Can Psychedelics Like MDMA Cure Eating Disorders?

This article was originally published on Psychedelic Spotlight and appears here with permission.

Multidisciplinary Association for Psychedelic Studies (MAPS) published a study which found that MDMA-assisted therapy significantly reduced symptoms of eating disorders.

Anyone who has ever suffered from an eating disorder, such as anorexia or bulimia, knows that beating the mind virus is a constant struggle. While therapy can help some, for many, the situation can seem hopeless.

But it need not be.

Now, a new tool is coming into focus that may be able to help those engaged in mental civil war: psychedelics. Specifically, evidence is emerging that MDMA, sometimes referred to as ecstasy, when combined with therapy, can effectively treat a range of eating disorders.

The need for an effective treatment is high. Far from being a throwaway joke, as presented in films such as Zoolander, eating disorders like bulimia and anorexia destroy lives. In fact, they are the second deadliest mental illness, after opioid addiction. Tragically, 26% of Americans with eating disorders make an attempt on their own life, and each year 10,200 succeed. That’s one death every 52 minutes. Finally, these disorders are extremely prevalent, with an estimated 9% of the American population expected to battle with one at some point in their life.

Despite the apparent hopelessness, this March, the Multidisciplinary Association for Psychedelic Studies (MAPS) published a study which found that MDMA-assisted therapy significantly reduced eating disorder symptoms. 

The study was part of the nonprofit’s Phase 3 clinical trial attempting to treat PTSD. According to MAPS, PTSD and eating disorders are highly comorbid, meaning that often those who have PTSD also have an eating disorder. Of the 90 PTSD patients in the trial, 46.5% had symptoms of eating disorders either in the clinical or high risk range.

Severity of eating disorder symptoms was measured using a scale called the EATS-26 assessment. Scores can range from 0-78, with a lower score indicating fewer symptoms. Those with a score of 20 or higher most likely have an eating disorder, while scores of 11-19 indicate that a person is at high risk. Of those who received the MDMA treatment, as opposed to the placebo group, there were 12 participants with a score between 11 to 19, and five who had a score of 20 or higher.

Of the five patients who received MDMA that had a diagnosable EATS-26 score, four of the five improved enough to drop their score below the threshold for an eating disorder diagnosis. This compares to the placebo group, where all 6 participants with clinically relevant symptoms remained in a diagnosable category. This shows clearly that the MDMA has a measurable effect on treating eating disorder symptoms, at least in those with more severe symptoms.

In the 12 patients in the MDMA group that had a score of 11-19, after treatment, the number had fallen to six, while of the 12 in the placebo group, after treatment there were still 11 patients with a score of 11 or higher. Again, this shows that MDMA treatment clearly had a positive effect on lessening eating disorder symptoms.

So, does this mean we have found a cure to conditions such as anorexia and bulimia? Well, unfortunately, this evidence is by no means conclusive. First, all patients had PTSD, so if the eating disorders were solely a symptom of PTSD, and the MDMA therapy effectively treated PTSD, then the eating disorder may also disappear. We would need to see data on MDMA treatments for those who only suffer from eating disorders before making more definitive statements.

Second, the sample size was very small, with only 11 patients with diagnosable eating disorders, and 24 who were at risk. Any future studies must have a larger population to ensure that any change is not due to dumb luck. Or, put more scientifically, to ensure that there is statistical significance.

Luckily, we already have several studies planned to dig deeper into this subject. First, MAPS themselves have a Phase 2 study in the works to test treating eating disorders with MDMA. I am very excited to see this data, as it will be our best indication yet of whether MDMA therapy can treat eating disorders. But the psychedelic potential isn’t necessarily limited to MDMA. For example, the company Compass Pathways is set to launch a Phase 2 trial attempting to treat anorexia using psilocybin. 

Though we of course need more data, it makes sense that MDMA therapy may be able to treat eating disorders. It has been hypothesized that eating disorders often are rooted in deep seated trauma. For example, a perceived failure to live up to particular beauty standards as a child, causing internal shame and self loathing that persists into adulthood.

The reason MDMA and other psychedelics have been successful in treating mental conditions such as PTSD, depression, and addiction, is that these substances allow you to face your trauma head-on, to come to terms with it and ultimately accept it. In this context, expanding psychedelic therapy to treat eating disorders makes sense.

Though we are still early, this data is very promising. Perhaps in the future, we will be able to say that MDMA therapy is an effective treatment for eating disorders.