Psilocybin Treatment as an Adjunct to Cognitive Behavioral Therapy for Eating Disorders: Therapeutic Rationale & Considerations for Protocol Development.

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.

Study at a glance

Abstract

Eating disorders (EDs) remain challenging to treat, with high dropout and low remission rates in cognitive-behavioral therapy for EDs (CBT-ED). Psilocybin treatment (PT) demonstrates therapeutic potential to enhance CBT-ED by exerting several neurobiological, psychological, and experiential effects (e.g., antidepressant, neuroplasticity, emotional openness) that are hypothesized to increase psychotherapeutic engagement, reduce dropout, and improve clinical outcomes. This narrative review provides the first consolidation of theoretical evidence for PT/CBT-ED, proposes considerations for a concurrent intervention protocol, and presents clinical and research considerations to empirically test its feasibility, safety, and efficacy. This line of inquiry is expected to advance the development of approaches that improve ED treatment outcomes and, more broadly, advance the study of psychedelics as tools to enhance evidence-based psychotherapy models.