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Anorexia nervosa. Bulimia nervosa. Binge eating disorder. These three eating disorders afflict people of all ages, ethnicities, and genders, and it is estimated that about 30 million Americans engage in some form of disordered eating to control perceived problems with weight and body image.
Eating disorders are also notoriously difficult to treat, with relapse rates after traditional treatment—which may include nutritional counseling, psychotherapy, hospitalization, and medication—estimated at around 40 percent. In fact, eating disorders have the most lethal morbidity of any mental illness, killing one people every 62 minutes. But some researchers studying psychedelic drugs are considering non-westernized healing methods to treat eating disorders, and they think ayahuasca, a psychoactive Amazonian tea that many believe to have mental health benefits, might provide some answers.
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“Psychedelic medicine is really old and has been the cornerstone of many cultures of the American continent and Native American medicines; medicines of the soul for cultural, religious and therapeutic purposes,” says Anja Loizaga-Velder, Ph.D., a founding member and director of research and psychotherapy at the Nierika Institute for Intercultural Medicine in Mexico.
Loizaga-Velder has been studying the therapeutic potential of psychedelic plants for the past 20 years. Last October, she was in New York City at the Horizons Psychedelic Conference to present some startling findings from a Canadian exploratory study on ayahuasca and eating disorders, published in the peer-reviewed Journal of Psychoactive Drugs. The report, called “Nourishing the Spirit: Exploratory Research on Ayahuasca Experiences Along the Continuum of Recovery from Eating Disorders,” revealed some compelling discoveries.
Ayahuasca is a powerful South American psychedelic tea and entheogen, a term ethnobotanists and mythologists apply to sacred plants like ayahuasca to denote its cultural sanctity. English botanist Richard Spruce first noted ayahuasca use in shamanic ceremonies in the mid-19th century, though it is believed its use goes back much further.
For the study, the authors found 14 women and two men with eating disorder diagnoses and a mean average age of 33.5. Ten of the participants had anorexia and the other six bulimia. All had previously participated in at least one ayahuasca ceremony—some multiple times—with a cohort average of 11 ceremonies. Most of the study participants, found through word of mouth, targeted list-serves, social media, and a project website, had been previously treated for their eating disorders, often repeatedly with little success.
The study’s researchers contacted participants by phone for an extensive interview, who then self-reported their previous ayahuasca experiences and gave researchers their personal evaluations as to whether ayahuasca had been of therapeutic value for their eating disorder.
The findings were intriguing. Loizaga-Velder told the Horizons audience that many in the cohort reported an improved connection with food and body image, though she did not state exact figures. Half of the participants also reported reductions in anxiety, depression, self-harm, suicidality, and problematic substance use. Overcoming dysfunctional patterns felt more within reach, and the group expressed motivation to continue therapy for their eating disorder.
One participant told researchers, “I would say that [the most important therapeutic elements were] the therapeutic trust in the medicine men and, as well, the follow-up. The psychotherapy follow-up was crucial. I don’t know if I would ever recommend an ayahuasca ceremony without that therapeutic [follow-up], the first one at least.”
The group also described a sense of inner peace and meaning, and revealed that they sensed a spiritual connection, something that comes up frequently in other psychedelic studies. “In the contemporary psychedelic research that’s being led by Johns Hopkins and NYU, who are looking at drugs like psilocybin for tobacco and alcohol, the therapeutic outcomes are correlated with mystical-type experiences,” says study researcher Dr. Kenneth Tupper, the director of implementation and partnerships at the British Columbia Centre on Substance Use, and an adjunct professor at the University of British Columbia’s School of Population and Public Health.
“Perhaps the secular approach around modern science isn’t fully encompassing all the dynamics at play with both addiction and eating disorders,” he continues. “And we certainly saw that in the reports with the subjects. They reported spiritual connection.”
"After doing ayahuasca, it’s not like I could say ‘Oh, because I’ve done ayahuasca I’m not going to diet anymore…' It was, well, I feel more able to be with myself. "
However, the researchers did have some concerns.The small participant sample size was a study limitation. Additionally, ayahuasca ceremonies are no walk in the park. Many of the physical effects can include rapid heart rate, agitation, and a loss of muscle control. Psychedelics also can induce a feeling of physical displacement, paranoia, and intense fear and anxiety as deeply buried emotional states may come bubbling to the surface.
Ayahuasca, sometimes referred to as “la purga” (“the purge” in Spanish) can induce diarrhea and vomiting, behaviors that perpetuate systems of eating disorder pathology. The “la purga” aspect of ayahuasca certainly seems counterintuitive for those seeking relief from their eating disorder, and the study’s authors did indeed have reservations about the food rituals accompanying traditional ceremonies, including abstinence from certain foods. “This is one of the questions that we had right off the bat,” says Tupper. But though it did reignite familiar patterns for some participants, many believed that it did not exacerbate their behavior, but felt more like an emotional “purge” on the path to wellness.
Another participant explained, “After doing ayahuasca, it’s not like I could say ‘Oh, because I’ve done ayahuasca I’m not going to diet anymore,’or ‘because I did ayahuasca I’m not going to compulsively exercise anymore.’ It wasn’t that—it was, well, I feel more able to be with myself. I feel more capable of experiencing my emotions. So that I don’t go to those behaviors that shove those emotions down that I don’t want to experience anymore.”
Loizaga-Velder points out that ayahuasca is not a panacea, but rather a therapeutic tool which can have positive or negative outcomes depending on how it is used and in what context. Until more conclusive studies can be done with a larger sample size, she cautions, “it is important not to encourage people with eating disorders to take psychedelics.” At this time, the researchers have no plans to move forward with their findings, citing the daunting regulatory hoops as barriers to studying controlled substances.
However, Tupper thinks the study’s findings are promising. “Given the morbidity and mortality [of eating disorders] there is certainly a need for additional tools in the toolbox for clinicians and people seeking treatment,” he says. “Our findings find we should be doing more research in this area.”