Article written for THE CUT, by Megan Zhang
The first time Sophia Anderson tripped on psychedelic mushrooms, she was 16 years old. It happened in late 2020, in the coastal jungle near Puerto Vallarta, Mexico, and the whole thing had been her mother’s idea. Under the influence, Anderson felt dazed and oddly at ease — which was disconcerting. For the last few years, her life had revolved around desperately and meticulously maintaining the carefully constructed reality inside her head.
Symptoms of Anderson’s eating disorder began to emerge when she was 14. After making the cut for the dance program at the performing-arts academy she attended in Phoenix, Arizona, Anderson threw herself into training. Over the next couple months, she grew increasingly fixated on her body and developed a pattern of not only restricting foods — first her Halloween-candy haul, then entire food groups — but exercising constantly. Her mother, Jennifer Jacobs, had even found Anderson, her eldest of two daughters, awake in the middle of the night doing leg lifts and sit-ups in her bed. “There was a part of me that felt that being skinnier or smaller would make people like me,” Anderson says. In ten weeks, she shed 20 pounds from her five-foot-seven frame and dropped to 103 pounds. (Both Anderson and Jacobs are pseudonyms.)
Her demeanor and personality changed, too. Anderson stopped socializing and became irritable and unruly, flying into hysteria when anyone interfered with her workouts or suggested that she should eat more. “She was always my sweet, mellow, laid-back little girl, and she just started to be full of rage,” Jacobs says. “I’d never seen her like that.” Eventually, in January 2019, Jacobs and her husband drove Anderson to an eating-disorder treatment center in Tucson — an in-patient clinic, which meant she had to stop attending school. Jacobs had scarcely let her daughter attend sleepovers before that. It was, she recalls, “probably the worst day of my life.”
In less than three months, Anderson had restored 20 pounds of weight. But upon returning home, she resumed old habits, like hiding food she claimed to have eaten. “She would look in the mirror and cry all the time about how fat she was and how she hated everything about the way she looked,” Jacobs says.
While there are FDA-approved medications for treating bulimia nervosa and binge eating disorder, there is nothing for anorexia nervosa — and the disorder has the highest mortality rate of all psychiatric illnesses. In addition, “we have almost nothing to offer in terms of proven psychological treatment,” explains Dr. Allan Kaplan, a senior clinician scientist at the Centre for Addiction and Mental Health in Toronto and a professor at the University of Toronto’s Department of Psychiatry.
There was a part of me that felt that being skinnier or smaller would make people like me.
While desperately searching online for treatment options, Jacobs stumbled upon a news story about a University of Arizona clinical trial that studied the impact of psilocybin mushrooms, or “magic mushrooms,” on patients with OCD (which Anderson had also been diagnosed with). The study is part of a growing area of mental-health research, which has so far mostly focused on illnesses like PTSD and depression; now, a growing number of researchers are seeing new potential for also helping eating-disorder patients. Jacobs couldn’t shake the idea that maybe the drug could finally jolt Anderson out of the labyrinthian narratives in which she was trapped. Clinical trials, though, require participants to be at least 18 years old, so Jacobs decided to look elsewhere.
That’s how she came across the Buena Vida Psilocybin Retreats in Mexico, where magic mushrooms are illegal for recreational use but permitted for traditional spiritual and ceremonial purposes. She pleaded with the owner, Amanda Schendel, to admit her daughter. Schendel, a white American woman originally from Orange County, California, had spent several years studying plant-based ceremonial healing with medicine people from Ecuador, Colombia, Peru, and Mexico. She herself had previously also struggled with disordered eating for years; with the help of psychedelics, “I’ve come to a place of peace with it,” says Schendel of her relationship with food and her body. She agreed to admit Anderson if Jacobs joined as a chaperone. As with many luxury psychedelic retreats, the plush amenities along with a trained staff (which includes facilitators, a chef, and a medical doctor who screens applicants) came with a hefty price tag: an all-inclusive, seven-day package cost approximately $1,000 per person per day.
Anderson had never heard of psychedelic mushrooms before, but she agreed to go with her mother to Mexico. She was intrigued by the possibility that the drug could improve her OCD symptoms, but her eating disorder was a different story.
For those with disordered eating, surrendering to the possible tearing down of the mental frameworks that govern their symptoms can be challenging, as “there is so much disconnection and dysregulation inside of the body,” says eating-disorder recovery coach and psychedelic guide Francesca Annenberg. Patients may perceive their rigid behaviors (like ignoring natural hunger signals in favor of obsessive calorie counting) as protection from things they fear, be it weight gain or loss of control.
Over the phone, Schendel explained to Anderson what the retreat would entail. “I didn’t really know what the psychedelic was going to do,” says Anderson. What she did know was “I was scared that it would mess up the eating disorder.”
The scientific journal Eating and Weight Disorders — Studies on Anorexia, Bulimia and Obesity published the first quantitative analysis of the psychological effects of psychedelics in eating-disorder sufferers in September 2020. The data “demonstrated overwhelming evidence for improvements in depression and well-being scores following the psychedelic experience,” researchers wrote.
