RFK Jr. has passed over a highly regarded neuroscientist to lead the National Institute of Mental Health (NIMH), favoring instead a “metabolic psychiatrist” who has never held an NIH grant and was turned down by the agency’s own search committee. As Science-Based Medicine’s Steven Novella argues, the choice says more about ideology than qualifications.
NIH Director Jay Bhattacharya, a Kennedy appointee, recommended Vikaas Sohal for the post, “a very accomplished and appropriate scientist,” according to Novella, a clinical neurologist at the Yale University School of Medicine and executive editor of Science-Based Medicine. But, as Science reported, Bhattacharya “was overruled by his boss,” Novella writes. Kennedy’s pick is Shebani Sethi, whose research centers on ketogenic diets as a treatment for psychiatric illness.
“The full story is disturbing, and represents RFK’s continued ‘Lysenkoisation’ of the American health infrastructure,” Novella writes, invoking the Soviet campaign that subordinated biology to political dogma.
Metabolic psychiatry holds that metabolic health is a major contributor to, and possibly the root cause of, serious mental illness. Novella doesn’t dismiss the link outright. Exercise, nutrition, sleep and blood pressure all affect brain health. But those are secondary contributors, he argues, not root causes or cures. The trouble is that “proponents tend to go way beyond the current research, and are making claims for an entirely new explanatory paradigm of mental illness.”
The evidence doesn’t support that leap. Novella notes that most metabolic psychiatry studies are preliminary, poorly controlled or merely correlational, and so can’t establish what causes what. A 2026 systematic review of ketogenic diets for anxiety and depression, published in JAMA Psychiatry, found modest improvements in depressive symptoms, particularly when ketosis was verified, while evidence for anxiety was inconclusive. The authors called for larger, well-powered trials.
Novella likens the pattern to the hype around EMDR therapy and the old serotonin explanation for antidepressants: early, promising findings stretched into sweeping claims about how well a treatment works and why.
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Sethi’s own work fits that mold, he argues. Her ketogenic diet studies are mostly uncontrolled or poorly controlled, yet her public statements are far more enthusiastic. “We’re seeing huge changes,” she has said, extending the claim to patients taking antipsychotic medications. That kind of overreach, Novella contends, is the opposite of the causal skepticism an NIMH director needs.
“She seems underqualified, and the search committee seems to have come to the same conclusion,” Novella writes. Her research does, however, align neatly with Kennedy’s Make America Healthy Again agenda, which, in his assessment, “is apparently all that matters.”
