Ketamine Therapy for Anorexia?
Updated: Mar 10
This article includes a non-exhaustive list of latest research findings on anorexia nervosa. It's important to stay current with latest research findings in order to help determine the best methods of treatment and how to prevent relapse.
Research topics in this roundup include:
anorexia relapse prevention
health complications associated with anorexia
research on alternative and emerging treatments including ketamine therapy
New research on anorexia says...
relapse is preventable;
heart health monitoring is a good idea for people with a history of anorexia; and
zinc and ketamine therapy research shows some promising results.
A Note on Anorexia Relapse + Prevention
No one wants to think about relapse, but preparing ahead can actually help prevent relapse from occurring. When it comes to anorexia and other eating disorders, the rates of relapse are high.
Recent research suggests:
"More than one third of all patients treated for anorexia or bulimia relapse within the first few years of completing treatment."
The highest risk for relapse from anorexia nervosa occurs in the first 18 months after treatment, with anywhere between 35-41% of people falling back into eating disordered behaviors, says the same research. This is true of my experience, too.
So let's find out WHY in part by looking at some new research that dropped last month.
1. Predictors of relapse in eating disorders: A meta-analysis.
Date: February 2023
Citation: Sala, M., Keshishian, A., Song, S., Moskowitz, R., Bulik, C. M., Roos, C. R., & Levinson, C. A. (2023). Predictors of relapse in eating disorders: A meta-analysis. Journal of psychiatric research, 158, 281–299. https://doi.org/10.1016/j.jpsychires.2023.01.002
Relapse risk is higher in people with other mental health conditions and with a higher level of care needed and with a higher level of severity of disordered eating belief systems or psychopathologies.
The risk of anorexia relapse, according to several recent studies, is greater in certain cases including situations where:
A greater level of care and support is needed (ie., the severity of illness is high)
The person has psychiatric comorbidity or they are also experiencing many symptoms of psychiatric distress
The person has disordered eating beliefs due to family, culture, media, and/or a combo of all
The same study that examined multiple studies (a meta analysis), found factors that protected against relapse risk including higher leptin (hormone associated with body fat), higher meal calorie density and food variety, higher motivation for change, and a higher body mass index/weight/body fat percentage when starting treatment.
Summary list of factors that contribute to an overall better response to treatment:
Certain hormones associated with how the body stores fat in cells
The types of foods and meals being eaten during recovery (ie., higher density foods and more variety are worth paying attention to)
Having a desire to recover or heal from disordered eating
Being at a higher weight because it's genuinely easier to recover when you're not underweight (being underweight is associated with a host of health complications including thinking, concentration, and memory problems because the organs aren't receiving adequate nutrients)
This meta analysis also found people with a later onset of anorexia had lower odds of relapse.
This means if you develop anorexia later in life, your odds of full recovery or remission is greater than someone who develops the eating disorder in their developmental years. In either case, early warning signs warrant early treatment to prevent prolonged illness.
Long-term cardiovascular consequences of adolescent anorexia nervosa
Date: February 2023
Citation: Springall, G. A. C., Caughey, M., Zannino, D., Kyprianou, K., Mynard, J. P., Rudolph, S., Cheong, J., Yeo, M., & Cheung, M. M. H. (2023). Long-term cardiovascular consequences of adolescent anorexia nervosa. Pediatric research, 10.1038/s41390-023-02521-5. Advance online publication. https://doi.org/10.1038/s41390-023-02521-5
I gave anorexia my heart, quite literally...not only was I dedicated to eating healthy and exercising and losing weight, I was starving my heart of necessary nutrients, all in the name of health and fitness. I had no idea...but now I know...
People who experience anorexia in adolescence are at increased risk of heart problems throughout life, including early death by heart disease or sudden heart attack.
But this study from Feb 2023 looked specifically at whether individuals who recovered from anorexia in their adolescence experienced long-term cardiovascular risks (ie., in early adulthood).
In nearly half of the previous patients, the answer was, "Yes."
Heart issues ranged from structural weaknesses to dysfunction. The authors note the cause behind these long-term consequences is malnutrition (due to calorie restriction and/or food group restrictions).
From this finding, they recommend heart health monitoring in people with history of anorexia.
Ketamine and Zinc: Treatment of Anorexia Nervosa Via Dual NMDA Receptor Modulation Date: January 2023
Citation: Mitchell, J. S., Hermens, D. F., Bennett, M. R., Can, A. T., & Lagopoulos, J. (2023). Ketamine and Zinc: Treatment of Anorexia Nervosa Via Dual NMDA Receptor Modulation. CNS drugs, 37(2), 159–180. https://doi.org/10.1007/s40263-022-00984-4
Treatment resistance for anorexia has encouraged the exploration of alternative means of treatment including nutritional supplementation with zinc and controlled dose ketamine assisted therapy.
Zinc and ketamine are said to both work independently on and by interacting with the exact brain areas affected by anorexia and by altering (modulating) the levels of neurotransmitters sending specific signals to and from your brain and to other body areas all responsible for the development and continuation of eating disorder pathology or disease.
In the case of zinc, for example, zinc deficiency from malnutrition has been shown to worsen psychiatric symptoms of anorexia including depression, which makes it more challenging to recover. Many reasons are behind this, including the way nutrient deficiencies contribute to brain signaling dysfunction and inflammation.
Ketamine on the other hand is said to promote rapid and immediate relief of anorexia symptoms but the effects are not consistent across patients and they do wear off rather quickly.
"Low-dose ketamine is not effective in all cases of anorexia and therapeutic effects dissipate with time, suggesting that although ketamine is capable of ameliorating neuropsychiatric pathology, the system may tend back towards the pathological wiring."
Please note that while ketamine is showing potential in other research studies on anorexia treatment, the treatments are taking place in controlled doses in controlled settings. Drug-assisted therapies for healing should be done with the guided care and supervision of an experienced eating disorder treatment professional or other medical or psychiatric professional.
Want to learn more about anorexia recovery?
You can always find the OG memoir I wrote while still in high school and updated in my early 30s with new essays and recovery tools in the shop (signed and sealed by yours truly) or on Amazon in pretty much every country. Thank you supporting content creators with lived experiences!