There is no single cause of eating disorders, and illness profiles vary widely, but certain characteristics are common and help explain the diseases’ resistance to treatment. Eating disorders have significant genetic underpinnings, which intertwine with factors like life experiences, personality traits, and sociocultural influences. Clinical psychologist Dr. Adele Lafrance, who is researching the effects of psychedelics in eating-disorder sufferers, notes that many patients have difficulties expressing and modulating emotions; symptoms like restrictive dieting engender a sense of control that helps them regulate emotional stress, which “can lead to ruminative patterns around weight, body image, and calorie counts,” she explains. “In some ways, the eating disorder is an attempt at self-medication,” adds UCSF Benioff Children’s Hospitals pediatrician and psychiatrist Dr. Amanda Downey. By tampering with what the brain perceives as “rewards,” eating disorders rewire behaviors that should be aversive as beneficial actions.
So full recovery, researchers postulate, could require not just changing how patients eat or exercise but how they think.
Psychedelic drugs are known to quiet activity in the brain’s default mode network, a group of interconnected structures involved in various cognitive processing related to introspection and self-reflection. In eating-disorder patients, this network often upholds a negative self-image and encourages repeating maladaptive behaviors around eating, exercising, and weight monitoring. “The disorder hijacks neuronal systems in a pathologic way,” Kaplan explains. “No drug that we have now can break those connections. Psychedelics seem to be able to facilitate that.”
A psychedelic experience that disengages neuronal connections dictating patterns of thought can be a powerful respite for individuals who are, say, stuck in a pattern of obsessing over the appearance of their bodies. Moreover, a trip often heightens a sense of mind-body connection and thus helps patients get back in touch with physiological cues like hunger signals, explains Ben Greenberg, a clinical psychologist. But the impact of mushrooms doesn’t end during the trip itself. It’s in the weeks and months that follow when users examine what happened during the psychedelic experience that lasting effects can take hold. Meg Spriggs, a research scientist at the Imperial College London’s Centre for Psychedelic Research, calls this the post-acute phase: “You have this window of opportunity, after the psychedelic, where the brain is kind of more malleable and more plastic,” and perhaps more able to generate new neuronal connections and thinking patterns.
Still, the research is nascent. A team at UCSF is currently getting regulatory approvals for a new study that could be the first to research the impact of psychedelics on young adults with anorexia nervosa. Downey, the assistant medical director of the UCSF Eating Disorders Program, which is leading the study in conjunction with the UCSF Translational Psychedelic Research Program, explains that because young adults still have ongoing neurodevelopment, it’s important to make sure these drugs are safe and effective for them. Because “side effects and adverse effects are remarkably rare” in psilocybin use, she explains, and because psychedelic research is “slowly starting to make its way into more medically vulnerable populations,” researchers feel hopeful about moving their work into younger adults, an age group with an already high prevalence of disordered eating.
Jacobs and Anderson landed in Puerto Vallarta in November 2020. After a 40-minute shuttle ride, they reached Buena Vida’s luxurious oceanfront property on the lush peninsula of Punta Mita, where amenity-rich resorts dot the beaches. Upon arrival, Jacobs and Anderson attended a welcome orientation, during which staff explained the physiological and neurological effects of the mushrooms, which guests would be experiencing three times during the retreat.
In psychedelic medicine, “set and setting” — the former referring to mind-set and the latter to surroundings — are critical for ensuring a safe context for a productive trip. In the right conditions, brain plasticity can enable a positive impact, Spriggs explains. At Buena Vida, facilitators incorporated music, sound, and prayer into the psilocybin rituals, surrounding Anderson with vibrations to encourage her to enter a ceremonial headspace. According to Schendel, the rituals, coupled with the tranquil natural surroundings and the communal environment, help participants open their minds to the newness and wonder of the hallucinogenic experience — and surrender to the realizations that may present themselves.
The disorder hijacks neuronal systems in a pathologic way,” Kaplan explains. “No drug that we have now can break those connections. Psychedelics seem to be able to facilitate that.
The environment “opened my eyes to a more spiritual place,” Anderson says. She sensed the psychedelic cajoling her to loosen her grip, then saw visions in her mind’s eye of tight knots loosening. “I could see it kind of rewiring up there,” Anderson recalls. “Kind of letting go of being scared to, like, be me.”
After each ceremony, facilitators organized participants into small groups to unpack any revelations the trip had occasioned. “I felt so much more at peace,” Anderson says of those first psychedelic experiences. Her guides advised her to make time and space in the following weeks and months to tap back into that feeling, through meditation, journaling, and spending time in nature. After they returned home, Jacobs noticed an improvement in her daughter’s OCD symptoms. Compulsive behaviors didn’t dictate Anderson’s routines as much, and she was becoming more relaxed and independent — learning to drive and spending more time with friends. She also allowed herself to eat more food. “She wasn’t pushing back when we would give her meals. She wasn’t hiding food as much,” says Jacobs. After eating a big meal, though, “I would still feel really guilty about it the next day and I would restrict,” Anderson says. Still, the psychedelic experiences had begun poking holes in the narratives that had come to dictate her self-image. “I don’t think I was as angry with myself. And I wasn’t as angry with my parents. But I still definitely was only partially recovered,” she says. “I didn’t hate how I looked anymore, but I didn’t like how I looked.”
