Ketamine Therapy for Eating Disorders

Eating disorders like anorexia nervosa, bulimia nervosa, and binge-eating disorder leave many stuck in cycles of unhealthy food intake, body obsession, and declining mental and physical wellness. Traditional treatments often fail to help, which is why researchers are looking at ketamine therapy. Twenty-five years of clinical data prove ketamine’s fast-acting antidepressant effects. Now, emerging research suggests ketamine may also help people with eating disorders by reducing obsessive thoughts about food and weight and even promoting weight restoration.

In recognition of Eating Disorder Awareness Week, this article explores this growing health crisis in the U.S. and how ketamine therapy might offer a new path to eating disorder (ED) recovery.

Who Experiences Eating Disorders the Most?

Roughly 9% of the U.S. population, or 28.8 million Americans, will experience an eating disorder in their lifetime. Additionally, eating disorders (EDs) have among the highest mortality rates of any psychiatric condition, with an estimated 10,200 deaths in the U.S. in 2018-2019. Anorexia nervosa (AN), in particular, carries the highest risk of death. Despite the impact, many people remain undiagnosed or untreated due to bias, stigma, and confusion about who is most at risk.

Eating disorders are often associated with young, white, underweight women.  However, research shows they affect people across all genders, races, body sizes, and socioeconomic backgrounds. In fact, higher-weight individuals, ethnic minorities, and LGBTQ+ members are more likely to struggle with ED than lower-weight, white, heterosexual people. Additionally, military members, veterans, and athletes have the highest in-group eating disorder rates. 

Women vs. Men: Eating disorders are twice as common in women, but rates in men are rising faster than in women. 4% of U.S. males—6.6 million men—will develop an eating disorder, yet men are less likely to seek treatment due to stigma and misdiagnosis.

Racial and Ethnic Minorities: Black, Indigenous, and People of Color (BIPOC) individuals experience higher rates of disordered eating than white people but are half as likely to receive a diagnosis or treatment. Racial discrimination increases the risk, particularly for binge eating disorder (BED).

LGBTQ+ Community: LGBTQ+ people experience higher rates of eating disorders than their heterosexual counterparts. Transgender college students are four times more likely than their cisgender peers to report an ED diagnosis. Body dissatisfaction affects 87% of LGBTQ youth.

Higher-weight Individuals: People with higher body mass indices (BMIs) are 2.45 times more likely to engage in disordered eating behaviors than those with smaller bodies. Unfortunately, they are diagnosed half as often and receive delayed care due to weight stigma.

Children and Adolescents: 22% of youth globally struggle with disordered eating. Early intervention is crucial, as dieting in adolescence increases the risk of developing an eating disorder fivefold.

Veterans and Military Personnel: One-third of female veterans and one-fifth of male veterans report eating disorder symptoms, often linked to trauma and rigid military weight standards.

Athletes: Up to 45% of female athletes and 19% of male athletes experience eating disorders, with performance pressure and body expectations fueling dangerous behaviors.

Addressing eating disorders requires safe, tailored, inclusive, and stigma-free screening, diagnosis, and treatment. Ketamine therapy is one of those approaches. 

The Link Between Eating Disorders and Ketamine

Eating disorders stem from intricate neurobiological mechanisms linked to imbalances in brain networks that govern reward, self-control, and emotional processing. Ketamine’s ability to modulate these brain pathways opens up a compelling avenue for eating disorder treatment, especially for people who haven’t responded to conventional pharmaceuticals.

Anorexia 

Ketamine therapy appears to help treat anorexia nervosa by addressing both treatment-resistant depression (TRD) and the rigid thought patterns that perpetuate disordered eating behaviors. Several case reports and series have illustrated this effect.

1998 (Mills et al.) – One of the first reports on ketamine for anorexia followed 15 patients with chronic, hard-to-treat anorexia. Some received 2–15 ketamine infusions (20 mg/h over 10 hours) and showed partial remission of depression and obsessive-compulsive behaviors. The treatment seemed to help, but some patients relapsed.

2021 (Schwartz et al.) – A small case series followed four patients with severe anorexia or EDNOS (Eating Disorder Not Otherwise Specified) who also had TRD. They received multiple IV or IM ketamine doses over 12+ months and reported moderate improvements in depression, anxiety, and eating disorder symptoms.

2021 (Scolnick et al.) – A 29-year-old woman with severe, long-term anorexia saw complete remission of her depression and obsessive-compulsive tendencies after four IV ketamine infusions. Interestingly, she was also on a ketogenic diet, which may have played a role in her recovery.

2024 (Timek et al.) – A 33-year-old woman with severe and enduring anorexia (SE-AN) and TRD, who had failed multiple antidepressants, therapy, and electroconvulsive therapy, showed improved mood, increased cognitive flexibility, and reduced suicidal ideation after seven IV ketamine sessions in a hospital setting.

