Psilocybin as a Transdiagnostic Treatment for Eating Disorders and Comorbid Psychopathology: Implications for Clinical Nosology and Research Directions
International Journal of Eating Disorders July 2, 2026 Elena Koning, Jérémie Richard, Aaron Keshen
Psilocybin treatment shows promise as a transdiagnostic intervention for eating disorders and their common psychiatric comorbidities. Preliminary clinical evidence supports its feasibility, safety, and therapeutic effects, with robust transdiagnostic effects observed across comorbid conditions. Proposed mechanisms include serotonergic receptor agonism, psychoplastogenic effects, and neural network desynchronization that target shared vulnerabilities. These vulnerabilities map onto dimensional constructs in the Hierarchical Taxonomy of Psychopathology (Emotional Dysfunction superspectrum, Internalizing spectrum) and Research Domain Criteria (negative/positive valence, cognitive, and social process domains). Future research should explore pragmatic trial designs and dimensional outcome measures to capture real-world complexities.