Healing is usually nonlinear, explains Annenberg, who treated her own disordered eating with help from psychedelics. “There are things that can happen months, years down the line that finally click,” she says, noting how deeply ingrained eating disorders often are.
A few months later, Anderson asked her mother if they could go back to Buena Vida. Jacobs, feeling encouraged by her daughter taking the initiative to further her own healing, agreed. Though the retreat was expensive, the price was comparable to a week of inpatient treatment, Jacobs rationalized, which would have cost the family $900 per day out of pocket. They returned to Mexico in April 2021.
For Anderson, this second retreat was even more powerful than the first. Though the setting was the same, her mind-set had shifted. This time, she was actively seeking help.
During one ceremony, the mushrooms encouraged her to “try to be kinder to myself and other people,” she recalls, and to let go of the expectations of others. “If they don’t like me, that’s okay.” The sense of newfound freedom that accompanied this epiphany sparked a song lyric from Taylor Swift to play on a loop in her head like a prophecy: “Sacred new beginnings that became my religion.” To better remember her insights, Anderson described them in a journal afterward: “I wrote that ‘skinny and toned is not necessarily good or perfect.’ That was hard for me to write down, I remember — admitting that,” she says.
But the final ceremony of the retreat was the most transformative one Anderson had yet experienced. It didn’t take long for what she describes as a feeling of empowerment and self-compassion to take over her senses. “I felt beautiful for the first time in forever, and I felt happy with myself,” she says. “Just so purely happy.”
After returning home, Anderson began to devote less attention to what her body looked like. “I realized that that feeling (from the final ceremony) was better than any feeling that the eating disorder had ever given me,” she says.
Looking back, Jacobs believes magic mushrooms gave her daughter a second chance. “It’s literally saved Sophia’s life,” Jacobs says — and Anderson agrees. “I’m not scared to eat anymore. I’m excited when my friends are like, ‘Hey, want to go eat ice cream?’ I eat what I want, and I eat when I feel like eating,” she says. “I want to be strong. I don’t just get the lowest-calorie thing — I get what’s going to support my body.” Her days no longer revolve around exercise and calorie restriction, and that has “made my life more exciting. It’s not all about food anymore.”
Now, nearly two years after her second trip to Mexico, Anderson’s eating- disorder symptoms are mostly gone. “We all have bad body-image days, but it’s so much less often, and I can see through it,” she says. During stressful periods at school, she sometimes takes a microdose (not enough to perceptibly “trip”) of magic mushrooms as a form of maintenance treatment, which Anderson feels may help prevent old symptoms from potentially resurfacing. As Greenberg explains, psychedelic healing doesn’t erase the impact of trauma, and “trying to persist in the illusion that ‘I’m completely over this by now’” can be dangerous territory. “Oftentimes, with eating disorders especially, it’s a lot more about remission and maintenance,” he adds.
While psychedelics look like one of the most hopeful interventions in the offing for those struggling with disordered eating and unhealthy body image, Kaplan of the Centre for Addiction and Mental Health cautions it’s much too early to celebrate. But he is hopeful. “Based on the neurobiology of anorexia, and how we know psychedelics work, there seems to be a reason to believe that this could work.” As Downey points out, psilocybin acts on the 5-HT2A serotonin receptor, which is “thought to be highly variable or mutated in anorexia nervosa.”
Her days no longer revolve around exercise and calorie restriction, and that’s “made my life more exciting. It’s not all about food anymore.”
It’s critical that research proving safety and efficacy in younger patients gets underway soon, Downey adds. “The longer patients go untreated, the longer they stay static, the worse the chance of recovery is down the line,” she explains.
By relying on currently legal and available treatments for the illness, many eating-disorder patients will never fully recover. Over a 20-year period, only 46 percent of people with anorexia will overcome the disorder and go on to lead a life with normal eating behaviors. Another third may experience a reasonable quality of life but will continue to exhibit symptoms, Kaplan says. The remaining 20 percent will suffer from what he calls severe and enduring anorexia nervosa — the same group, he says, that psychedelic treatment could help the most.
Considering the inadequacy of available treatments for anorexia nervosa patients and the illness’s high mortality rate, there is little to lose. “Of all the disorders in psychiatry, this is the one disorder where we really need to try something out of the box,” Kaplan says.
Anderson is now in her senior year of high school. She’s applying for colleges and plans to elect psychology as her major. “When people ask me what I want to do career-wise, I tell them I would love to do psilocybin-assisted therapy,” she says. “Mushrooms changed my life, and I’m forever grateful for that.”
“The great irony of having psychedelics and heroin together on the same “Schedule” is that the former has the potential to reduce the harm done by the latter— not to mention its lower-scheduled cousins — in a way that criminalization never will.”