest mortality rates among psychiatric disorders. While recent neurobiological research has implicated the interaction between anxiety traits and dopaminergic circuits in the pathophysiology that perpetuates the illness, there is a fundamental lack of understanding of how weight loss can occur in individuals with anorexia nervosa given nature’s typical survival mechanisms. In fact, there is growing evidence that suggests that it is a disturbance in energy metabolism that is at the core of such pathophysiology in individuals with anorexia nervosa. This presentation proposes a model for how such an alteration in brain-glucose metabolism could drive food restriction and emaciation. A ketogenic diet is a nutritional approach that avoids using glucose as an energy source and utilizes fat as energy source instead; this talk explores how a ketogenic diet can interrupt the vicious cycle of food refusal and emaciation in anorexia nervosa and promote long-term recovery.