Psilocybin Therapy Shows Early Promise in Treating Anorexia

A small open-label pilot study enrolled 21 women who had lived with anorexia nervosa for an average of 11 years. Over six weeks participants received three oral doses of psilocybin—an initial 1 mg dose followed by two 25 mg doses spaced two weeks apart—combined with intensive talk therapy before and after each session. The trial, completed in 2022, reported few adverse events; one participant withdrew and another attempted suicide twice, events the researchers said were unrelated to the drug.

Scientific American

The intervention differed from standard eating-disorder care by omitting nutritional rehabilitation and focusing on self-compassion and family support. Body-mass-index changes were not meaningful, but symptom severity scores fell markedly. At the three-month follow-up, half of the participants scored on an eating-disorder measure at a level comparable to individuals without a diagnosis, and many maintained increased motivation to recover for up to a year. No control group was used, limiting causal inference.

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Robin Carhart-Harris, Ralph Metzner Distinguished Professor of Neurology and Psychiatry at the University of California, San Francisco, predicts the U.S. Food and Drug Administration could approve psilocybin for depression or eating disorders within five years. Jennifer Danby, a psychotherapist specializing in eating disorders, emphasizes the therapy’s potential to alleviate suffering. Independent clinicians note the results are encouraging but stress the need for larger, controlled trials to identify who benefits most.

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Anorexia carries the highest mortality rate of any psychiatric disorder, with patients more than 18 times as likely to die by suicide as the general population. Conventional treatments such as cognitive-behavioral therapy or antidepressants succeed in roughly half of cases, leaving a substantial unmet need. Recent policy shifts—including encouragement from the Trump administration for regulators to explore psychedelic medicines—have accelerated research into compounds like psilocybin.

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• “Psilocybin therapy has the potential to stop a lot of unnecessary suffering,” — Jennifer Danby

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• “These are people who’ve tried everything, and nothing’s worked,” — Robin Carhart-Harris, who co-authored the study

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• “The results of this study are profound,” — Claire Finkelstein, a clinical psychologist at Swinburne University of Technology in Australia

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• “People have likened anorexia to a slow suicide,” — Robin Carhart-Harris, who co-authored the study

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