Psychedelic-assisted therapies show promise for severe psychiatric illnesses, and interest is growing in their use for eating disorders. To proceed safely and rigorously, the field must address critical risks, ethical considerations, and methodological aspects in trial design. The authors provide provisional guidelines for clinical research trials to protect participants and maximize methodological rigor.
This paper argues that current psychedelic-assisted therapy studies for eating disorders may fail to capture meaningful outcomes because they rely on standard psychiatric measures that overlook the subjective, first-person experience of the disorder. From a phenomenological psychopathology perspective, the authors contend that eating disorders involve profound alterations in self-perception, embodiment, and identity that cannot be adequately assessed through symptom checklists or behavioral metrics alone. They suggest that incorporating experiential data and qualitative accounts of transformative shifts in sense of self and body relationship could provide a more accurate picture of therapeutic efficacy.
Innovative pharmacologic treatments for eating disorders, including psychedelics and stimulant medications, are being explored. Preliminary evidence suggests psilocybin may enhance cognitive flexibility and support psychological interventions in some eating disorders such as anorexia nervosa. Lisdexamfetamine offers benefits for binge-eating disorder, while medications for avoidant/restrictive food intake disorder and bulimia nervosa remain understudied. The article underscores the need for robust clinical trials to evaluate these approaches and advocates for integrating novel treatments into existing therapeutic frameworks to address the complex biological and psychological dimensions of eating disorders.