This Special Chapter in My Ketosis+BDNF Book is for the Honor of Dr. Richard Mackarness for Mental Health Month. An Overview of “Eat Fat and Grow Slim”, “The Calorie Fallacy”, and the Impact of the “Stone-Age Diet for Functional Disorders”
What I Learned from Dr. Richard Mackarness, a Forgotten Rebel Who Changed How I Saw Nutrition and Why He Deserved a Chapter in My Ketosis+BDNF Book
Dear Subscribers,
Today, I want to introduce you to a late psychiatrist and best-selling book author who influenced my diet and thoughts about metabolism and mental health, and who helped millions of people with his books and scientific work.
Here is a Summary of My Fond Memories When I Serendipitously Met Dr. Richard Mackarness in the 1980s and Said Goodbye to him in the mid-1990s
This chapter takes me back to a defining moment in my life, reflecting a time when fat was celebrated as essential, then condemned, and finally rediscovered as vital again.
The purpose of this chapter is to establish that bridge and provide you with valuable insights from the scientific, clinical, and personal experiences of an unforgettable figure in my life and the lives of many people with metabolic challenges like me.
When I was struggling with metabolic challenges and chronic stress in my undergraduate studies in Europe, I remember my mentor, an anthropology professor at the Max Planck Institute in Germany, handing me a photocopied scientific paper with a knowing smile.
The title of the paper read, “Stone-Age Diet for Functional Disorders,” published in 1956. Beside it, he placed a well-worn copy of Eat Fat and Grow Slim by his own mentor, Dr. Richard Mackarness, a name I barely knew then, but one that would later shape my understanding of metabolism and metabolic resilience as I grew older.
I could never have imagined that a decade later, through a dear psychiatrist friend in Melbourne, I would meet Dr. Mackarness himself or that I would one day stand at his funeral in Mornington Peninsula, quietly thanking the wise man who changed my life and gave hope to countless others struggling with metabolic challenges.
The title of the paper and the book felt unusual and rebellious, which intrigued me to read quickly and report back to him about my thoughts and feelings.
It was a quiet act of defiance against everything mainstream nutrition insisted was true. Fat, they said, made you fat. Calories were the sole currency of health. Eat less, move more, and you will find salvation.
Yet here was a British psychiatrist, Dr. Richard Mackarness, offering a contrasting view, suggesting that dietary fat could play a restorative role in health and that the calorie model did not tell the whole story.
He called this idea “The Calorie Fallacy.” His paper and book convinced me to study the biochemistry of ketogenesis and gluconeogenesis, and apply it to my life, acting like a metaphorical rebellion like himself.
Mackarness’s logic was unsettlingly simple: all calories are not equal. What matters is how the body interprets them, such as how hormones, enzymes, the gut, and signaling molecules orchestrate their use.
To him, obesity and fatigue were not signs of gluttony or laziness but symptoms of metabolic confusion. Reading that book and his papers in the 1980s, when “low-fat” labels ruled the supermarket shelves, was like reading heresy wrapped in science.
The Courage to Think Against the Tide
Despite selling millions of copies of the book, Dr Mackarness was not merely a diet author; he was a psychiatrist who understood that the mind and metabolism were inseparable.
Long before the term metabolic psychiatry existed, he noticed that what his patients ate altered how they felt, thought, and behaved. He saw depression, anxiety, and lethargy not as isolated mental conditions but as reflections of nutritional imbalance.
He challenged the idea that obesity came from weak willpower or simple overeating. He wrote that people were being “starved into metabolic chaos by calorie mathematics.”
To him, the issue was hormonal. Excess carbohydrates drove insulin levels up, insulin locked fat inside cells, and chronic hunger was the inevitable result, starving our cells in the body and neurons in the brain.
In 1958, this was scientific blasphemy. Yet his patients lost weight, regained clarity, and rediscovered vitality. Many of his colleagues dismissed his work, but Mackarness remained steadfast. He treated patients with several open-minded physicians as living systems, not mathematical abstractions.
When I discovered his book decades later, I felt as if someone had whispered the truth I had sensed but could not articulate.
I was a young technology and science student, tired of calorie counting and battling my own creeping prediabetes and abdominal obesity. Mackarness gave me something rarer than advice. He opened my mind and allowed me to question, bringing me closer to the truth.
