Who Started the Keto Low-Carb Diet? The Surprising History of Ketosis

December 27, 2025 •

3 min read

The ketogenic diet was not originally designed for weight loss, but rather as a medical treatment for a neurological condition. This high-fat, low-carbohydrate regimen was first developed in the 1920s at the Mayo Clinic to help control seizures in children with epilepsy, building upon the metabolic effects of fasting.

Quick Summary

The ketogenic diet was pioneered by Dr. Russell Wilder at the Mayo Clinic in the 1920s as an epilepsy treatment, building on observations about how fasting impacted seizure control.

Key Points

Medical Origin: Dr. Russell Wilder of the Mayo Clinic developed the ketogenic diet in the 1920s to treat epilepsy, not for weight loss.
Based on Fasting: The diet was created to mimic the anti-seizure benefits of ancient fasting practices in a more sustainable way.
Biochemical Foundation: Earlier research by Rollin Turner Woodyatt identified the metabolic state of ketosis, which underpinned Wilder's work.
Popularized for Weight Loss: While historically medical, the diet gained modern fame for weight loss partly influenced by Dr. Robert Atkins' low-carb popularity in the 1970s.
Epilepsy Resurgence: A major revival occurred in the 1990s, led by The Charlie Foundation, to promote its use for drug-resistant pediatric epilepsy.
Historical Precursors: Other low-carb approaches existed for centuries, with figures like William Banting advocating for carb restriction for weight loss in the 1860s.

The Medical Origins of the Keto Diet

The ketogenic diet's history is rooted in medicine, stemming from ancient observations that fasting could reduce epileptic seizures. In the early 20th century, researchers sought a way to mimic the metabolic state of fasting sustainably. Endocrinologist Rollin Turner Woodyatt's work in 1921 identified that ketone bodies are produced by the liver during starvation or very low-carbohydrate, high-fat intake, providing the biochemical basis.

Dr. Russell Morse Wilder of the Mayo Clinic built on this research. In 1921, he coined the term "ketogenic diet" and conducted the first clinical trials using this high-fat, low-carbohydrate diet to treat epilepsy. His work formalized the diet as a therapeutic option, which was subsequently adopted by institutions like Johns Hopkins.

Early 20th-Century Pioneers

Dr. Hugh William Conklin: Used fasting to treat epilepsy patients successfully.
Mynie Gustav Peterman: Refined the classic ketogenic diet protocol and documented its effects in children at the Mayo Clinic.

The Rise, Decline, and Resurgence

The ketogenic diet was a primary epilepsy treatment in the 1920s and 30s. However, the development of effective anticonvulsant drugs in the late 1930s led to its decline, though it remained an option for drug-resistant cases.

The diet saw a significant revival in the 1990s. Hollywood producer Jim Abrahams' son's severe epilepsy was successfully treated with the diet at Johns Hopkins after other methods failed. This inspired Abrahams to found The Charlie Foundation for Ketogenic Therapies in 1994, increasing research and public awareness.

The Role of Low-Carb Diets for Weight Loss

Separately from its medical history, the concept of low-carbohydrate eating for weight loss has a longer timeline. William Banting promoted it in the 1860s, and Dr. Robert Atkins popularized a low-carb diet for weight loss in the 1970s. This contributed to the modern understanding and popularity of keto outside of its original medical application.

Key Figures in the Evolution of Low-Carb and Keto


Figure	Contribution	Timeline	Primary Purpose
Dr. Russell Wilder	Coined "ketogenic diet" and initiated its use to treat epilepsy.	1921	Therapeutic treatment for epilepsy.
William Banting	Popularized low-carbohydrate dieting for weight loss.	1860s	Weight loss and management of corpulence.
Rollin Turner Woodyatt	Discovered ketone bodies were produced during high-fat, low-carb intake.	1921	Biochemical understanding of ketosis.
Dr. Robert Atkins	Popularized a low-carb diet for weight loss, influencing modern perceptions.	1970s	Weight loss.
Jim Abrahams	Revived scientific and public interest in ketogenic diet for epilepsy.	1990s	Public and clinical awareness of diet therapy for epilepsy.

Conclusion: From Clinic to Cuisine

The ketogenic diet originated as a medical intervention for epilepsy in the early 20th century, based on the metabolic effects of fasting and the discovery of ketone bodies. Though its use declined with the advent of medications, a revival driven by The Charlie Foundation brought it back into clinical focus, particularly for refractory epilepsy. Simultaneously, the broader history of low-carb diets for weight loss, popularized by figures like William Banting and Dr. Robert Atkins, influenced its current widespread recognition as a diet for weight management and general wellness. Today's popular keto diet has evolved from its strict medical beginnings.

For more detailed information on the historical timeline of the ketogenic diet and epilepsy treatment, you can visit Johns Hopkins Medicine's Epilepsy Center.

Key Milestones in the History of Ketosis

c. 400 BC: Ancient physicians note fasting can reduce epileptic seizures.
1921: Rollin Turner Woodyatt describes ketone body production during starvation or low-carb/high-fat intake.
1921: Dr. Russell Morse Wilder coins the term “ketogenic diet” and uses it for epilepsy treatment.
1938: Discovery of anticonvulsant drugs leads to reduced use of dietary therapy.
1972: Dr. Robert Atkins popularizes a low-carb diet for weight loss.
1993: Jim Abrahams' son is successfully treated with the diet at Johns Hopkins.
1994: The Charlie Foundation for Ketogenic Therapies is founded.
1997: The TV movie ...First Do No Harm further publicizes the diet.
2021: The ketogenic diet marks its 100th anniversary as a formalized epilepsy therapy.

Frequently Asked Questions

Dr. Russell Morse Wilder of the Mayo Clinic is considered the founder of the modern ketogenic diet. He coined the term in 1921 and was the first to use it clinically as a treatment for epilepsy.

No, the keto diet was not originally created for weight loss. It was developed as a medical nutritional therapy to treat epilepsy, particularly in children for whom medication was ineffective.

The ketogenic diet was specifically designed to mimic the metabolic effects of fasting. Ancient physicians observed that fasting could reduce seizures, and the keto diet was created to induce a similar state of ketosis sustainably, without prolonged starvation.

The diet's use declined after the development of effective anticonvulsant drugs in the late 1930s. Medication was a more convenient and often effective treatment option compared to the diet's restrictive nature.

The ketogenic diet experienced a revival in the 1990s largely due to Hollywood producer Jim Abrahams, who started The Charlie Foundation to raise awareness after his son's epilepsy was successfully treated with the diet.

Dr. Robert Atkins helped popularize the broader low-carb movement with his namesake diet in the 1970s. While distinct from the strict medical ketogenic diet, his work contributed to the public's awareness of low-carbohydrate eating and its potential for weight loss.

The biochemical observation that ketone bodies are produced during periods of starvation or a high-fat, low-carbohydrate diet was made by endocrinologist Rollin Turner Woodyatt in 1921, providing the scientific basis for the diet.

Yes, the classic ketogenic diet used for epilepsy is typically much stricter, with a higher fat-to-carb/protein ratio, and is medically supervised. The popular weight-loss keto diet can be a less restrictive adaptation.