This episode deals with anorexia and
contains mentions of other eating
disorders, as well as depression and
suicide.
So please take care.
My first psychedelic ceremony
was with Ayahuasca
in 2016.
By that point, I've been working on
my recovery from anorexia
and restrictive eating
for about eight years.
My intention was to not look
at my eating disorder and
I felt really afraid.
And I thought by saying, I don't
want to look at my eating disorder,
I would avoid anything negative
because the eating disorder felt
like such a negative place.
In the weeks before her first
ayahuasca ceremony, Francesca
Rose Annenberg was excited
and nervous.
She was given a small list of rules
to follow, including dietary rules.
No pork, no caffeine, no added
sugar or processed foods.
It was a little bit triggering in
the lead up to that
ceremony and I didn't quite know
any better.
The diet brought up old and
familiar feelings.
Even those few hours of fasting,
slight restriction around the diet
that woke up the disorder
in a way that I hadn't experienced
before.
With her eating disorder now fully
awake, Francesca made her
way to the location of the ceremony
on the appointed day,
a spot outside of Cape Town in South
Africa.
The ceremony began.
I don't really even remember an
opening circle.
Just feeling totally like
unprepared and then sitting next
to strangers who are
making their own sounds that are
purging.
The medicine, even though it was my
first time, was light for
me.
The constant chatter
of I'm not good enough,
of I am unworthy, I'm undeserving,
I am a bad person, I don't belong
here.
All of the variations of
those beliefs just
quieted down.
And in that was a
sense of embodiment, like I was in
my body.
I could feel my body on the ground.
I wasn't going too far
into space.
I was very much on the earth with
my breath.
And this feeling of genuine
self-love, this sense of enoughness
and this feeling of,
I belong here on this earth and
I'm part of this
greater...
orchestra and how wonderful is
that that I have a certain
sound to share,
to sing, to contribute and that it
matters.
It was like a sense of
innate enoughness, innate
worthiness, innate belonging
and what was really important was
that it landed in a cellular
way in the body.
For Francesca, that experience
was profound.
And although it didn't free her of
the anorexia she'd been struggling
with since her teens,
it did accelerate her recovery
in ways she hadn't anticipated.
Now, 10 years ago, scientists
weren't actively exploring the idea
of using psychedelic-assisted
therapy to treat anorexia nervosa.
But now they are,
and there is real excitement
around this idea.
So, today on the show,
anorexia is one of the deadliest
mental illnesses, and recovery
is notoriously difficult.
But what if psychedelic-assisted
therapy could change that?
We'll hear about an ongoing and
innovative clinical trial that's
testing this idea in young adults
using psilocybin.
And we'll hear about
what an attempt to self-treat this
disorder without the benefit of
therapeutic guardrails might look
like.
Because, as you've just heard,
some people are definitely already
doing that.
I'm Arielle Duhaime-Ross, and this
is Altered States.
So my name is Francesca
Rose Annenberg.
Francesca lives in Cape Town,
where she works as an eating
disorder recovery coach.
But in the 90s, she was
a kid growing up in what she
describes as a bubble shortly
after the end of apartheid in South
Africa.
My early childhood passions
were ballet and horse riding.
I fell in love with horses when I
was five and
started competing at the age of 12.
Show jumping, dressage,
eventing, cross country.
Ballet began also at about five
and was competing from
maybe, six, seven.
At first, the dancing and
horseback riding gave her
confidence.
They made her feel free.
But that changed when she started to
compete.
She began showing signs of
perfectionism.
Because there was now a goal
to gain,
and there were people watching
with judgments, perceived
or real,
and a certain way
that I had to look,
specifically with the ballet.
At dance practice, for instance?
I just tried to really
nail the technique, but
it was so hard to
allow myself to be seen in practice,
to share my vulnerability.
Whilst I was trying to get something
perfect.
She was self-critical and constantly
trying to meet the highest
of standards, often to
her detriment.
I would come to practice
completely expressionless.
It's like my heart was not even in
my body.
And it took a lot of energy to
withhold a lot of that emotion
that I would feel in class.
There would be a lot of emotion and
then a lot of shame for feeling a
lot of emotion.
She developed this deep fear
of failure.
I was just terrified of people
seeing me make mistakes.
And growing older came with
its own set of challenges.
I was a late bloomer
and at the same time didn't want
to bloom even
from a young age before
major eating disorder symptoms
showed up.
