Psilocybin and eating disorders — patient experiences and the research landscape

The Imperial trial (published 2023) enrolled 10 patients with severe, chronic anorexia nervosa (average illness duration over 18 years — these were people for whom nothing had worked). All 10 completed two psilocybin sessions with structured psychological support. At 1 month: 6 of 10 showed clinically significant improvement in eating disorder symptoms. At 3 months: improvements sustained in most completers. A remarkable signal given the population — though Phase 2 trials are needed.

My personal experience: I have a history of anorexia and did psilocybin in a supported setting without specifically targeting my ED. The most useful thing that happened was a shift in how I experienced my body — less as an object to be controlled and more as something I inhabit. I can't say this happened because of psilocybin specifically, but the shift in body relationship was real and different from what years of therapy had achieved.

Important caution: the restrictive behaviors of anorexia often include very low body weight, which creates medical risks (cardiac arrhythmias, electrolyte imbalances) that interact with psilocybin. Any psilocybin-assisted therapy for eating disorders requires careful medical screening. The Imperial trial had strict weight thresholds — patients at the most extreme underweight were excluded.