From Theory to Transformation: The Biochemistry of Ketosis and Gluconeogenesis
In the early 1990s, I began to apply his principles. I stopped counting calories and started trusting biology. I replaced cereal, bread, and pasta with eggs, fish, butter, meat, and a bit of vegetables, moving from a herbivore to an omnivore.
I handed my wife a photocopy from his book and suggested we shape our meals around its ideas. We adapted it to our lifestyle, for example, by swapping orange juice for half a grapefruit with eggs, choosing lamb or steak instead of bacon, and drinking homemade kefir instead of milk. It served as guidance, not a rigid rulebook.
Within weeks, my hunger faded. Within months, my blood sugar stabilized. By the end of the year, I lost visceral fat and reclaimed a mind that finally felt awake. The best part was reversing my prediabetes.
I did not know then that I was living inside a biochemical masterpiece, a design that Mackarness had intuited but never fully described. Years later, as I studied ketosis and autophagy, I realized that his “Calorie Fallacy” was not just philosophical. It was molecular.
Calories are not the language of life. They are units of heat in maths, not signals of vitality. Biology speaks in chemistry, such as in hormones, enzymes, gut microbiome, and feedback loops.
When carbohydrates dominate the diet, the pancreas releases insulin, allowing cells to absorb glucose and store excess as glycogen in the liver and muscles.
Once glycogen stores are full, the overflow becomes visceral fat. For many, that cycle continues day after day until the body forgets how to burn fat at all and becomes overweight or obese.
But when carbohydrates are scarce, through fasting or deliberate restriction, insulin levels fall. Fatty acids are released from adipose tissue and carried to the liver.
There, they are broken down through beta-oxidation into acetyl-CoA. When acetyl-CoA accumulates beyond the liver’s capacity to process it, it follows another route, the ketogenic pathway.
The liver converts acetyl-CoA into ketone bodies: acetoacetate, acetone, and beta-hydroxybutyrate (BHB). These molecules travel through the bloodstream and become an alternative fuel for nearly every organ, especially the brain, which thrives on their stability.
BHB crosses the blood–brain barrier and feeds neurons directly, producing clean energy with minimal oxidative waste. It also increases BDNF, which is essential for neurological and mental health.
While the body runs efficiently on these ketones, it still maintains a small but steady production of glucose through gluconeogenesis, literally “making new glucose.”
The liver and kidneys create glucose from lactate, glycerol, and amino acids to supply red blood cells and select neurons that cannot use ketones.
This partnership, ketosis providing fuel, gluconeogenesis maintaining balance, forms the metabolic duet that sustained our ancestors during scarcity.
Ketogenesis and gluconeogenesis are the body’s built-in survival system, allowing creativity and strength even when food is limited. No, the sugar never becomes ZERO, as some silly tweets by so-called experts claim. Here is the evidence from my 10-day fasting glucose last year:
The beauty of this system is not only in its efficiency but in its intelligence. BHB is not merely fuel; it is also a signaling molecule. It lowers inflammation by inhibiting the NLRP3 inflammasome, enhances stress resistance through histone deacetylase inhibition, and stimulates the production of brain-derived neurotrophic factor (BDNF), which supports learning, focus, and resilience.
This is why so many people, myself included, describe mental clarity and emotional calm in ketosis. The brain, instead of riding glucose spikes and crashes, runs on a clean, continuous current of energy. It is not just fueled differently but governed differently.
Mackarness could not have known these molecular details in 1958, but his instincts were astonishingly accurate. He sensed that the calorie model ignored the body’s intricate regulation.
To him, fat metabolism based on his anthropological studies in psychiatry was not dangerous but natural. Modern biochemistry has vindicated his intuition.
Why does the Calorie Model Fail the Human Body?
Once we see metabolism through this biochemical lens, the flaw in calorie arithmetic becomes obvious.
A gram of carbohydrate and a gram of fat may release similar energy in a bomb calorimeter, but in the human body, they follow entirely different hormonal and enzymatic paths.
Carbohydrates spike insulin and encourage storage; fats lower insulin and promote release.
Calories cannot capture these hormonal dynamics any more than a stopwatch can measure joy.
Mackarness recognized this long before insulin resistance became a household term. He understood that weight, mood, and energy are not products of math but outcomes of molecular signaling.
As a psychiatrist, he saw beyond calories. He was not defying science but restoring its depth and nuance.
In his later years, Mackarness extended his curiosity into psychiatry and what he called clinical ecology.