I was seeing people, seeing
their bodies changing and
becoming fuller, bigger and
that really scared me.
I thought if I stay in
this industry for
much longer I'm going to develop an
eating disorder.
At the age of 15, she quit ballet.
But still, come the age 16,
Francesca found herself restricting
her food intake for the first time.
It began initially
with a desire to lose
some weight and then
got really bad with a
breakup. That happened about
maybe five, six months
later after that initial
impulse to just cut
back here, restrict over here,
exercise a little bit more over
there.
At first, Francesca felt invincible.
Feeling like I was a
superhuman by how much I could
control.
Because I was eating so little,
but doing all the things.
And yeah, feeling this kind of weird
superiority that anorexia
can give.
As she got smaller, so did her
world.
I wasn't very fun to have around
because most
of what I was engaging with
was many obsessive thoughts
in my head and the capacity
to be socially engaged
was just really offline and
of course I wasn't eating enough so
I didn't have a lot of energy.
She started to push her sister and
her parents away, but she
kept up with her studies and
horseback riding.
It was the last three years of
school, so I was just
trying to eat as little as I could
while still getting good
grades and going to
my horse riding classes and
competitions.
The obsessive behaviors continued and
deepened.
Looking at myself in the mirror from
all angles, lots
of times on the scale.
As did the thought patterns.
I'm fine.
I just need to lose more weight.
I need to run that extra
kilometer.
I'm only allowed to eat at this
time.
I am weak if I get hungry before
then.
Lots of anxiety when it came to
social events.
Wanting to avoid them or
bring my own food, but I don't want
to look weird.
Maybe I can just eat a little bit,
and then how will that impact the
rest of my day, my next days?
The thought processes, they
sound superficial,
but they're indicating very
deep fears and dysregulation.
Fear about change for example.
People around Francesca, people who
loved her, they noticed that she
was different.
My best friend, she came up to me
and said, like, hey, like,
are you, are
your okay?
You're, you've lost a lot of weight
and you're not eating.
You've become really internal
and worried about you.
And my immediate response was just
defensiveness.
She's overreacting,
but knowing that she was right
ultimately.
Francesca's parents got her to see a
therapist, but she went reluctantly.
So as graduation loomed, her parents
and dietitian decided that the best
course of action would be to send
Francesca to a mental health
treatment center where she'd receive
24-hour care.
So when I'd finished school
at 18, my friends went to go
party and I went to an inpatient
facility.
It was a very unique experience
being with nurses who would
facilitate you in and out of the
bathroom and
getting certain health markers
checked each day, each
week.
But it became a very safe place
for me.
I still tried to secretly
exercise and
got caught twice.
The four weeks she spent at that
treatment center didn't end
her eating disorder.
When I spoke with her, she read a
passage from a diary entry she wrote
shortly after she left the program
in 2010.
Today I didn't do yoga, but
I went horse riding, toned,
and walked.
I'm already scared.
This is the start of my laziness.
I can't see my spine through my
clothes.
I really want it to show.
I don't even know if it showed
before, but now I can hardly feel
it when I bend over.
And the bones of my back, of my
neck, don't feel as prominent.
Once again, is it in my head or
real?
Francesca wasn't ready to let go
of the anorexia, which by then
had become a part of her.
That would change in time,
but just not right away.
I feel some
grief for that part of
me and how much torment
I was in to
control my
body and its size and
how ultimately out of
control I was.
I was a completely different
paradigm of existence and I'm
so grateful that I'm not there
anymore.
Still, Francesca told me that her
time at the clinic helped her
realize that she didn't want to get
any worse.
Something in me, woke up.
I want something different for my
life.
Francesca eventually found tools
that helped her heal.
She credits a few things, her
connection with nature, therapy she
received later on, her meditation
practice, her love of dance,
and her experience with
psychedelics.
Beginning with that one ayahuasca
trip that you heard about at the top
of the episode.
It was like a sense of
innate enoughness, innate
worthiness, innate belonging.
So there was a real sense
of coming home to
me and me in the wider world
without needing to achieve
or perform or
do something to earn that
belonging.
Less than a year later, Francesca
attended another ceremony.
This one was pretty different.
For one thing, she took psilocybin.
And for another, she went
in with the explicit aim of
tackling her eating disorder.
