How Plant Medicine Can Treat Eating Disorders: Neuroscience, Psychedelic Science and the Science of Healing
We need a new way of treating eating disorders. Maybe it’s more accurate to say that we need a way of treating eating disorders, full stop. At present, there is no agreed-upon way of treating EDs, although there is usually some combination of biological, pharmacological, and psychological interventions that include nutrition, medication and some kind of talk therapy with or without the family or primary caregiver.
Eating disorders are also sometimes laced with other mental health conditions like anxiety, OCD, depression, and other forms of addiction (such as substances, exercise, or work). Additionally, when we consider the impact of cultural pressures, media messages, suppressing gender norms, sexism, ageism, ableism, racism, fatphobia and weight discrimination, we see that what we are swimming in is super complicated, complex, nuanced, and tender. It is important to consider the intersectionality of all these factors on an individual and collective level that fuels internalised and externalised oppression. Oh, how about adding in a dose of intergenerational trauma too. What a stew we have!
Recovery is thus a multi-layered journey that calls for a multi-disciplinary team to work through the many threads that have woven together as the reality of an eating disorder.
With the highest death rate of any mental disorder, and around 50% of people never fully recovering, we must ask, what now?
Phew, ok there’s a lot going on! Let’s take a breath together. It’s going to be fine, and we will get through this together. And it all starts with giving ourselves permission to acknowledge the grief, the anger, the confusion, the hopelessness, the fight, the flight, the freeze. By acknowledging the feels, we give them space, and with this extra breathing room, we give the feeeelz room to move. But there’s one thing about those of us with eating disorders: we don’t like to feel. We don’t like to feel our emotions and sometimes we can’t even recognize or name them (tip: start developing a language of these sensations. You can literally search “body sensations” on the web, find a list and start incorporating them in your day).
Being out of touch from our feelings keeps us floating outside of our bodies – a kind of dissociation, or disembodiment. This is quite convenient for the eating disorder as this is exactly what it wants. Yet, by walking the road of recovery, there is the inevitable moment where one has to come face-to-face with the body. There is a point where the talk therapy ends and the meeting of the body begins on a very raw, somatic, tangible “this is my body” kinda way. Starting to feel somatic sensations of emotion can be one of the hardest parts of recovery because feeling the emotions can be scary and overwhelming - like everything is spilling over. And this is sometimes messy but rewarding phase of embodiment.
There are many ways to start this process of re-embodying. You can read my article on Embodied Eating Disorder Recovery here where I go into greater depth on this subject. For now, I would like to talk about one of my favourite topics: the intersection of ED recovery, plant medicines (or psychedelics) and embodiment as a way of approaching eating disorder treatment.
Psychedelics and eating disorder recovery are still very much in the early days, however what we know about psychedelic therapy is that it shows a promise to address a broad range of mental health conditions, indicative of psychedelics’ transdiagnostic action. Curiously, psychedelics and plant medicines seem to go beyond focusing on the symptoms and go straight to the root cause through their abilities of relax higher-level beliefs and liberate bottom-up wisdom to flow. Literal ninja magic!
This provides beautiful relief for individuals with eating disorders. More on this in a second, so hang in there, and let’s keep exploring.
Let’s cue in some neuroscience basics for this next section. I found that understanding “what is under the hood” (aka the underlying mechanisms) I feel more empowered to take inspired, educated actions towards my recovery, along with feeling confident to choose which healing tools would be best suited for me based on my current circumstances.
Brain scans show those with EDs have decreased neural activity in ventral reward regions and increased neural activity in prefrontal control regions. These imbalances may speak to the rigid, controlling diet and exercise regimes that we see in individuals with eating disorders, that is excessive behavioural control and diminished cognitive flexibility (this seems to be prevalent for those with anorexia nervosa).
Studies done on the reward centers in the brain in people with anorexia shows both hyporesponsiveness to reward and different ways of relating to reward, for example: positive stimuli become aversive and vice versa, such that the feeling of hunger becomes rewarding. This speaks to the chemical, dopamine, that if disturbed causes repetition of behaviour (eg. food restriction), hyperactivity (eg. excessive exercise), and anhedonia (aka decreased sense of pleasure).
