Bio

Dr. Sethi Dalai is double boarded in Psychiatry and Obesity Medicine. She is a Clinical Assistant Professor in the Department of Psychiatry and Behavioral Sciences and Director of the Metabolic Psychiatry Clinic. (https://med.stanford.edu/psychiatry/patient_care/metabolic.html). She has specialized training and expertise in obesity medicine and adult eating disorders. She completed her residency in Psychiatry at Stanford University and specialized training in obesity at Duke Medical Center. Dr. Sethi Dalai received her MD jointly from Duke University School of Medicine and National University of Singapore. She also received a Masters degree in Biotechnology from Johns Hopkins University. Dr. Sethi Dalai’s approach to psychiatric treatment incorporates metabolic evaluations, principles of obesity treatment, metabolism, and nutrition. She was awarded a grant by the Obesity Treatment Foundation as principal investigator to study the effectiveness of a low - carbohydrate ketogenic dietary intervention in an outpatient cohort of patients with obesity or metabolic dysfunction and bipolar illness or schizophrenia. In addition, she is a co-investigator on a pilot randomized clinical trial testing an FDA approved obesity medication for binge-eating disorder and bulimia nervosa at Stanford University funded by SPARK. She is a recipient of the Symonds Fellow Award from the Association of Women Psychiatrists for innovation in psychiatry and contributions to women’s health. She is a member of the Obesity Medicine Association, the American Psychiatric Association, and served on the council of the Northern California Psychiatric Association.

Clinical Focus

  • Psychiatry
  • Obesity Medicine
  • Adult Eating Disorders
  • Metabolic Syndrome

Academic Appointments

  • Clinical Assistant Professor, Psychiatry and Behavioral Sciences

Honors & Awards

  • Kuen Lau Bipolar Research Award, Stanford Department of Psychiatry (2021)
  • Obesity Treatment Foundation Grant Award, Obesity Medicine Association (2018)
  • Symonds Fellow Award, Association of Women Psychiatrists (2016)
  • ASCP Clinical Trial Scholarship, American Society of Clinical Psychopharmacology (2016)
  • Recipient, The Coaching Fellowship (2015)
  • Scholar, Stanford Society of Physician Scholars (2015)
  • Clinical and Translational Science Award (CTSA) Seed Grant, Stanford Office of Community Health (2010-2012)

Professional Education

  • Board Certification: American Board of Obesity Medicine, Obesity Medicine (2020)
  • Board Certification, Obesity Medicine, American Board of Obesity Medicine (2020)
  • Board Certification: American Board of Psychiatry and Neurology, Psychiatry (2018)
  • Residency, Stanford University Medical Center, Psychiatry (2017)
  • Internship, Stanford University Medical Center, Psychiatry (2014)
  • MD, National University of Singapore, Medicine (2013)
  • MD, Duke University School of Medicine, Medicine (2013)
  • MS, Johns Hopkins University, Biotechnology (2007)

Contact

  • Academic
    shebanis@stanford.edu
    University - Staff Department: Psych/General Psychiatry and Psychology (Adult) Position: Clinical Assistant Professor
    University - Affiliate Department: Psychiatry and Behavioral Sciences
  • Clinical Psychiatry 401 Quarry Rd Ste 2114 MC 5723 Stanford, CA 94305 (650) 725-3762 (fax)
  • Clinical Psychiatry 401 Quarry Rd Ste 2119 MC 5723 Stanford, CA 94305 (650) 725-3762 (fax)

Additional Info

  • Mail Code: 2078

Current Research and Scholarly Interests

Clinical and academic interests are in the management of psychiatric disorders with co-morbid obesity, poor metabolic health and/or eating disorders, particularly binge eating disorder and bulimia nervosa. Improving metabolic and mental health through dietary interventions, pharmacological optimization, and other lifestyle means in those with severe mental illness, such as bipolar disorder or schizophrenia is another major focus of her research.

Clinical Trials

  • Impact of a Ketogenic Diet on Metabolic and Psychiatric Health in Patients With Schizophrenia or Bipolar Illness Recruiting

    To initiate a low-carbohydrate, high-fat (LCHF) ketogenic dietary intervention among a small cohort of outpatients with either schizophrenia or bipolar illness and comorbid overweight/obesity currently taking psychotropic medications. Adults with mental illness represent a high-risk, marginalized group in the current obesity epidemic. Among US adults with severe mental illness, obesity and overweight are highly prevalent conditions having severe consequences, with patients estimated to die on average 25 years earlier than the general population largely of premature cardiovascular disease. In addition, many psychiatric medications, particularly antipsychotics and mood stabilizers, can contribute to metabolic side effects and weight gain. Low-carbohydrate high-fat (LCHF) diets have been shown to reduce cardiovascular risk in those with insulin resistance. The purpose of this study is to evaluate both the metabolic and psychiatric outcomes with an LCHF diet in this psychiatric population.

    View full details

  • FDA Approved Medication to Reduce Binge Eating and/or Purging Not Recruiting

    This study will demonstrate the efficacy of Qsymia versus placebo in treating bulimia nervosa and binge eating disorder.

    Stanford is currently not accepting patients for this trial. For more information, please contact Debra L Safer, MD, 650-723-7928.