And so this time, she was
actually able to see this embodied
version of her eating disorders as
she was tripping.
It came to her in the form of a
box.
Just carrying around this box
wherever I go and I can
choose to put down that
box at any time.
And with that was this feeling of
I'm not my eating disorder and
then that question of well then
who am I?
So that was a really
important realization to
see it as something
that I was holding and not
my whole identity.
I could create some distance
and being able
to put it down like I can choose
to put it down gave me
a sense of responsibility
and choice and autonomy.
She had heard all of this before.
She talked about it in therapy
plenty of times, but she'd
always been resistant to the idea.
There was always that invitation of
someone else saying to me, "You can
put the box down.
You can. You can."
Now, under the influence of
psilocybin, she finally saw
that it was possible.
I can. And so the realization itself
wasn't necessarily new,
but it came from within
me and
came with a feeling of empowerment
that I hadn't experienced in therapy
before.
When you look back on those first
two ceremonies, how do you
characterize the role that they
played in your eating
disorder recovery?
It's a reminder of you are more
than the seeding disorder and
you are the co-creator
of your reality and
the psychedelics opened up
that doorway and of course
it is my own two feet to
walk through that doorway that
it requires active choosing and
choice.
Francesca's story offers a glimpse
into a complete cycle,
the downward spiral brought on by
too many factors to count,
and in this case, a
hard-fought recovery that happened
over years and for more
reasons than one.
And as moving as this story
is, Francesca is
just one person,
so we can't really draw any
generalizable conclusions from her
story.
For that, we turn to clinical
trials, where many people
receive the same treatment and
data are gathered, analyzed,
and published.
Unfortunately for us, results
are coming.
I spoke with a doctor who's
currently conducting a trial to test
if psilocybin-assisted therapy
might lead to better outcomes
for young adults with anorexia,
people who are around same age
Francesca was when she entered the
clinic.
I was blown away not just
by the reasons why researchers think
this might work, but also
how they're setting up this trial.
More on that after the break.
Since 2022, scientists have
completed four clinical trials
examining the use of psilocybin
to treat anorexia nervosa.
Among them were a pair of
trials funded by one of the most
prominent psychedelic companies in
the world, Compass Pathways.
The results of only one of those
studies has been published so far,
but Compass Pathway is moving
forward with its clinical trials.
Hoping that the U.S.
Food and Drug Administration will
approve its patented formulation
of synthetic psilocybin to
treat anorexia nervosa.
There is genuine excitement
that people with anorexia might
soon have more options for
treatment, which any doctor
who treats eating disorders will
tell you is very much
needed.
We just absolutely need more
options.
Marissa is one of those doctors.
My name is Marissa Raymond-Flesch.
I work at UCSF.
I am a physician and
a researcher.
Marissa is a pediatrician who mostly
works with teenagers and sometimes
in her practice, she
feels helpless.
It is absolutely
heartbreaking to watch
a patient starve to death.
That feeling is why Marissa is
now running a clinical trial,
looking at whether psilocybin
assisted therapy might work as
a treatment for anorexia nervosa
in young adults, something that
still surprises her.
I was a D.A.R.E. Student of the
year.
I never set out to do this
work. I think that's really
important to know.
She was the just say no to
drugs girl, and she didn't come to
this work because of her interest in
eating disorders either, at least
not at first.
What got her here is her love of
working with teenagers.
Oh my gosh, they're so much fun.
They are just blooming, and
the potential for impact is huge.
It's so fun to see their
energy, to see their hopefulness, to
their incredible capacity
for growth.
And I love to witness
that and support young people as
they do that.
And then really discovered what
a challenge eating disorders are
for our patient population.
As a pediatrician, Marissa had
always seen eating disorders in her
practice, but at
the height of the COVID-19 pandemic,
things suddenly got much worse.
All mental health concerns for
adolescents and young adults just
exploded. And when I say that, I mean, literally exponentially worsened.
The hospital where Marissa works had
reached capacity and
couldn't admit all of the
patients coming in with severe
anorexia.
We just don't have beds and
resources in our hospital to do
that. That's something we just
couldn't have fathomed needing to
learn about our service a couple of
years before.
Not only that, but because of the
isolation that many people
experienced during the first two
years of the pandemic.
Our patients were presenting
later and sicker.
And things had already started
to worsen even before that.
Patients are presenting at younger
ages.
