Psilocybin for Eating Disorders: Anorexia and Binge Eating

## The Short Answer Eating disorders — particularly anorexia nervosa — are characterized by extreme cognitive rigidity: rigid rules about food, rigid body image distortions, and rigid behavioral patterns that persist despite severe health consequences. Psilocybin's primary therapeutic mechanism — disrupting rigid neural patterns and increasing cognitive flexibility — is directly relevant to eating disorder treatment. A 2023 pilot study at Johns Hopkins found psilocybin-assisted therapy produced significant improvements in anorexia symptoms in all 10 participants. ## Why Eating Disorders Are So Treatment-Resistant Anorexia nervosa has the highest mortality rate of any psychiatric condition — approximately 10% of patients die from the illness or its complications. Standard treatments (CBT, nutritional rehabilitation) have limited effectiveness, particularly for severe or long-standing cases. The core problem is cognitive rigidity: the eating disorder thoughts and behaviors are deeply entrenched neural patterns that are extremely resistant to change through conventional therapeutic approaches. ## The Johns Hopkins Pilot Study A 2023 open-label pilot study at Johns Hopkins enrolled 10 adults with anorexia nervosa. After two psilocybin sessions with psychotherapy: - All 10 participants showed improvements in eating disorder symptoms - Significant reductions in eating disorder cognitions (rigid food rules, body image distortion) - Improvements in quality of life and psychological flexibility - No serious adverse events ## Binge Eating Disorder Binge eating disorder involves compulsive eating patterns that share characteristics with addiction — impulsive behavior driven by rigid neural patterns. Psilocybin's effectiveness for addiction suggests it may also help with binge eating. [See the protocol →](/research-checkout) *This article is for informational purposes only and does not constitute medical advice.*