Why Disordered Eating Needs Psychedelic Treatment

Eating disorders are in crisis. Psychedelics might be the answer.

My son is a month away from graduating high school—just as I was, thirty years ago. Watching him move toward this milestone with a grounded sense of self has stirred up memories of my senior year, when I was deep in a silent, consuming battle with anorexia.

Disordered eating isn’t exclusive to women, but it does disproportionately impact us. And I can’t help but think that this imbalance-the gendered nature of who suffers—might explain why so little progress has been made in treating it. Anorexia is still the deadliest psychiatric disorder. Still without a single approved pharmacological treatment. Still stuck in therapeutic models that too often don’t work.

Thankfully, I didn’t remain stuck, and as an adult, I now understand these behaviors for what they were: an attempt to bring structure to the chaos of an undiagnosed ADHD mind. A way to impose order on the messiness inside.

This is why the recent research on psychedelics and eating disorders lands so profoundly for me. The way psilocybin works to disrupt entrenched thought patterns, ease cognitive rigidity, and soften harsh internal narratives—it just makes sense. The mechanisms of action we’re now beginning to map out reflect exactly what I needed back then: a pattern interrupt. A way back into my body and out of the loop of shame and control.

I share my personal history with this topic because I know I’m not alone. So many of us—especially women—have been managing, masking, and muscling through misunderstood or missed conditions. I created SetSet for women who are turning to psychedelics to make sense of themselves, their choices, and their lives.

If you’ve lived with disordered eating—or love someone who has—I hope this week’s post offers insight, maybe even some hope.

🔵 Eating Disorders Are in Crisis. Psychedelics Might Be the Answer.

We are facing what researchers now call a “crisis in care” for eating disorders—especially anorexia nervosa. The numbers are stark. Suicide rates are elevated, recovery is elusive, and relapse is common. There are no FDA-approved medications for adult anorexia, and less than half of patients fully recover. For 1 in 5, the disorder becomes chronic, with minimal advancements in treatment over the past two decades (Nature Medicine, 2023).

Into this bleak landscape steps a new possibility: psychedelics.

More than a chemical shortcut or silver bullet, psychedelic therapy—especially psilocybin—offers something previously unseen in eating disorder treatment: the chance to disrupt entrenched patterns and invite a deeper sense of connection, empathy, and self-compassion.

What makes this moment so urgent? And why are so many eyes turning to psychedelics as a breakthrough?

🔵 Gender and Eating Disorders: Who's Affected?

Eating disorders disproportionately affect women, but they touch all genders.

• 70%–80% of diagnosed cases are among women and girls.

• Men account for 20%–30%, though likely underreported due to stigma and gender-biased screening tools (NIMH).

• Trans and nonbinary people are at even higher risk. One study found transgender college students were nearly 4x more likely than cisgender women to report disordered eating behaviors (Diemer et al., 2015).

Emerging psychedelic therapies must recognize and adapt to these disparities, making sure care is inclusive, trauma-informed, and affirming.

🔵 Why Current Treatments Fall Short

Eating disorders aren’t just about food or thinness—they’re about control, shame, and rigid cognitive patterns. In anorexia, we often see:

• Obsessive-compulsive traits (Steinglass et al., 2006)

• Disrupted interoception (Kaye et al., 2013)

• Hyperactive default mode network (DMN) activity (McFadden et al., 2014)

• Emotional avoidance and cognitive inflexibility (Sato et al., 2013)

These patterns are deeply ingrained and notoriously resistant to treatment. And while cognitive behavioral therapy (CBT) and family-based therapy (FBT) are considered first-line approaches, they often lose effectiveness in adults. Most pharmacological interventions—usually SSRIs—have limited efficacy, particularly when it comes to reversing core anorexic symptoms. Nutritional rehabilitation is essential, but it’s not enough.

In fact, no medication has ever been approved to treat anorexia, and therapeutic innovation has remained essentially stagnant for decades (Nature Medicine, 2023).

🔵 Why Psychedelic Therapy Feels Like a Breakthrough

Psychedelics don’t aim to manage symptoms—they aim to interrupt the internal narratives and neurological loops that perpetuate disordered eating.

Here’s how psilocybin works differently:

• Ego dissolution allows for the temporary release of fixed self-identities that fuel disordered eating (Carhart-Harris et al., 2016)

• Reduced Default Mode Network connectivity may ease compulsive rumination and body dysmorphia (Preller et al., 2020)

• Serotonin 5-HT2A receptor activation and BDNF increases support neuroplasticity, which is often disrupted in anorexia (Vollenweider & Kometer, 2010)

• Lowered amygdala reactivity may reduce emotional triggers tied to food and body image (Kraehenmann et al., 2015)

This isn't theoretical anymore. Early trials and case studies report significant, lasting shifts in perception and behavior in patients previously considered treatment-resistant.

Psychedelic therapy invites something other interventions don’t: a full reset of the story a person tells about their body and their worth.

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🎙️ Learn more about the Default Mode Network in this episode 🎙️

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🔵 The Role of Cannabis in Recovery

While psilocybin gets the headlines, cannabis plays a supportive role—particularly in recovery from anorexia or medication-induced appetite suppression.

Cannabis, especially THC, is well-known to stimulate appetite (Volkow et al., 2014). Low-dose edibles or hemp-derived beverages can offer gentle, functional support for eating when hunger cues are blunted. THC also interacts with the body’s ghrelin and leptin signaling, potentially helping to rebalance hunger and fullness cues (Bellocchio et al., 2013).

For many women in the SetSet community, cannabis isn’t recreational—it’s part of a ritual of repair. I’ve met so many women who rely on cannabis to reset their relationship with food and maintain a healthy weight after years of restrictive eating - and it works.

🔵 From Self-Loathing to Self-Connection

One of the most profound effects of psychedelic therapy is its ability to foster interconnectedness and compassion—directly countering the isolation and shame that fuel eating disorders.

Participants in early psilocybin trials describe a return to the body not as an object to control, but as a home to come back to. This emotional and somatic reorientation may be the most essential part of healing.

For individuals with obsessive-compulsive tendencies tied to food and control, the cognitive flexibility that psychedelics unlock may represent the first real shift in years.

As one participant in a recent psilocybin pilot study put it: “For the first time, I didn’t want to disappear.”

🔵 What Comes Next?

We’re still early. Clinical trials are ongoing. But the anecdotal reports are encouraging, the neuroscience is compelling, and the need is urgent.

If you or someone you love is navigating the long road of recovery, know this: psychedelic therapy isn’t a replacement for care—it’s an expansion of it. When done safely and with integration, it might become a cornerstone of the future of mental health.

SetSet exists because we believe women deserve better options, better tools, and better outcomes.

Take care,
April

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Are you looking to cut back on alcohol or cannabis? Maybe you’re stuck--in your job, relationship, on a loop in your mind? Me, too! This is why I sought out a clinician to create DIY mushroom and microdosing guides. And now these accessible downloads are bundled with my favorite mushroom chocolate.

Get started to get SetSet!