Bulimia Nervosa

Ketamine may have a similarly positive impact on people with bulimia nervosa (BN). Most ketamine therapy evidence is limited to case series and reports on AN. However, one published case report shows that ketamine therapy helped eliminate compulsive binge-eating episodes, rigid thought patterns, and associated distress.

2021 (Ragnhildstveit et al.) – A 21-year-old woman with extreme and long-term bulimia (40 binge-purge episodes per day) received 18 ketamine-assisted psychotherapy (KAP) sessions over three months Sessions combined with IV ketamine (0.5 mg/kg) with structured psychotherapy. The patient completely stopped bingeing and purging and maintained recovery for over a year—one of the most striking cases of ketamine’s potential in BN.

Specifically, she reported feeling “free” from intrusive BN thoughts and compulsions, “less impulsive” when faced with the urge to binge and purge, and “more confident” about her body in general. The patient has resumed academic studies in preparation for a doctoral program.

Eating Disorder Subgroups

Ketamine has the potential to work for all broader eating disorder groups, anorexia nervosa, bulimia nervosa, binge eating disorder (BED), and avoidant/restrictive food intake disorder (ARFID) due to its unique neurobiological mechanisms and its ability to address core underlying factors shared across different ED subtypes. Rather than targeting just symptoms, ketamine influences deeper brain circuits.

Ketamine’s Mechanisms of Action for ED

Ketamine changes how the brain uses glutamate, a key chemical that helps neurons communicate. It increases glutamate in some areas, which can promote brain flexibility and learning, while reducing excessive glutamate activity in others, which may lower stress and anxiety. 

Neuroplasticity: Ketamine promotes neuroplasticity—the brain’s ability to rewire itself and form new, healthier connections. This heightened neural flexibility makes it easier to shift away from obsessive thoughts and challenge harmful beliefs about food, weight, and self-worth.

Neurogenesis: Ketamine promotes the growth of new neurons. Researchers think this function could counteract the brain volume loss seen in anorexia nervosa due to prolonged malnutrition.

Synaptogenesis: Ketamine strengthens communication pathways between brain cells, reinforcing healthier ways of thinking and processing emotions. This improved connectivity can support better emotional regulation and decision-making, in turn reducing impulsive reactions to food, weight, and body image.

Reduced Anxiety and Depression: Anxiety and depression often coexist with eating disorders, making recovery more difficult. Ketamine’s rapid-acting antidepressant effects can help stabilize mood, reducing the distress that fuels disordered eating behaviors.

Future Directions for Ketamine in ED Treatment

Ketamine shows promise as a treatment for eating disorders. However, research is still in its early stages. Scientists must answer key questions about ketamine’s effectiveness and best use in ED clinical settings.

Expanding Research: Most current studies on ketamine for eating disorders are small or anecdotal. Larger, well-controlled trials are essential to confirm its effectiveness and understand its full potential.

Optimizing Treatment: Researchers have not yet determined the best dosage, frequency, or duration for ketamine treatment in eating disorders. Individualized approaches will be key to maximizing benefits while ensuring safety.

Evaluating Long-Term Impact: Scientists still do not know whether ketamine’s positive effects on mood and cognition last over time. More research is needed to assess the long-term outcomes and potential risks of repeated use.

Integrating Care: Ketamine should complement, not replace, existing eating disorder treatments. Combining it with psychotherapy, nutritional support, and other proven therapies will likely produce the best results.

Eating Disorder Treatment at Avesta Ketamine and Wellness

At Avesta Ketamine and Wellness, patients receive cutting-edge, compassionate care designed to support lasting recovery from eating disorders. Our ketamine therapy program helps people reduce anxiety around food, improve emotional regulation, and break free from unhealthy self-talk that drives eating disorders.

Personalized Treatment: Every patient receives a tailored approach that considers their unique history, symptoms, and recovery goals. Our team ensures that ketamine therapy integrates seamlessly with psychotherapy, nutritional counseling, and other essential treatments.

Expert-Led Care: Our experienced clinicians specialize in ketamine therapy for mental health conditions, using the latest research to guide treatment. Patients receive attentive, evidence-based care in a safe and supportive environment.

Whole-Person Healing: Recovery requires a team approach. Avesta partners with leading eating disorder specialists, psychotherapists, and integration providers throughout the DMV area. We offer trusted referrals to ensure patients receive comprehensive, ongoing care during and beyond ketamine therapy.

If you or a loved one is struggling with an eating disorder, Avesta Ketamine and Wellness is here to help. Contact our team today to learn how ketamine therapy can be part of a comprehensive, personalized treatment plan.