Magic mushrooms may one day treat anorexia, but not just yet

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Anorexia nervosa is a severe mental health disorder where people fear weight gain. Those with the disorder have distorted body image and hold rigid beliefs their body is too big. They typically manage this through restricted eating, leading to the serious medical consequences of malnutrition.

Anorexia has one of the highest death rates of any mental illness. Yet there are currently no effective drug treatments and the outcomes of psychotherapy (talk therapy) are poor. So we’re desperately in need of new and improved treatments.

Psilocybin, commonly known as magic mushrooms, is one such novel treatment. But while it shows early promise, you won’t see it used in clinical practice just yet – more research is needed to test if it’s safe and effective.

Ground Picture/Shutterstock

What does treatment involve?

The treatment involves the patient taking a dose of psilocybin in a safe environment, which is usually a specifically set up clinic. The patient undergoes preparation therapy before the dosing session and integration therapy after.

Psilocybin, extracted from mushrooms, is a psychedelic, which means it can produce altered thinking, sense of time and emotions, and can often result in hallucinations. It also has the potential to shift patients out of their rigid thinking patterns.

Psilocybin is not administered alone but instead with combined structured psychotherapy sessions to help the patient make sense of their experiences and the changes to their thinking. This is an important part of the treatment.

What does the research show?

Research has shown improved effects of psilocybin-assisted psychotherapy after one or two dosing sessions, a couple of weeks apart. Most research to date has targeted depression.

Psilocybin has been found to increase cognitive flexibility – our ability to adjust our thinking patterns according to changing environments or demands. This is one of the ways researchers believe psilocybin might improve symptoms for conditions such as depression and alcohol use disorder, which are marked by rigid thinking styles.

People with anorexia similarly struggle with rigid thinking patterns. So researchers and clinicians have recently turned their attention to anorexia.

In 2023, a small pilot study of ten women with anorexia was published in the journal Nature Medicine. It showed psilocybin-assisted psychotherapy (with 25mg of psilocybin) was safe and acceptable. There were no significant side effects and participants reported having valuable experiences.

Although the trial was not a formal efficacy trial, 40% of the patients did have significant drops in their eating disorder behaviour.

However, the trial only had one dosing session and no long-term follow up, so further research is needed.

Lab technician holds mushroom with tweezer
Researchers are still working out dosages and frequency. 24K-Production/Shutterstock

A recent animal study using rats examined whether rigid thinking could be improved in rats when given psilocybin. After the psilocybin, rats gained weight and had more flexible thinking (using a reversal learning task).

These positive changes were related to the serotonin neurotransmitter system, which regulates mood, behaviour and satiety (feeling full).

Brain imaging studies in humans show serotonin disturbances in people with anorexia. Psilocybin-assisted psychotherapy is showing promise at modifying the serotonin disturbances and cognitive inflexibility that have been shown to be problematic in anorexia.

Research with animals can provide unique insights into the brain which can sometimes not be investigated in living humans. But animal models can never truly mimic human behaviour and the complex nature of chronic mental health conditions.

What’s next for research?

Further clinical trials in humans are very much needed – and are underway from a research team at the University of Sydney and ours at Swinburne.

Our trial will involve an initial 5mg dose followed by two subsequent doses of 25mg, several weeks apart. An initial low dose aims to help participants prepare for what is likely to be a new and somewhat unpredictable experience.

Our trial will examine the usefulness of providing psychotherapy that directly addresses body image disturbance. We are also investigating if including a family member or close friend in the treatment increases support for their loved one.

Drazen Zigic/Shutterstock
We’re investigating whether including a family member or close friend in treatment could help. Shutterstock

Data from other mental health conditions has suggested that not everyone sees benefits, with some people having bad trips and a deterioration in their mental health. So this treatment won’t be for everyone. It’s important to work out who is most likely to respond and under what conditions.

New trials and those underway will be critical in understanding whether psilocybin-assisted psychotherapy is a safe and effective treatment for anorexia, and the optimal conditions to improve the patient’s response. But we are some way off from seeing this treatment in the clinic. One of the big issues being the cost of this intervention and how this will be funded.