There's been an increase in the
incidence of anorexia in kids
below the age of 15.
The age of onset may be falling or
our ability to detect it earlier may
be improving, but we are starting
to take care of people at younger
and younger ages.
Marissa told me one of her patients
in particular.
I remember being in a patient's
room who was profoundly sick.
Most of my patients don't actually
want to die, but she was really in a
place where she did want to die.
She didn't want to eat.
We had to support her with a feeding
tube, which is rare, but something
that happens for some of our
patients.
And she wanted so much to
die that she was able
to sort of take that feeding tube
out in a way that I've never seen
someone do.
And I felt really
powerless. I didn't know what I was
going to do to help her.
Anorexia is one of the most fatal
mental health conditions.
It has the second highest fatality
rate of any mental health condition.
It's second only to opiate use
disorder right now in terms
of likelihood of death.
Feeling
overwhelmed and more powerless
than I think most doctors would like
to feel, Marissa got
to thinking.
That was a moment when I
would say I let my heart and mind
open to this thing that had been
floating in the back of my mind,
the idea of psychedelics.
Which brings us back to her ongoing
trial.
That trial is a study of psilocybin
for young adults with anorexia
nervosa. And we are enrolling
young people between 18 and
25 years old.
And what we're really testing, and I
wanna emphasize this, is psilocybin
assisted therapy.
So this isn't just about the
medication.
It's about having appropriate
psychotherapy support while
engaging with this medication.
The trial focuses on young people
whose brains are still developing.
The brain continues to change
and develop into the mid-20s.
And Marissa says that unlike
previous trials.
We're enrolling patients down
to a BMI of 12 because we really
want the sickest patients,
the patients who need these new
treatments most to be able to access
them.
BMI, or body mass
index, is a metric that doctors
use to determine if a person's
weight is, quote, healthy in
relation to their height.
It's an imperfect metric.
But for people in their 20s,
the general recommendation is that
their BMI should fall between 19
and 25.
So 12 is really
low.
And the researchers had to take that
into account when they designed the
study, right down to the dose
of psilocybin.
The first dose is a 20-milligram
dose, which is a little lower than a
lot of other clinical trials use
just because of how medically
fragile some of our patients are and
we want to make sure they're okay.
Each participant will also undergo
extensive medical testing throughout
the trial.
You need to show up to medical
visits? You need to show up to some brain scans, you need to show to a
lot of psychotherapy. I think the total for our trial is about 21 visits.
And then there's two full days off of work or school for the actual
dosing days in our trial. And really asking people to make as much room
in their lives as they can for processing these experiences, right? You
shouldn't kind of have a psilocybin dosing day and go straight to taking
finals.
And.
Because of...
What we know so far about what
is helpful in supporting young
adults through treatment, we are
actually asking each of the young
adults who enrolls in the trial to
bring in two support people.
Very often that's family members,
but at least one up to two people
who have been supporting the young
adult for at least a year with their illness.
The researchers had originally made
it mandatory that each participant
bring two people into the trial
with them, but Marissa told
me that fairly early on they
recognized that they had to revise
the requirement.
This is a very isolating illness.
It was very hard for some people to
find two people, so we backed down
to one support person to make it
more accessible for more people.
How many participants are you hoping
to enroll?
Forty.
And we are trying to recruit
across all genders, across all
races, across all ethnicities and
socioeconomic statuses.
The trial is open
to anyone who fits the criteria.
And the recruitment?
It was a crucial element for Marisa,
in part because of the stereotypes
that are associated with the
illness.
I think sometimes when people think about anorexia
nervosa, they picture someone,
perhaps someone who is white,
perhaps someone who was female.
Sometimes even the stereotype
extends to socioeconomic class
to someone who has more financial
resources.
But that is not actually what we see
at all in practice.
There's a large chunk of our
patients who are Latine,
a large chunk of patients who have
various Asian backgrounds.
And then given kind of our
geography, a smaller portion of our
patience who are black identifying
and other racial and ethnic groups.
But it is not an overwhelmingly
white group and there's no reason
to believe that it doesn't occur
with the same frequency
in all populations.
To make it easier to recruit a wide
range of individuals, Marissa
and her team are conducting the
trial in both Spanish and English.
And because of what we know about
the patient population that we treat
at UCSF.
In the future, I would love to roll
it out in other Asian languages as
well.