    View full details

All Publications

  • Treating binge eating and food addiction symptoms with low-carbohydrate ketogenic diets: a case series Carmen , M., Safer, D. L., Saslow, L. R., Kalayjian , T., Mason, A. E., Westman, E. C., Sethi Dalai , S., et al Journal of Eating Disorders. Biomed Central . 2020

    Abstract

    Background: Many patients with obesity and comorbid binge eating symptoms present with the desire to lose weight. Although some studies suggest that dietary restriction can exacerbate binge eating, others show dietary restriction is associated with significant reductions in binge eating. The effect of a particular type of dieting on binge eating, the ketogenic diet (a high fat, moderate protein, very low carbohydrate diet), is not known. Case presentations: We report on the feasibility of a low-carbohydrate ketogenic diet initiated by three patients (age 54, 34, and 63) with obesity (average BMI 43.5 kg/m2) with comorbid binge eating and food addiction symptoms. All patients tolerated following the ketogenic diet (macronutrient proportion 10% carbohydrate, 30% protein, and 60% fat; at least 5040 kJ) for the prescribed period (e.g., 6–7 months) and none reported any major adverse effects. Patients reported significant reductions in binge eating episodes and food addiction symptoms including cravings and lack of control as measured by the Binge-Eating Scale, Yale Food Addiction Scale, or Yale- Brown Obsessive-Compulsive Scale modified for Binge Eating, depending on the case. Additionally, the patients lost a range of 10–24% of their body weight. Participants reported maintenance of treatment gains (with respect to weight, binge eating, and food addiction symptoms) to date of up to 9–17 months after initiation and continued adherence to diet. Conclusions: Although the absence of control cases precludes conclusions regarding the specific role of ketogenic diets versus other forms of dietary restriction, this is the first report to demonstrate the feasibility of prescribing a ketogenic diet for patients with obesity who report binge eating and food addiction symptoms. Further research should seek to reproduce the observed effects in controlled trials as well as to explore potential etiologies. Keywords: Binge eating, Food addiction symptoms, Obesity, Ketogenic diet, Dietary restriction

  • Ketogenic diet as a metabolic treatment for mental Illness. Current Opinion in Endocrinology, Diabetes and Obesity. Norwitz , N., Sethi Dalai , S., Palmer , C. 2020 ; 27 (5)

    View details for DOI 10.1097/MED.0000000000000564

  • Low Carbohydrate Ketogenic Therapy as a Metabolic Treatment for Binge Eating and Ultra-processed Food Addiction. Current Opinion Endocrinology, Diabetes and Obesity Sethi Dalai , S., Anika, S., Ashley , G. 2020; 27 (5)

    View details for DOI 10.1097/MED.0000000000000571

  • Ketogenic diet as a metabolic therapy for bipolar disorder: Clinical developments Yu, B., Oz, R., Sethi Dalai , S., et al Research Square Preprint . 2021
  • If Americans were healthier, we could have been better prepared for this pandemic. Sethi Dalai , S. The Hill Op-Ed. 2020
  • A randomized, placebo‐controlled crossover trial of phentermine‐topiramate ER in patients with binge‐eating disorder and bulimia nervosa International Journal of Eating Disorders Safer, D. L., Adler, S., Sethi Dalai , S., Bentley , J., Toyama, H., Parajito , S., Najarian , T., et al 2019

    View details for DOI 10.1002/eat.23192

  • Study protocol and rationale for a randomized double-blinded crossover trial of phentermine-topiramate ER versus placebo to treat binge eating disorder and bulimia nervosa. Contemporary clinical trials Dalai, S. S., Adler, S. n., Najarian, T. n., Safer, D. L. 2018; 64: 173–78

    Abstract

    Bulimia nervosa (BN) and binge eating disorder (BED) are associated with severe psychological and medical consequences. Current therapies are limited, leaving up to 50% of patients symptomatic despite treatment, underscoring the need for additional treatment options. Qsymia, an FDA-approved medication for obesity, combines phentermine and topiramate ER. Topiramate has demonstrated efficacy for both BED and BN, but limited tolerability. Phentermine is FDA-approved for weight loss. A rationale for combined phentermine/topiramate for BED and BN is improved tolerability and efficacy. While a prior case series exploring Qsymia for BED showed promise, randomized studies are needed to evaluate Qsymia's safety and efficacy when re-purposed in eating disorders. We present a study protocol for a Phase I/IIa single-center, prospective, double-blinded, randomized, crossover trial examining safety and preliminary efficacy of Qsymia for BED and BN.Adults with BED (n=15) or BN (n=15) are randomized 1:1 to receive 12weeks Qsymia (phentermine/topiramate ER, 3.75mg/23mg-15mg/92mg) or placebo, followed by 2-weeks washout and 12-weeks crossover, where those on Qsymia receive placebo and vice versa. Subsequently participants receive 8weeks follow-up off study medications. The primary outcome is the number of binge days/week measured by EDE. Secondary outcomes include average number of binge episodes, percentage abstinence from binge eating, and changes in weight/vitals, eating psychopathology, and mood.To our knowledge this is the first randomized, double-blind protocol investigating the safety and efficacy of phentermine/topiramate in BED and BN. We highlight the background and rationale for this study, including the advantages of a crossover design.Clinicaltrials.gov identifier NCT02553824 registered on 9/17/2015. https://clinicaltrials.gov/ct2/show/NCT02553824.

    View details for PubMedID 29038069

  • Could Pokémon Go Have Some Mental Health Benefits? Sethi Dalai, S. American Psychiatric Association . Washington DC. 2016