Sign in Subscribe
ACS Pharmacology & Translational Science

Psychedelics and Eating Disorders: Exploring the Therapeutic Potential for Anorexia Nervosa and Beyond

A review of the therapeutic potential of psychedelics for anorexia nervosa, highlighting neurobiological and psychological mechanisms.

Matt Hallowes

• 2 min read
Psychedelics and Eating Disorders: Exploring the Therapeutic Potential for Anorexia Nervosa and Beyond

Title & Introduction

  • Paper Title: Psychedelics and Eating Disorders: Exploring the Therapeutic Potential for Anorexia Nervosa and Beyond
  • Published In: ACS Pharmacology & Translational Science
  • Publish date: March 3, 2025
  • Authors: Shuai Hu, Cong Lin, Hongshuang Wang, Xiaohui Wang
  • Objective: To examine the potential therapeutic role of psychedelics, particularly psilocybin and MDMA, in treating anorexia nervosa (AN) and other eating disorders.
  • Importance: Anorexia nervosa remains one of the most challenging psychiatric disorders to treat, with high morbidity and mortality rates. Traditional therapies often fail, necessitating novel approaches such as psychedelic-assisted therapy.

Summary & Takeaways

Key Takeaway: Psilocybin and MDMA show promise in treating anorexia nervosa by enhancing cognitive flexibility, disrupting maladaptive neural circuits, and facilitating emotional processing. However, more research is needed to confirm their long-term efficacy and safety.

Practical Application: Psychedelics could serve as an adjunct to existing treatments for anorexia nervosa and other eating disorders, particularly for patients unresponsive to conventional therapies.

Key Background Information

  • Context: Conventional treatments for anorexia nervosa, such as cognitive-behavioral therapy (CBT) and pharmacotherapy, often yield limited success. Psychedelics offer a novel mechanism of action that could target both the psychological and neurobiological underpinnings of the disorder.
  • Hypothesis: Psychedelics improve eating disorder symptoms by modulating neural circuits involved in cognitive rigidity, emotional dysregulation, and maladaptive reward processing.

Methodology

  • Study Design: Narrative review of existing research and clinical trials.
  • Participants: Analysis of studies involving individuals with eating disorders, particularly anorexia nervosa.
  • Intervention/Exposure: Examination of psilocybin, MDMA, and other psychedelics in the treatment of AN.
  • Controls: Not applicable (review article).
  • Duration: Reviewed studies included both short-term and long-term assessments.

Key Findings

Primary Outcomes:

  • Neurobiological Effects:
    • Psychedelics disrupt maladaptive neural circuits associated with anorexia nervosa, particularly in the cortico-striato-thalamo-cortical (CSTC) pathway.
    • Psilocybin reduces hyperactivity in the default mode network (DMN), promoting cognitive flexibility and reducing obsessive thought patterns.
    • MDMA enhances emotional processing, potentially aiding in trauma-related aspects of eating disorders.
  • Psychological Effects:
    • Increased cognitive flexibility allows individuals to reconsider rigid beliefs about food, body image, and self-worth.
    • Psychedelics may facilitate emotional breakthroughs and reduce anxiety around eating behaviors.
  • Clinical Evidence:
    • A phase 1 study using psilocybin in 10 women with anorexia nervosa showed reductions in eating disorder symptoms and improved psychological well-being.
    • MDMA-assisted therapy has shown promise in individuals with comorbid PTSD and eating disorders, suggesting potential benefits for trauma-related aspects of AN.

Secondary Outcomes:

  • Safety concerns include possible anxiety, nausea, and transient psychological discomfort.
  • Regulatory barriers and ethical considerations remain challenges for widespread clinical use.
  • Standardized treatment protocols and controlled clinical trials are necessary before psychedelics can be integrated into mainstream eating disorder treatments.

Interpretation & Implications

  • Conclusion: Psychedelics, particularly psilocybin and MDMA, represent a promising new frontier for treating eating disorders, offering potential benefits for patients unresponsive to traditional therapies.
  • Implications: If further validated, psychedelic-assisted therapy could be incorporated into multidisciplinary treatment programs for eating disorders.
  • Limitations: Current studies have small sample sizes, and long-term effects remain unclear. Larger, controlled trials are needed to establish safety and efficacy.

Researchers & Publication