There also seems to be links between people with EDs and abnormal serotonin levels which is associated with anxiety, depression, impulsivity, insomnia, low self-esteem, and poor appetite. For people with bulimia, there is a tendency for lower levels of serotonin while people with anorexia, there may be higher serotonin levels resulting in anxiety. This is why some people actually experience a sense of calmness when they starve: as one reduces calorie intake, serotonin levels decrease too.
Phew again! Let’s take another breath as we acknowledge all of the complexities that make us the humans we are, just trying our best to navigate this psychedelic experience we call life.
Recent clinical trials are showing us how psychedelics, like psilocybin (magic mushrooms) have a therapeutic potential for many mental health conditions. With ED’s neurobiological and behavioural signature of modified serotonergic signaling and cognitive inflexibility, it positions eating disorders well to be impacted by the healing effects of psilocybin mushrooms.
Psychedelics, like psilocybin, may help people with eating disorders by alleviating symptoms that relate to serotonergic signaling and cognitive inflexibility and help lay a foundation of desirable brain states that assist in accelerating the healing process. Exciting!
Plant medicines like psilocybin and ayahuasca, along with with the other cool kids, LSD, MDMA and ketamine, are all showing their therapeutic benefits in their own ways. One of the ways that psychedelics lend a helping hand is that they interrupt the default mode network (DMN), which is a network of interacting brain regions that is active when a person is not focused on the outside world. We can view it as the part of the brain that runs the show when we are on autopilot, or the “ego” in the brain. It governs our self-image, deeply ingrained beliefs and thought patterns. These patterns are so deep that we can’t even see them, hence they are automatic and form the foundation of our feelings, thoughts, and behaviours. When the DMN takes a break and is downregulated, thanks to psychedelics, there is a pause. The eating disorder behaviours can be seen in a new light. All of the rumination over food, calories, food rules, exercise, and body checking are shaken up, leaving a blank slate for new patterns to be laid down. There is a chance for new neural networks to connect, creating potential for a new reality, quite literally.
Additionally, sacred plant medicines and psychedelics can heighten our emotional state. Our near and far senses are increased, and we can feel so much more. Why is this a good thing? Well, our brain remembers experiences that have a higher emotional quotient. This is why traumatic events have such high stickiness in our brain and our body. In psychedelic experiences we can leverage this higher emotional state along with visualisation techniques to embody the person, free of an eating disorder. We can visualise ourselves as healed and transformed in our mind’s eye and feel it in our body too; that is, embodying the felt sensations of someone who is completely free of an eating disorder. Holding that vision in a journey is a powerful healing technique. This is a superpower, promise. Practice this in your meditation or journal practices so that when the time comes to journey or sit in ceremony, you have practiced these visualisation and mental rehearsal skills. This type of focus requires practice (I’m currently working on this myself in my daily practice and microdosing morning flows), so practice, practice, practice!
All of this is super exciting for me. Knowing that there is hope for one of the hardest mental disorders to treat inspires me to keep walking on my own path of recovery. For many, many years, I believed there was simply no full recovery from an ED. I thought I would be living with it for the rest of my life. I held onto this belief tightly and it actually restricted my recovery process. The belief led to me think “well what’s the point in trying to recover if I never will” which led me to carry out certain actions that weren’t oriented towards recovery. It were the plants who showed me otherwise. I now believe it is possible for full recovery. And with this new belief, I think and act differently. Boom. New reality made.
Psychedelics are showing us that there is hope for eating disorder recovery. Wooohooo! While we are still in the early days of research for eating disorders specifically, there is a large amount of evidence from other studies as well as thousands upon thousands of personal anecdotes of how this medicine has improved the quality of people’s well-being and psychological health. I am so excited for what is it come.
Big thanks to researchers Adele LaFrance and Meg Spriggs who I am honoured to have met personally and whose work is trailblazing the way forward with ED and psychedelic therapy and research.
Photo by Daniel Öberg on Unsplash