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The visionary ayahuasca state has been linked to a number of healing effects. It seems as if the profound mystical experience of an ayahuasca trip can help people confront trauma, reduce anxiety, and gain a fresh sense of purpose and meaning in life.
Eating disorders are widespread conditions with high fatality rates, and are often associated with other mental health conditions like depression, self-harm, and addiction. Most eating disorders have a physical toll on the body, as well as a potentially deadly toll on the mind. Around 5% of Americans will develop an eating disorder in their lifetimes, with many more women and girls affected than men or boys.
Treatments for eating disorders are of limited effect in some patients, and many people will drop out or relapse. With ayahuasca already looking like it could be a groundbreaking treatment of depression, could it also be a tool to help people with eating disorders get healthy?
Research into Ayahuasca and Eating Disorders
Public health expert Dr Kenneth Tupper oversaw the first ever study of ayahuasca’s potential to help people heal from eating disorders, published in late 2017. Dr Tupper has been working in psychedelic research for over 20 years, and is a vocal advocate for the benefits of psychedelics in improving health, education, and community cohesion.
The study, co-led by psychologist Dr Adele Lafrance, interviewed 16 people who had participated in an ayahuasca ceremony while they were suffering from an eating disorder. 13 of them had previously sought treatment for their eating disorder, unsuccessfully. Most of them had drunk ayahuasca more than once.
11 out of the 16 people interviewed said that their experience with ayahuasca helped to reduce their eating disorder symptoms. Half of them said that they also felt improvements in other concurrent mental health conditions – including depression, anxiety, self-harm, suicidality and addiction.
Most people reported that the reason ayahuasca was so healing was because it helped show them the root causes of their eating disorders. In the words of some of the participants:
“I remember having a ceremony where I really saw that at the time bingeing and purging and restricting were actually adaptive coping mechanisms; at the time, they were the only coping mechanisms that I actually knew to use to deal with the difficulty that I was experiencing, that I had no words for and that no one was asking about.”
“Ayahuasca helped me deeply connect with myself so that self-love has been the prevalent priority over self-criticism […] self-love became more important and more prevalent. And that to me is the antidote for an eating disorder.”
“I saw myself as a rotting, decaying skeleton and then I saw myself as this beautiful full-bodied, just beautiful woman with this long hair, and I, like, I wanted to be that woman. I wanted to be that full, loving woman that has so much to offer my family and world. It was, and then I felt my ribs and I could feel them, they were so hollow and I was just, I was like, I can’t wait to get back and just start gaining some weight.”
An Unusual Choice for an Eating Disorder Treatment?
Ayahuasca may seem like an imperfect treatment for an eating disorder at first glance – due to its purgative effects. This was certainly a concern for some of the study leaders and for the ayahuasca practitioners themselves, who thought that the restrictive dieting prior to the ceremonies and the purging during the ceremonies could be triggering for the participants.
However, none of the participants reported problems with the purging aspect of the experience. They found it easy to differentiate between an eating disorder purge, and the purge of an ayahuasca experience.
Dr Tupper highlights the difference in perspectives between ayahuasca facilitators and eating disorder experts:
“While ayahuasca facilitators were concerned about the purge in particular for patients with bulimia, eating disorder experts struggled more with understanding the ceremonial context in which most people experience ayahuasca. It is totally outside the normal treatment paradigm.”
But the preliminary results suggest that ayahuasca can help some eating disorder patients overcome their condition; despite the unusual ceremonial aspects, and the involvement of traditional preparatory diet restriction, and purging after drinking the brew.
What Do These Results Mean?
There is a limit to what we can take from these results. But the authors are clear on this too – Dr Tupper states:
“We are under no illusions, as this was a preliminary trial. There is no way of knowing how much the self-selection bias or other factors affected the results. The gold standard for determining therapeutic efficacy would be a randomized control trial.”
Yet the fact that most of the participants reported deep and effective insight into their own conditions is an exciting finding for therapists. Ayahuasca appeared to give sufferers the ability to directly address their emotions, and to find motivation for change: two things that people with eating disorders often struggle with.
The study is also encouraging for proponents of holistic health approaches. Holistic medicine asserts that mental health is about more than just chemistry. As Dr Tupper explains:
“The etymology of the word ‘health’ comes from the word ‘whole.’ There is a growing acceptance of the concept of holistic wellbeing in modern medicine; especially in Canada, where traditional indigenous wellness approaches are being revitalized among First Nations peoples. The latest scientific research in the re-emergence of psychedelic medicine has shown a link between the mystical experience and healing – this may be an important step in the acceptance of holistic approaches in mainstream health sciences.”
As the researchers acknowledge, their preliminary study was not ideal. It involves self-selection of participants, which may skew the results towards the positive. The study also primarily recruited well-educated white people from North America.
However, Dr Tupper hopes that these qualitative reports about the power of ayahuasca to produce a mystical and healing experience for sufferers of eating disorders will help to pave the way for further research. Ultimately, it could catalyze the acceptance of holistic therapies using psychedelics in the treatment of a number of different health conditions.
The Future of Ayahuasca Therapy
There is a lot of work to do before ayahuasca therapy can be given as a treatment to sufferers of eating disorders.
Clinicians need to educate themselves about ayahuasca, so that they can help those patients who may independently decide to use it in their own healing journeys. This will in turn produce a greater understanding of the ways therapists can start to help patients integrate their experiences from ayahuasca ceremonies into their practice.
All participants in the study mentioned how important it was that the ceremonies they attended felt safe; with strong leadership, and minimal risks. Many felt safest in the presence of a medical professional or therapist. This highlights the need for ayahuasca therapy to be carefully guided, and for facilitators to be highly ethical and professional. The real risks of abusive or negligent facilitators should always be addressed, but especially so for vulnerable people who are seeking healing.
There are many other risks that are associated with the expansion of ayahuasca. As Dr Tupper puts it:
“Ayahuasca today may be where yoga was 40 years ago. Its adoption into modern culture might end up being a double-edged sword if it goes the same way as yoga.”
The double-edged sword is real. People are already reporting unethical and exploitative appropriation of ayahuasca for profit, or misguided attempts at marketing its healing properties as a cure-all. Although globalization of ayahuasca can bring healing, there is a risk of our capitalist and colonial systems using its rising popularity to do great harm.
Dr Tupper also warns against the notion that ayahuasca can only help people who are at “rock bottom.” Some people feel as if ayahuasca should only be recommended to people who have tried every other approach, and are in a truly desperate situation:
“There is a danger of that idea. It can encourage risky behaviors, or encourage the stigma that healing is not deserved except by those in the most dire circumstances. ‘Rock bottom,’ in the case of eating disorders and substance use disorders, can be death.
It’s really important to illustrate the potential benefit of ayahuasca in healthy people too, so we don’t get into the ‘rock bottom’ mindset that only the people in terrible trouble can be helped by it.”
Hopefully this research, and further research like it, will be a step towards the approval of ceremonial ayahuasca use as beneficial for both healthy and suffering people.
 Galmiche et al (2019) Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. The American Journal of Clinical Nutrition, 109(5), p1402-1413. Retrieved from: https://academic.oup.com/ajcn/article/109/5/1402/5480601
 Lafrance et al (2017) Nourishing the spirit: exploratory research on ayahuasca experiences along the continuum of recovery from eating disorders. J Psychoactive Drugs, 49(5), p427-435. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/28895501