Obesity is a multifactorial disorder involving a behavioural aetiology in subsets of patients that traditional therapeutic approaches have failed to address. Drawing parallels with addiction, the rewarding aspects of a chronic energy-dense diet can compromise dopaminergic reward circuits, eventually causing individuals to become habitually responsive to food-related stimuli despite adverse health consequences. The maladaptive prediction of reward and motivational salience that becomes associated with food-related stimuli can exert top-down influence on perception and attention, promoting compulsive eating behaviour. Emerging research suggests that psychedelics, e.g., psilocybin and LSD, induce non-ordinary mental states where the influence of such behaviours could potentially be reduced and modified. Based on current evidence, mechanisms have been proposed which suggest that psychedelics might relax the top-down influence of high-level predictions encoded within neuronal hierarchies and sensitise them to bottom-up information flow. Additionally, psychedelics are thought to open a window of psychological flexibility, allowing people to potentially become open to new cognitive and behavioural strategies that can be offered via assisted psychotherapy. Therefore, psychedelics-assisted psychotherapy may encourage beneficial changes to eating behaviour, in those with maladaptive eating habits. While promising in theory, new research is needed to assess the potential efficacy of psychedelics-assisted psychotherapy in treating compulsive eating behaviour.
Obesity is a complex condition, and for some people, it involves patterns of overeating that resemble addictive behaviours. Eating too much energy-dense food, such as junk food, can affect the brain's reward system, making it harder to resist food (similar to addiction), even when it leads to negative health effects like weight gain and disease. This behaviour can become compulsive, meaning that people keep eating in response to food cues, even if they don’t feel hungry.Recent research suggests that psychedelics, like psilocybin (found in “magic mushrooms”) and LSD, might help people break these habits. These substances can alter the way the brain processes information and make people more open to change. Combined with psychotherapy, psychedelics might help people with compulsive eating behaviour by weakening the strong mental associations they have with food and instead adopt healthier habits. Although this idea shows promise, more research is needed to determine how effective psychedelics-assisted therapy could be in treating overeating and obesity.
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