By Brian Lissak
Nearly 30 million Americans suffer from an eating disorder, resulting in 10,200 deaths annually. Perhaps more than other mental illnesses, eating disorders demonstrate the interconnectedness of our mental and physical well-being. An eating disorder is a severe disturbance in one’s eating habits due to psycho-emotional distress. Potentially life-threatening conditions can result if untreated. However, there are no widely effective treatments. Psychiatric medications have proven ineffective, and talk therapy is only slightly better.
What Are Eating Disorders?
An eating disorder is a serious disturbance in one’s eating behaviors. Though it’s not clearly understood how, this disturbance is linked to emotional and psychological states. In the vast majority of cases, eating disorders are concurrent with a host of other psychiatric disorders. These include anxiety, depression, obsessive compulsive disorder, alcohol and drug abuse, and others. Untreated, eating disorders can lead to a variety of health issues. There are many types of eating disorders. We’ll detail two of the most common.
Anorexia nervosa is characterized by limited food intake, fear of being “fat,” and body image issues. Sufferers often exercise compulsively and take laxatives or force themselves to vomit in order to lose weight. No matter how thin the person becomes, they still see themselves as fat. Over enough time, the body becomes malnourished and goes into starvation. This can result in menstrual period cessation, anemia, muscle atrophy (including heart muscle), hypotension, severe constipation, lethargy, osteoporosis, and osteopenia (thinning of the bones). That’s just to name a few of the physical symptoms. The mental symptoms, which are both a cause and a result of anorexia nervosa, include obsessive-compulsive behavior, severe anxiety, and bouts of depression.
Binge Eating Disorder
Binge eating disorder is when people have frequent episodes of consuming large quantities of food over a short period of time. People who struggle with binge eating feel out of control during these episodes. Unlike those with anorexia nervosa, they do not purge the food by inducing vomiting or taking laxatives. Binge eating disorder is chronic and can lead to severe health complications including cardiovascular disease, hypertension, obesity, and diabetes. Those who binge eat will often feel disgusted with themselves, or guilty and ashamed of their behavior. These feelings lead to emotional repression, depression, anxiety, and a tendency to hide the behavior from others.
How Psychedelic-Assisted Psychotherapy Can Treat Eating Disorders
Eating disorders are some of the most complicated and life-threatening mental health illnesses. Obviously, the first goal in treating someone with an eating disorder is getting them physically healthy. This includes treating malnutrition, obesity, diabetes, hyper/hypotension, and so on. However, unless the emotional and psychological sides are treated, the harmful eating behavior will return.
The power of psychedelic-assisted psychotherapy is that it gets to the root cause. It lowers ego defenses (sometimes called ego death) and temporarily dismantles habituated neural pathways. This allows one to freely explore their identity and safely interact with traumatic memories. Eating disorders have proven so difficult to treat because they present with a host of other mental illnesses. However, it is becoming increasingly clear that these other mental illnesses are symptoms of an underlying problem. It is hoped, and with good reason, that psychedelic-assisted psychotherapy can cut through all of the complicated layers associated with eating disorders and help the person heal at their very core.
Psilocybin-Assisted Psychotherapy for Treating Anorexia
Researchers at UC San Diego are conducting early phase trials testing the safety and feasibility of psilocybin-assisted psychotherapy for those suffering from anorexia. The study’s primary goal is to assess safety, as this population has never received psilocybin-assisted psychotherapy before. The study’s secondary goal is to assess the efficacy of psilocybin-assisted psychotherapy on anorexia. Based on recent clinical trials in other mental illnesses, there is strong reason to believe it is both safe and effective.
Participants will receive preparatory and integrative psychotherapy sessions, and one session with a single 25mg dose of psilocybin. The study began in December 2020, and will run until the end of this year.
MDMA-Assisted Psychotherapy for Treating Eating Disorders
MAPS is currently conducting a Phase 2 trial on the safety and feasibility of MDMA-assisted psychotherapy for anorexia nervosa and binge eating disorder. This study is doing something quite novel in the world of psychotherapy. Every participant who suffers from an eating disorder has a supportive caregiver as a treatment ally. This could be a parent, sibling, partner, or friend. The supportive caregiver receives non-drug therapy to aid them in supporting the trial participant. The inclusion of a treatment ally reflects the evolving view of medicine, which is increasingly looking at psycho-social components in both illness and health. The supportive caregiver also reflects the unique nature of eating disorders, which so clearly link physical and mental health.
Since MDMA-assisted psychotherapy has proven safe and effective in treating other mental health issues like anxiety, PTSD, and depression, it is hoped it can treat eating disorders as well.
Ayahuasca Ceremonies and Reduction in Eating Disorder Symptoms
Psychologist Adele Lafrance has been doing research on eating disorders and participation in ayahuasca ceremonies. Ayahuasca is a psychoactive plant blend from the Amazon basin. Indigenous groups have used it in healing ceremonies for generations. In the last half-century, ayahuasca has seen rising popularity among westerners who are exploring its benefits as well. With the scientific community’s renewed interest in psychedelic-assisted psychotherapy, ayahuasca has received special attention.
Lafrance’s research shows that ayahuasca ceremony participation significantly reduced eating disorder symptoms and body image perception while improving overall mental health. This research further bolsters the growing consensus that psychoactive compounds can have a positive impact on many branches of psychotherapy. For those suffering from an eating disorder, psychedelic-assisted psychotherapy may offer hope where other treatments have failed.
If you’re interested in going deeper on this subject, please view the recording of PsyTech’s 2020 webinar, which featured the leading experts in psychedelic-assisted treatment for eating disorders.
For an immersive dive into psychedelics, their history, and their current research and medicinal uses, check out PsyTech’s comprehensive course on the fundamentals of psychedelic medicine.