The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) defines feeding and eating disorders as “a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning.”1
Approximately 30 million Americans suffer from eating disorders such as anorexia nervosa and bulimia nervosa. Around the world, the rate drastically rises to 70 million people suffering from eating disorders at any given time, most often women between the ages of 12 and 35.2 Eating disorders are difficult mental disorders to treat due to the lack of consistent evidence suggesting one treatment over another, and due to the high dropout rates of patients in treatment and exceptionally high relapse rates. Research suggests that over 50% of those who proceed with treatment for EDs continue to struggle with symptoms and remain chronically ill. This inconsistency in the treatment for eating disorders calls for more stability for promising treatments and therapeutic modalities that transcends across differential demographics and characteristics.
In many cases, eating disorders co-occur with other psychiatric disorders such as anxiety and panic disorders, obsessive-compulsive disorders, and substance use disorders.2 Without treatment that addresses both the emotional and physical symptoms of these disorders, malnutrition, heart problems and other potentially fatal conditions can result.
A recent resurgence in research into psychedelic compounds such as LSD, MDMA, psilocybin, and ayahuasca show the potential to be utilized as therapeutic tools in the field of mental illness for treating conditions including mood, affective and substance use disorders, and as of most recently, eating disorders.3 Recent studies provide evidence that psychedelic treatment can have profound effects to help those recover from their eating disorder symptoms by uncovering and resolving the root causes for related contributing factors.
Current Treatment for Eating Disorders
Cognitive Behavioral Therapy (CBT), a psychotherapeutic treatment often combined with pharmacological treatment, is an example of a treatment that may only be efficacious in the management of co-morbid conditions or for weight recovery in eating disorders. These symptom-focused treatments often overlook the more fundamental components that underlie eating disorders.4 There is a growing interest in the therapeutic use of classic psychedelic compounds including LSD, psilocybin (the major psychedelic component in magic mushrooms), and DMT (dimethyltryptamine), the major psychedelic component of ayahuasca – substances that “exert their key behavioural effects via serotonin type 2A (5-HT2A) receptor agonism.”4
The Impact of Psychedelics on Eating Disorder Treatment
Recent clinical trials have shown a potential mediating role that psychedelic therapy can develop from psychedelic experiences.
As abnormal serotonin functioning and high emotional avoidance are hypothesised to play a role in EDs, there is a mechanistic grounding for exploring the use of psychedelics in the treatment of EDs.” 4
Psychedelic treatments allow for a safe avenue to confront challenging emotions and the ability for revision of core beliefs and behaviors.4 Such processes can result in revising problematic, long-held mental schemata and behaviors, particularly pertinent in eating disorders, where emotional and experiential avoidance is high. Emotional breakthrough may be an additional mechanism through which psychedelic-assisted psychotherapy may be relevant for the treatment of eating disorders. Results from psychedelic treatment studies for eating disorders revealed improvements in depression and wellbeing scores two weeks after a psychedelic experience, yielding to immense emotional release and great personal insight which promotes positive mental health changes.
Conclusion
The therapeutic use of classic psychedelic compounds including LSD, psilocybin, and DMT show promise for the treatment of comorbid conditions for recovery in people combating eating disorders, such as anorexia and bulimia. When combined with specialized psychotherapy, psychedelic medicine shows potential for a novel therapeutic approach to treat eating disorders. Psychedelic treatment can aid in the treatment of eating disorder symptomology by going deeper than traditional treatments have in the past to uncover and resolve the underlying compounding concerns.
Taschauna A. Richards, MS, RMHCI
Taschauna Richards holds a Master of Science degree in Counseling Psychology with a concentration in Clinical Mental Health Counseling from Nova Southeastern University. She has experience providing clinical counseling services utilizing other treatment modalities such as Cognitive Behavioral Therapy (CBT), trauma-focused therapy, mindfulness, Motivational Interviewing, and psychedelic integration and coaching to treat those with co-occurring disorders and other mental health concerns. She is interested in holistic and alternative medicine, especially how psychedelics and natural substances can aid in mental health treatment.