Psychedelics in the treatment of eating disorders: Rationale and potential mechanisms
Seline Mock, Nicole Friedli, Patrick Pasi, Gregor Hasler, Abigail E. Calder
European Neuropsychopharmacology June 21, 2023 DOI: 10.1016/j.euroneuro.2023.05.008 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Interventions | Psychedelic-assisted therapy with ketamine MDMA psilocybin ayahuasca |
| Topics | Anxiety |
| Keywords | Anorexia nervosa Bulimia nervosa Eating disorders Binge-eating disorder Binge eating Mood disorders Psychotherapist Comorbidity Exposure therapy Clinical psychology |
| Citations | 46 |
| Key findings | Preliminary evidence suggests psychedelic-assisted therapy may be effective in treating anorexia nervosa and bulimia nervosa, with very little data available on binge eating disorder. |
Abstract
Eating disorders are serious illnesses showing high rates of mortality and comorbidity with other mental health problems. Psychedelic-assisted therapy has recently shown potential in the treatment of several common comorbidities of eating disorders, including mood disorders, post-traumatic stress disorder, and substance use disorders. The theorized therapeutic mechanisms of psychedelic-assisted therapy suggest that it could be beneficial in the treatment of eating disorders as well. In this review, we summarize preliminary data on the efficacy of psychedelic-assisted therapy in people with anorexia nervosa, bulimia nervosa, and binge eating disorder, which include studies and case reports of psychedelic-assisted therapy with ketamine, MDMA, psilocybin, and ayahuasca. We then discuss the potential therapeutic mechanisms of psychedelic-assisted therapy in these three eating disorders, including both general therapeutic mechanisms and those which are relatively specific to eating disorders. We find preliminary evidence that psychedelic-assisted therapy may be effective in the treatment of anorexia nervosa and bulimia nervosa, with very little data available on binge eating disorder. Regarding mechanisms, psychedelic-assisted therapy may be able to improve beliefs about body image, normalize reward processing, promote cognitive flexibility, and facilitate trauma processing. Just as importantly, it appears to promote general therapeutic factors relevant to both eating disorders and many of their common comorbidities. Lastly, we discuss potential safety concerns which may be associated with these treatments and present recommendations for future research.
Comparable studies
Other narrative reviews on anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-based interventions: an overall review General (healthcare, schools, workplace) | 2021 | Review | |
| A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders | 2017 | Review and consensus statement | |
| Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part II—Clinical Applications and Guidelines | 2005 | Review | |
| Mindfulness Meditation and Psychopathology | 2018 | Review | |
| Management of Treatment-Resistant Depression: Challenges and Strategies | 2020 | Review |
Citations in the library
Cited by 37
- Naturalistic psychedelic therapy: The role of relaxation and subjective drug effects in antidepressant response Journal of Psychopharmacology September 20, 2024
- Altered States and Social Bonds: Effects of MDMA and Serotonergic Psychedelics on Social Behavior as a Mechanism Underlying Substance-Assisted Therapy Biological Psychiatry: Cognitive Neuroscience and Neuroimaging February 9, 2024
- Efficacy, all-cause discontinuation, and safety of serotonergic psychedelics and MDMA to treat mental disorders: A living systematic review with meta-analysis. European Neuropsychopharmacology November 7, 2025
- Psychedelics and the treatment of eating disorders: considerations for future research and practice. Journal of Eating Disorders October 22, 2024
- Clinical and preclinical evidence of psilocybin as antidepressant. A narrative review Progress in Neuro-Psychopharmacology and Biological Psychiatry 2025
and 32 more in the library
Cites 90
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder JAMA Psychiatry November 4, 2020
and 85 more in the library