One thing that impressed me when I
spoke with Marissa was how badly
she wants to get this right.
She told me that part of her process
when she was designing the study
involved forming two advisory
boards.
One made up of parents of people
with anorexia and another made
up of young adults with anorexia or
a history of anorexia.
And she got some important feedback
from both of those boards.
To illustrate this, she told me
about speaking with the members of
the young adult board about the need
for preventing low blood sugar.
During and after the dosing
sessions.
She asked them.
I really need our patients in
this study to eat on dosing
day. How can I talk with
our patients about that and make
sure that the participants
understand the reason for it and
come up with a structured way to do
it that will be as least
anxiety provoking as possible.
And one of the answers was
unexpected, but also deeply
informative, she told me, because
one of the young advisors mentioned
that.
The first thing I would have thought
if I was enrolling for this trial at
the height of my illness is you
want to get me high and then feed
me all day.
And so you need to tell them
that that is not your intention.
That needs to be the first thing you
say.
And it was simultaneously like
heartbreaking and I was deeply
grateful to have that feedback.
After that Marissa worked with the
board members to develop food
options that felt appropriate,
where participants have a few
options and can also feel safe
knowing exactly what they are
eating.
We created a sheet so that people
could literally see like this is the
exact kind of soy milk we're
offering you.
And now that the trial is underway,
all anyone can really do is hope
that all that careful planning pays
off.
How is the trial going so far?
In the exit interviews participants
have been glad that they have
participated and found it really
meaningful and most family
members have felt that way too.
We're hearing a little bit about
participants and families feeling
more connected and able to
communicate which wasn't a
specific intended consequence
exactly but something that makes me
hopeful and obviously
we will wait and see what the data
looks like as the trial progresses.
Marissa and her team are still
recruiting participants right now,
and they'll be checking in with them
for up to a year after their second
session, so it'll be a while before
we see complete results.
But thanks to previous trials
that were done on treating PTSD
and alcohol use disorder with
psychedelic assisted therapy, as
well as the published results from
one very small safety trial done on
patients with anorexia, Marissa
told me that she has some sense of
what psilocybin might be able to do
for participants in her trial.
We have a few different hypotheses.
The biggest one is if
you have a severe and enduring
mental illness, your mind kind of
gets stuck in ruts.
You can imagine like a sled
going through the snow over and over
and in the same circle.
And after a while, it's very hard
for the sled to change course,
right?
Psilocybin is like if you had that
in a snow globe and you shake the
snow globe, right, all
the ruts disappear.
It's a huge moment of potential.
And we actually can kind of see that
on brain scans using fMRI.
We can actually see
this change in connectivity in
the brain when people are on
psilocybin and after psilocybin.
That rut, that stuck place is
called the default mode network, how
we think about ourselves.
And it's often where our mind rests
when we don't give our mind anything
else to do.
So for some of my patients with
eating disorders, it might be I'm so
fat, I'm so ugly, it's never going
to get better.
Our patients need help out of those
ruts, and then they need help to
make new pathways, where they have
more choice.
And on fMRI, we
see that that really tight
referential loop gives way
to this incredible interconnectivity
over the brain surface.
There's still a lot that we don't
know about how this works in human
brains, but Marissa told
me about some interesting research
in mice.
After just one administration of
psilocybin, an isolated neuron
from a mouse will grow extra
dendrites, those little arms that
reach out to connect to other
neurons.
Some scientists think this might be
happening in humans, too, and
that maybe those growing dendrites
are related to a therapeutic
effect.
That's still unclear at this point.
But in the trial, Marissa and
her team are looking at the brains
of participants using fMRI
brain scans to see if they
can spot new connectivity.
And then I don't have to go into a
deep detail, but we are
hypothesizing, and there's growing
evidence in the field, that
psilocybin also has
anti-inflammatory properties in
some illnesses.
And there are some people who
hypothesize that there is an
inflammatory aspect of anorexia
nervosa.
So that's something that we will be
investigating as well.
And those ruts, we're gonna be
measuring cognitive flexibility
is the technical term.
So like how quickly can people learn
new rules, adapt to different rules,
adapt to things.
And that's hopefully a proxy for
like, are you able to get out of
these ruts and these stuck places?
Right, because there is an
incredible rigidity involved in
the way that anorexia manifests,
right? Like, that's right.