He suspected that food sensitivities and chemical exposures could affect mental health, an idea decades ahead of its time. Patients who changed their diets saw their depression and anxiety ease.
Today, research confirms many of his observations. Nutritional psychiatry, microbiome studies, and metabolic therapy trials all show that what we eat reshapes how we think and feel.
I smile with joy when reading these studies because I know that, somewhere, Mackarness and many great leaders from the past are being quietly vindicated.
Everything in life comes to an end or transforms into another energy.
The Day I Said Goodbye to the Physical Form of Dr. Richard Mackarness
It was a quiet Monday morning, 18 March 1996, at work when I learned that Dr. Richard Mackarness had passed away at the age of 79. I was then living in Aspendale, a coastal suburb near Mornington, Victoria, just 37 kilometers from where he had spent his final years.
My psychiatrist friends who introduced me to him told me he had remained active until the end, still writing books, still helping his patients understand the connections between food, metabolism, and mental health. Benjamin, who had my work number, invited me to his funeral, which I accepted graciously.
His funeral was modest, a small gathering by the ocean near the Peninsula. The wind carried the salt air across the hill, and the sky seemed to hover between light and reflection.
Standing there, I did not feel that I was saying goodbye to a generous soul. It felt more like witnessing the closing of a chapter in medical history that he had written long before most of us could grasp its meaning.
As I listened to the waves below, I thought about what his work had meant to me. His voice, once confined to the pages of Eat Fat and Grow Slim, had outlived the skepticism that surrounded him.
Decades earlier, he had warned that calories were a distraction from the real story: the dance of hormones, enzymes, gut microbiome, and signaling molecules that govern energy, hunger, and fat storage.
He was right. It was never simply about arithmetic. It was about chemistry, biology, and the adaptive intelligence of the human body.
I stood there leaner, sharper, and more alive than I had been in my youth, living proof that his ideas were not theoretical.
I had seen how insulin and leptin, glucagon, ghrelin, cortisol, growth hormone, and testosterone played their intricate roles, responding to nutrients and stress, shaping not just metabolism but mood and cognition.
His insights had given me tools to reverse prediabetes, abdominal obesity, arthritis, chronic inflammation, leaky gut, leaky brain, and foggy mind, not through deprivation, but through understanding.
As the ceremony ended, I whispered into the Peninsula ocean wind:
“Thank you, good Doctor. You were right. It was never about the calories. Hormones make the final decision. Thank you for encouraging me to eat 200 grams of healthy fat daily with courage and confidence.”
This unique funeral felt less like a farewell and more like a vow to carry forward the light of a brave scientist and healing practitioner who saw truth before the world was ready to see it.
I wrote an academic article during those days, which I will summarize in this chapter. It was titled “The Enduring Legacy of Dr. Richard Mackarness.”
Summary of “The Enduring Legacy of Dr. Richard Mackarness”
Writing about the legacy of Dr. Richard Mackarness feels like recounting a turning point in medical history, one that bridged the era of mechanistic calorie counting and the dawn of metabolic understanding.
His influence cannot be contained within a few pages, yet some moments deserve to be remembered as milestones that shaped modern nutritional science.
When The Independent published his obituary in April 1996, it did not sound like a farewell. It read like a salute to a man who had seen further than most, a physician of rare courage who connected psychiatry, immunology, and nutrition long before the term metabolic health entered common language. His ideas once seemed radical; today, they sound prophetic.
Dr Mackarness was among the first British doctors to introduce Clinical Ecology, a field grounded in the belief that food intolerances and environmental sensitivities could provoke not only physical illness but also behavioral and emotional distress.
In the 1950s and 60s, such a claim was close to heresy. Yet, his rigorous clinical observations consistently revealed patterns others ignored: migraines that vanished with dietary elimination, aggression that subsided when allergens were removed, and fatigue that lifted when blood sugar was stabilized.
Modern research into the gut–brain axis, neuroinflammation, and immune-mediated psychiatric disorders now validates what he intuited through decades of patient care.
In his 1976 book Not All in the Mind, Dr Mackarness recounted the remarkable story of a woman institutionalized for violent behavior who fully recovered after dietary modification. It was a case that challenged psychiatry’s dogma.
Dr Mackarness believed that many psychiatric symptoms were not purely psychological but biochemical responses to food and environmental toxins, a concept that neuroscience and nutritional psychiatry are now exploring through the study of cytokines, the microbiome, and neurotransmitter precursors.
