Bipolar disorder and epilepsy share several anti-convulsant medications and some similarities in underlying neurobiology. Recently, a metabolic therapy which has been used in the treatment of epilepsy, supported by data from 13 randomised controlled trials, has come into focus as a potential treatment for bipolar disorder. Preliminary data from case reports and observational studies have indicated beneficial effects on cardiometabolic health and psychiatric symptoms. People diagnosed with serious mental illness (SMI) face an increased metabolic burden and risk of cardiovascular disease. In the UK, over 70% of deaths among those with SMI are due to preventable physical illnesses. Growing evidence from the fields of genomics, epigenomics, metabolomics, and transcriptomics points to a significant biological overlap between metabolic dysfunction (such as insulin resistance, obesity, and type 2 diabetes) and severe psychopathology (including psychosis, mania, and severe depression). Dr. Iain Campbell a co-PI on the first published pilot study of a ketogenic diet for bipolar disorder will present the results of the study carried out here at Edinburgh University.