No, I can't do this before I do
that. This is the right way.
And this is what I always eat.
And, this is the time at which I
eat.
That's exactly right.
Yeah.
And so the idea is that this could
break down some of those walls,
shake that snow globe.
And from a therapeutic standpoint,
what are we talking about?
Giving you an opportunity to build
back different?
Exactly, that's exactly right.
And we're trying to hit this kind of
place where there's more room for
that plasticity and that connection
and that growth.
And I'm curious about what
that means in terms of their ability
to change behaviors and thoughts.
As I was listening to Marisa, I
couldn't help but wonder why there
aren't any medications that have
been approved to treat anorexia
already.
Because if psilocybin assisted
therapy ever gets this kind of
approval, it'll be the first.
We've tried a lot of different
medications for anorexia,
including antidepressants.
And they can help with some of the
symptoms that arise related to
anorexy in some cases,
but none of them shift the core
symptoms and the core drive towards
thinness or energy restriction or
body dysmorphia concerns.
Most of the antidepressants
prescribed in the US are SSRIs,
and these drugs, they target the
serotonin system in the brain.
Into the synapse, the place kind of
between neurons and the brain, and
they keep your serotonin there so
it can work for longer.
And having enough of it allows
those circuits to be more regulated
related to feeling down or
feeling anxious.
But anorexia can break that
system.
The problem is that if you're
severely malnourished, you don't
actually make enough serotonins.
You have to be eating tryptophan
and the amino acids that you need in
order to make those
neurotransmitters.
So our patients are often very
depressed and anxious because of
their lack of serotonin, but these
medications have nothing to work on.
And it's variable from individual to
individual and how malnourished
someone is. All of those things are
factors, but it's one of the reasons
these medicines don't work as well
and don't target the core symptoms
for anorexia.
So right now, the standard of care
for young adults is different forms
of psychotherapy.
But a lot of the time, it just
doesn't work.
Relapse rates are as high as 52%.
But maybe combining therapy
with psilocybin could change that.
And interestingly, one of the
reasons Marissa thinks that's
possible is because of the results
from a recent trial on alcohol use
disorder.
This is how she explained that.
Substance use disorders and
eating disorders, especially
anorexia, have a particular quality
that is often true for
patients who have them that's
different from many other illnesses.
They're egocentonic.
Egocentonic.
What that means is that the illness
may feel like part of someone or
like something that they don't want
to give up.
That's not always true.
It's not true for all patients.
But it's a common feeling that comes
up for those two sets of disorders.
And generally, no one wants to be
depressed, certainly no one who
wants to have cancer.
But there are times for some
patients with eating disorders and
some patients with substance use
disorders where the disorder is so
close in that it feels like part of
them and feels like something they
don't want to give up.
The results from the alcohol use
disorder trial were promising.
So Marissa found herself asking.
We could see results in
some very early trials related to
substance use disorder.
Could that translate for my
patients with anorexia?
Because there are not very many
illnesses like that, that are
egocentonic.
So coming back to the snow globe
idea, maybe one
of the ruts that psilocybin is
able to erase is
that attachment.
Like Francesca's box, that she
suddenly knew she could put down.
And then hypothetically, maybe that
could give the therapy part of
Marissa's trial more of
an in, more of a chance to
work as it should.
Oh, and the whole low serotonin
thing that people with malnutrition
can experience?
Turns out that psilocybin might
provide a fix for that too.
Instead of trying to keep the body's
serotonin in place for the
medication to work.
What psilocybin does is it pretends
to be serotonin.
It goes in and locks into
the serotonin receptors.
So for even really malnourished
patients, we hypothesize
that it could be effective.
And we even had a little bit of data
in patients who've done psilocybin
trials related to end-of-life
cancer, anxiety and
depression, as well as end-stage
HIV, who were very malnoursed
population.
And so all of those things converged
to make us want to focus in
on psilocybin as a possible
medication for anorexia.
How did this trial come together?
Blood, sweat, and tears.
The real story is worth telling
because it showcases just how badly
people want new treatments for
anorexia.
Back when Marissa was just starting
to explore the idea of doing this
trial, she reached out to a
colleague of hers at UCSF.
Josh Woolley, whose lab
goes by the acronym TRIPPER, which
is a very fun acronym.
And after a little bit of pestering,
he agreed to work with her to get
the trial off the ground and
conduct it with her.
