# Psilocybin Treatment as an Adjunct to Cognitive Behavioral Therapy for Eating Disorders: Therapeutic Rationale & Considerations for Protocol Development

## TL;DR

This paper explores using psilocybin to improve cognitive behavioral therapy for eating disorders by increasing engagement and reducing dropout rates.

## Contribution

The paper is the first to consolidate theoretical evidence for combining psilocybin treatment with CBT for eating disorders.

## Key findings

- Psilocybin may enhance CBT-ED through antidepressant and neuroplasticity effects.
- The review proposes a protocol for concurrent psilocybin and CBT-ED treatment.
- The approach could improve treatment outcomes and advance psychedelic-assisted psychotherapy research.

## Abstract

Eating disorders (EDs) remain challenging to treat, with high dropout and low remission rates in cognitive-behavioral therapy for EDs (CBT-ED). Psilocybin treatment (PT) demonstrates therapeutic potential to enhance CBT-ED by exerting several neurobiological, psychological, and experiential effects (e.g., antidepressant, neuroplasticity, emotional openness) that are hypothesized to increase psychotherapeutic engagement, reduce dropout, and improve clinical outcomes. This narrative review provides the first consolidation of theoretical evidence for PT/CBT-ED, proposes considerations for a concurrent intervention protocol, and presents clinical and research considerations to empirically test its feasibility, safety, and efficacy. This line of inquiry is expected to advance the development of approaches that improve ED treatment outcomes and, more broadly, advance the study of psychedelics as tools to enhance evidence-based psychotherapy models.