Exploring MDMA assisted therapy in eating disorders: mechanisms, clinical evidence, and future directions.
Journal of eating disorders December 29, 2025 Michael Harkhoe, Tim Offringa, Eric Vermetten
No clinical trials of MDMA-assisted therapy have been conducted in patients with eating disorders, including anorexia nervosa. Evidence from PTSD trials suggests MDMA's pro-social, fear-reducing, and neuroplastic properties may enhance emotional processing, therapeutic alliance, and cognitive flexibility—factors that often hinder eating disorder treatment. The paper synthesizes current research on MDMA, PTSD, and eating disorders, reviewing clinical trial outcomes, neurobiological mechanisms, and therapeutic frameworks. It argues that MDMA-assisted therapy may hold promise as an adjunctive treatment for eating disorders with comorbid trauma, but rigorous validation through well-powered trials and careful ethical oversight are needed before clinical integration.