Healthcare providers who treat eating disorders expressed interest in psilocybin-assisted psychotherapy but raised concerns about risks to malnourished patients and those with psychological comorbidities. In focus groups with 32 participants, providers also worried about equity in access for publicly insured and non-English speaking patients. They requested continuing education about psilocybin therapy. Despite concerns, providers were hopeful about psilocybin therapy as a treatment and valued collaboration to improve long-term patient outcomes as clinical trials develop.
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.