He said, okay, sounds like we're
gonna do this trial.
You just need to find $3 million.
Marissa was undaunted.
Within three years, she had the
money to get started.
And the funds, they didn't
come to her through government
grants.
We've had more than 100 individual
donors who have given a huge
range of donations
to make this trial possible largely
from families who have
children suffer with this illness.
When you say that there have been
more than 100 donations, can you
give me a sense of the range of the
donations?
You know, as small as, as large as?
As small as $5, as
larger as a million more.
Wow.
Yeah, so really a very wide
range.
That's incredible.
What is driving people to want to
donate to your clinical
trial?
Without sort of revealing any
personal information, I guess one
vignette that comes to mind is a
parent who has been
a really amazing champion of this
work. She told me, I
am running out of ideas about
ways that I can help my daughter,
and I feel powerless because
of that.
But you have power and privilege
because there's something you can
do.
And that was very striking to me.
I think it's been a big exercise in
trying to bring forth
power and privilege of a lot of
different people to see if
we can make change.
I'm hearing a certain amount of
emotion in your voice.
Yeah, I mean, I think, you know, I
use the words moral imperative.
As a physician, I have the privilege
of being trained as a researcher.
And it's my job to try and
make sure that my patients are never
without hope.
Do we think that this could also be
helpful for folks with
other forms of eating disorders?
Something that I'm very interested
in investigating over the long run.
We started with anorexia because of
its fatality rate and
we're kind of enrolling people with
three different subtypes with
atypical restrictive and
binge purge anorexy for this
trial and we are
trying to enroll enough people so
that we will get a large enough
sample that'll allow us to do some
amount of analysis on each group.
And that will give us some data
about both safety and efficacy
for people with that binge purge
subtype and maybe help us start to
think about what about this might
translate to a population of
patients with bulimia nervosa?
What about binge eating disorder?
I think all of those are really
important questions.
Someone dies about once every
hour in the United States from those
conditions.
And it's really important to
understand that part of
the urgency in finding new
treatments is about how
fatal this condition is.
And it's such a new feeling to
be able to feel hopeful about a new
treatment in this illness.
And I'm trying to, of
course, keep my perspective
and stay very grounded in
the fact that we won't know how it's
going. But even just in my role
as a physician in this space,
it's exciting to be thinking about
new things. To just have new
treatments that are actually coming
down the pathway is so different
than where we were five years ago.
I don't typically report on clinical
trials that are still in progress,
because you really never know what's
going to happen.
I don't want to give anyone the
wrong impression.
As this study and others begin to
publish their findings, we may
find out that psilocybin assisted
therapy can help people with
anorexia, or we
may not.
If that's the finding though,
if it helps, then that
will be a huge deal for a
lot of people, as well
as their friends and families.
And I would know because I
had anorexia in my very
early 20s.
And much like Francesca, I
am so happy that I am free
of it today.
But man, it would have been nice
to not have to do it on my own,
to have the support of a medication
that could have helped me overcome
the biggest barriers associated
with recovery.
Instead of just fighting hundreds
of tiny, excruciating
battles with my brain Every
single day?
Year after year.
I don't care if it's
psilocybin-assisted therapy or
something else, we just need
better options than what we have
now.
So I'm rooting for that.
If you or someone you know are
struggling with an eating disorder,
help is available.
Please call the National Alliance
for Eating Disorders helpline at
866-662-1235.
And for 24-7 support,
please call the national suicide
prevention lifeline at 988
or text HOME
to 741-741
to reach the crisis text line.
Those numbers and links can also be
found in our show notes.
Altered States is a production of
the UC Berkeley Center for the
Science of Psychedelics and PRX.
This episode was reported and
produced by me, Arielle
Duhaime-Ross.
Adizah Eghan is our senior editor.
Our executive editor is Malia
Wollan.
Jennie Cataldo is our Senior
Producer, and our researcher is
Cassady Rosenblum.
Our associate producer is Jade Abdul
Malik, and our audio engineers are
Terence Bernardo and Jennie Cataldo.
Fact-checking by Graham Hacia.
Special thanks to Michael Silver.
Our executive producers are Malia
Wollan and Jocelyn Gonzales,
and our project manager is Edwin
Ochoa.
Our theme music is by Thao Nguyen
and Nate Brenner.
And I'm your host, Arielle
Duhaime-Ross.
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