By 1979, The Lancet cautiously acknowledged that “food intolerance can produce widespread symptoms,” recognizing the potential value of elimination diets for treatment-resistant patients. That single paragraph marked a quiet victory for a man who had spent years defying convention.
Born in Murree, India, in 1916, Dr Mackarness returned to England for medical training before serving in the Royal Army Medical Corps during World War II.
Those wartime years instilled in him a disciplined compassion, a blend of scientific rigor and human empathy that defined his later work.
After the war, he began linking clinical evidence with evolutionary insight, arguing that our physiology was designed for the diet of our ancestors, not the refined carbohydrates of modernity.
His 1958 book, Eat Fat and Grow Slim, crystallized this philosophy. He introduced the “Stone-Age Diet,” a high-fat, high-protein, low-carbohydrate approach that defied the calorie model of weight control.
His thesis was elegant yet sounded controversial: “It is not the calories that make you fat; it is the carbohydrates that make you hungry.”
Published years before Dr. Robert Atkins and decades before modern ketogenic research, his book went through six editions, influencing generations of physicians, scientists, and sensible biohackers, myself included.
Dr Mackarness drew inspiration from Dr. Ted Rudolph, an American pioneer in the study of food and inhalant allergies. Building upon Rudolph’s work, he integrated elimination diets into psychiatric care, using food as a diagnostic tool and therapy.
His approach helped patients restore both biochemical and emotional balance without medication, a method that now resonates with integrative medicine and psychoneuroimmunology.
[Even the immunological ideas were celebrated in the 2025 Nobel Prize, as I documented in a recent story titled 2025 Nobel Winners in Medicine Give Hope for Our Complex Immune Issues, Including Cancers.]
At Park Prewett Hospital, Dr Mackarness established the first NHS Clinical Ecology Unit, an audacious institution where diet met psychiatry in a clinical setting.
Later, he co-founded Action Against Allergy, a global advocacy group that gave hope to patients dismissed by conventional medicine. These efforts positioned him as one of the earliest champions of personalized nutrition, a philosophy now echoed in genomic medicine and functional health models.
In his later years, he moved to Australia, continuing to treat patients with addiction and metabolic challenges while painting and writing quietly by the Peninsula ocean at Mornington.
Those who knew him described him as humble, compassionate, and unshakably devoted to the idea that medicine must heal the whole person, not just the symptom. He was a scientist, a clinician, and an artist, a rare hybrid who understood that healing involves biology, psychology, and purpose.
To me, Dr. Mackarness is not merely a historical figure. He represents a bridge between eras, a physician who laid the intellectual foundation for metabolic psychiatry, nutritional neuroscience, and the modern understanding of hormonal regulation.
His courage to question the calorie model and his insight into biochemical individuality continue to inspire me and many other new generation scientists and clinicians.
Every time I share my experiences reversing prediabetes, inflammation, and brain fog, I remember his words. I see his influence in the growing body of research that connects ketone metabolism, inflammation reduction, and mental clarity.
Dr. Mackarness may have said farewell to the planet in 1996, but his science lives in every patient who rediscovers vitality through understanding their own metabolism, and in every clinician who dares to look beyond convention.
Conclusions and Key Takeaways of the Chapter: Why His Lesson Still Matters and Lessons I Carry Forward
Decades have passed since I first opened Eat Fat and Grow Slim, yet every page still feels alive with quiet rebellion. Today, science finally speaks the language that Dr. Richard Mackarness once said, the language of hormones, not arithmetic.
We now understand what he saw through clinical observation: that insulin, leptin, ghrelin, cortisol, and glucagon — not calories — decide whether we burn or store energy, stay sharp or fatigued, heal or decay.
The latest research from Harvard, Stanford, and Virta Health confirms what he practiced intuitively: low-carbohydrate and ketogenic nutrition can reverse metabolic syndrome, type 2 diabetes, and fatty liver disease by restoring insulin sensitivity, reducing systemic inflammation, and renewing mitochondrial efficiency.
These are not anecdotes anymore; they are measurable physiological transformations. For example, Dr David Unwin helped 153 patients to reverse type II diabetes without drugs. He shared it on X recently.
A few years ago, when I wrote an article titled Here’s Why and How Type II Diabetes Is Preventable and Reversible some medical doctors told me it was impossible and my claim might be misleading.
Modern science on ketone metabolism, BHB signaling, and autophagy extends the vision of Dr. Mackarness even further.
