Eating disorders remain difficult to treat, with high dropout and low remission rates in cognitive-behavioral therapy for eating disorders (CBT-ED). Psilocybin treatment may enhance CBT-ED by producing antidepressant, neuroplasticity, and emotional openness effects that could increase therapeutic engagement and improve outcomes. This narrative review consolidates theoretical evidence for combining psilocybin treatment with CBT-ED, proposes considerations for a concurrent intervention protocol, and outlines clinical and research considerations for testing its feasibility, safety, and efficacy. The authors expect this work to advance treatments for eating disorders and the study of psychedelics as tools to enhance evidence-based psychotherapy.
Eating disorders remain difficult to treat, with high dropout and low remission rates in cognitive-behavioral therapy. Psilocybin treatment may enhance this therapy by producing neurobiological, psychological, and experiential effects such as antidepressant action, increased neuroplasticity, and emotional openness, which are hypothesized to improve engagement, reduce dropout, and boost clinical outcomes. This article consolidates existing theoretical evidence for combining psilocybin with cognitive-behavioral therapy for eating disorders, proposes considerations for a concurrent intervention protocol, and presents clinical and research considerations for testing its feasibility, safety, and efficacy. This line of inquiry aims to advance approaches that improve eating disorder treatment outcomes and the study of psychedelics as tools to enhance evidence-based psychotherapy.