Susan Rossell, Director Clinical Trials and Professor Cognitive Neuropsychiatry Centre for Mental Health and Brain Sciences, Swinburne University of Technology and Claire Finkelstein, Clinical Psychologist and PhD candidate, Swinburne University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Moore’s Clinically Oriented Anatomy – by Dr. Anne Argur & Dr. Arthur Dalley

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  • Eat to Beat Depression and Anxiety – by Dr. Drew Ramsey

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    Most of us could use a little mood boost sometimes, and some of us could definitely stand to have our baseline neurochemistry elevated a bit. We’ve probably Googled “foods to increase dopamine”, and similar phrases. So, why is this a book, and not just an article saying to eat cashews and dark chocolate?

    Dr. Drew Ramsey takes a holistic approach to health. By this we mean that to have good health, the whole body and mind must be kept healthy. Let a part slip, and the others will soon follow. Improve a part, and the others will soon follow, too.

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  • Almond Butter vs Cashew Butter – Which is Healthier?

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    Our Verdict

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    Pancakes have a bad reputation healthwise, but they don’t have to be so. Here’s a very healthy crêpe recipe, with around 20g of protein per serving (which is about how much protein most people’s body’s can use at one sitting) and a healthy dose of fiber too:

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    For those interested in some of the science of what we have going on today:

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  • How To Really Look After Your Joints

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    The Other Ways To Look After Your Joints

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    Reduce inflammation, have happier joints

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    Wrap up warmly and… No wait, skip that.

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    Note that this can be just localized, so for example if the problem joints are your wrists, a washing-up bowl with water and ice will do just nicely.

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  • Is Dairy Scary?

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    Is Dairy Scary?

    Milk and milk products are popularly enjoyed as a good source of calcium and vitamin D.

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    Dairy & Cancer

    Evidence is highly conflicting. There are so many studies with so many different results. This is partially explicable by noting that not only is cancer a many-headed beast that comes in more than a hundred different forms and all or any of them may be affected one way or another by a given dietary element, but also… Not all milk is created equal, either!

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    • There’s a probable association between diets high in calcium and increased risk of prostate cancer
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    • The decrease in cancer seems to be mostly, if not exclusively, from fermented dairy products. This usually means yogurts. The benefit here is not from the milk itself, but rather from the gut-friendly bacteria.

    You may be wondering: “Hardened arteries, gut microbiome health? I thought we were talking about cancer?” and yes we are. No part of your health is an island unrelated to other parts of your health. One thing can lead to another. Sometimes we know how and why, sometimes we don’t, but it’s best to not ignore the data.

    The bottom line on dairy products and cancer is:

    • Consuming dairy products in general is probably fine
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    Dairy and Heart Disease

    The reason for the concern is clear enough: it’s largely assumed to be a matter of saturated fat intake.

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    Dairy and Osteoporosis

    Does dairy cause osteoporosis? Research here tends to fall into one of two categories when it comes to conclusions, so we’ll give an example of each:

    1. “Results are conflicting, saying yes/no/maybe, and basically we just don’t know”
    2. “Results are conflicting, but look: cross-sectional and case-control studies say yes; cohort studies say maybe or no; we prefer the cohort studies”

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    1. Osteoporosis: Is milk a kindness or a curse?
    2. Consumption of milk and dairy products and risk of osteoporosis and hip fracture

    Conclusion: really, the jury is very much still out on this one

    Summary:

    • Moderate consumption of dairy products is almost certainly fine
    • More specifically: it probably has some (small) pros and some (small) cons
    • Yogurt is almost certainly healthier than other dairy products, and is almost universally considered a healthy food (assuming not being full of added sugar etc, of course)
    • If you’re going to have non-dairy alternatives to milk, choose wisely!

    That’s all we have time for today, but perhaps in a future edition we’ll do a run-down of the pros and cons of various dairy alternatives!

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