Beta-hydroxybutyrate (BHB), once dismissed as a mere metabolic byproduct, is now recognized as a signaling molecule that influences gene expression, protects neurons, and improves synaptic plasticity through upregulating BDNF (brain-derived neurotrophic factor).
These molecular pathways confirm what Dr. Mackarness sensed in his psychiatric practice: that when the body finds metabolic balance, the mind follows.
The body, he taught us, is not a furnace where calories are burned in isolation. It is a symphony. Calories are just the notes, simple, predictable, and mechanical.
The music, however, comes from hormones and enzymes, from the rhythms of fasting and feeding, from the harmony between fat oxidation and glucose metabolism. And like any symphony, it changes when we change the composition of what we eat.
His message, distilled over a lifetime, was elegantly simple yet profoundly subversive: Health begins not when we control hunger, but when we understand it.
Hunger is not a flaw to be punished; it is communication from a system seeking equilibrium. When I finally stopped suppressing my body’s signals and started listening to them, I began to heal.
Dr. Mackarness’s teachings gave me back my metabolic freedom and with it, a sharper brain, stronger muscles, and a calmer nervous system.
Every time I write about ketosis, metabolic flexibility, or neurogenesis, I feel his presence in the background, that quiet, compassionate psychiatrist who dared to ask why patients with anxiety, depression, and fatigue might be victims of dietary dogma rather than moral weakness.
His “Calorie Fallacy” was never just about food but about truth, the courage to align evidence with empathy. He believed that medicine must evolve by integrating data, lived experience, and humanity into one coherent understanding of health. He saw the biochemical individuality that modern precision medicine now embraces.
In his humility, he never sought fame. Yet his ideas live on in every clinician who questions why chronic illness persists in an age of abundance, and in every patient who finds peace through self-understanding rather than restriction.
Whenever I revisit his story, I think about the funeral overlooking the Mornington sea. The waves that day felt like echoes of his legacy, steady, rhythmic, enduring like in his paintings.
His work reminded me that nutrition science goes beyond control, transcending coherence within us. It involves listening to the body’s feedback, respecting evolutionary design, and trusting in biology’s wisdom.
Dr. Richard Mackarness remains, to me, the quiet psychiatrist who changed how I saw life itself. He proved that eating fat could heal the body, calm the mind, and awaken the spirit of inquiry.
His lesson endures: truth in science begins where comfort ends.
As I continue to experiment, teach, and write, I carry his torch forward, not as a doctrine, but as an invitation: to question bravely, to learn continuously, and to heal wholly with acceptance, empathy, and compassion for ourselves and others.
I decided to share this chapter with the community as a gift for Mental Health Month to create awareness.
Thank you for reading my perspectives. I wish you a healthy and happy life. I’d love to read about your experiences and thoughts on this important health topic.
If you enjoyed this chapter, you can also check out another chapter related to mental health:
Can Ketosis Prevent or Treat Depression and Anxiety?
I Care Deeply About This Question Based on My Research and Personal Experiences, and Here’s What I Can Offer as a…medium.com
As a health topic close to my heart, I recently completed and shared several sample chapters from an upcoming book, Ketosis + BDNF: The Healing Molecules That Saved My Life.
I provide the links to the chapters I published as early access to this book. As beta readers, your feedback will be appreciated to refine it and make it a valuable resource for the community.
What Is Beta-Hydroxybutyrate and Why I Decided to Write a Comprehensive Memoir Book About It
Neurobiology of Ketones in the Brain with Practical Lived Experiences
Other Related Stories for Producing Ketones Naturally
β-Hydroxybutyrate: 2 Vital Role of Ketogenesis in the Brain for Dementia Prevention / Treatment
Biochemistry of Ketosis Simplified with Nuanced Perspectives and Personal Experiences
A New Clinical Trial Found a Low-Carb Diet Better Than the Dash.
Perfect Storm in a Teacup: Can Intermittent Fasting Increase Heart Disease Risk by 91%?
Here’s Why I Focus on Nutritional Biochemistry Rather Than Diets
I wrote several stories about ketosis and the ketogenic lifestyle, reflecting my experiences and literature reviews, which you can find in the following list: Ketosis and Ketogenic Lifestyle
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Here’s How to Make the Nervous System More Flexible and Functional
Here’s How I Train My Brain Daily for Mental Clarity and Intellectual Productivity.
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