Perspectives on psychedelic treatment and research in eating disorders: a web-based questionnaire study of people with eating disorders

Introduction

Eating disorders affect an estimated 1.25 million people in the UK and carry high morbidity and mortality, with lifetime anorexia nervosa (AN) showing particularly poor outcomes and a tendency toward chronicity. Standard care typically consists of psychological programmes (for example, CBT, MANTRA, SSCM, FPT) and pharmacotherapies such as selective serotonin reuptake inhibitors, but systematic reviews and meta-analyses indicate limited efficacy for anorexia nervosa and substantial barriers to pharmacological trials in this population, including patients' reluctance to take medications perceived to induce weight gain. Treatment-resistant cases, which carry a poor long-term prognosis, motivate the search for novel therapeutic approaches. Harding and colleagues frame psychedelic drugs as a candidate avenue because of promising findings in other psychiatric disorders (depression, anxiety, OCD, substance use) and the neurobiological mechanisms implicated in psychedelics (principally 5-HT2A receptor agonism). The authors note a paucity of evidence specific to eating disorders—no randomised controlled trials at the time of data collection—and argue that patient views are an important preliminary step for designing ethical, acceptable clinical trials. To that end, they conducted a web-based survey to assess perspectives among people with eating disorders regarding complementary therapies and psychedelic research and treatment.