Although originally intended as a surgical anesthetic, ketamine now provides fresh hope for patients suffering from depression, chronic pain, PTSD and a range of other ailments. Today, some are wondering if a ketamine treatment for eating disorders is the best new path towards their healing. Before getting into the details, let’s go over a few ketamine basics first.
What Is Ketamine?
Calvin Lee Stevens, an American chemist, first synthesized ketamine in 1962 as an anesthetic alternative to PCP. After testing the effects on animals and gaining approval from the FDA in 1970, ketamine became the go-to battlefield surgical anesthetic in the Vietnam War for its fast-acting sedative effects.
Ketamine is an NMDA receptor antagonist, meaning it disrupts the typical flow of information in the brain and spinal cord by blocking neurotransmitters such as glutamate from binding to NMDA receptors. At high doses, drugs classified as NMDA antagonists, like ketamine or PCP, disrupt communication in the brain to such a degree that they induce a state of dissociative anesthesia.
Ketamine comes in a few different forms: injectable liquid, crystalline powder and a prescribed medicinal nasal spray. Those using ketamine recreationally most commonly consume the powder form intranasally-many of which buy ketamine online. In legal settings, medical professionals and researchers administer liquid ketamine intravenously through muscle injections or IV infusions. This ensures the efficacy of studies and treatments as injection guarantees the correct and full dosage gets to the brain.
Ketamine as a Treatment
Even before the COVID-19 pandemic, the numbers of adults and youth reporting symptoms of mental illness were steadily rising. Traditional treatments, like antidepressants, work to increase levels of serotonin and dopamine over time. While this works for some, about one-third of patients don’t respond to SSRI treatments. With more people than ever seeking relief and healing, mental health professionals are looking for cutting-edge treatments, especially for those experiencing treatment-resistant illness: enter ketamine treatments.
Mental illnesses like chronic depression or anxiety disrupt neural connections in the brain, presenting as changes in motivation, mood and cognition. Over time, consistent disruption of those neural pathways causes the synapses to atrophy. When ketamine is introduced to the brain, it blocks the NMDA receptors, creating a surge of glutamate. This surge causes a subsequent increase of neurotrophins involved in neural growth, allowing for lost neural connections to be re-established.
There are two main types of ketamine treatments: ketamine infusions and ketamine assisted psychotherapy.
Ketamine infusions are performed at ketamine clinics where patients act as passive participants as ketamine is administered intravenously. This form of ketamine treatment does not require a licensed psychotherapist to be present and can be administered by a nurse practitioner or clinician. There is no talk therapy component to ketamine infusions. The goal is antidepressant benefits and the emphasis is on the biochemical response to ketamine rather than the dissociative experience ketamine can produce.
Ketamine assisted psychotherapy requires a licensed psychotherapist to lead patients through discussions and aims to address the root causes of their mental illness while still utilizing ketamine’s biochemical effect on the brain. Some ketamine assisted psychotherapy adjusts the ketamine dosage enough that it induces a psychedelic state. Here, while dissociated from their usual sense of self, patients can work through trauma without the hindrance of their normal neural signaling.
What Is an Eating Disorder (ED)?
Eating disorders are psychiatric disorders presenting as severe disturbances in eating behaviors tied with obsessive thought and emotional disturbance. Today, around twenty million women and ten million men suffer from eating disorders in the United States. People of all genders and body types are affected, meaning there is no specific way for someone with an eating disorder to look.
Disordered eating is more than wanting the body to look a certain way or eating too much at dinner. It stems from a complex interaction of genetic, biological, psychological and social factors. Society places value on certain body types and demonizes others. The message is clear: If a body looks one way, they are unattractive or lazy and if they look another way, the person is viewed as healthy or desirable.
Eating disorder victims often experience body dysmorphia, a cycle of obsessive and pervasive negative thoughts on their appearance — leading to a distorted image of oneself. However, eating disorders are not only about body image. The compulsive eating behaviors are tied to anxious thought patterns, which compulsive eating works to soothe. Disordered eating can also come from difficulties with emotional regulation and a need for control.
Eating is an essential part of maintaining a healthy physical and mental state, but this disorder robs people of that. Recovery involves working to reestablish healthier thought patterns surrounding eating as well as treating the underlying emotional and cognitive challenges.
Types of Eating Disorders
There are several types of eating disorders, and they can affect just about anyone. But, here are three of the most common eating disorders.
Anorexia Nervosa
Anorexia nervosa is characterized by excessive weight loss due to self-starvation, often accompanied by excessive exercise. Anorexia is the deadliest psychiatric disorder because of both the increased suicide rate of those experiencing anorexia and the physical toll that starvation takes on the human body.
Bulimia Nervosa
Bulimia nervosa is characterized by cycles of binge eating and compensatory purging. Eating is considered binge eating when the amount of food consumed in a set amount of time is higher than the average person’s consumption. The person binging feels out of control while eating and can even be in a dissociative state. Purging can occur through self-induced vomiting, abusing laxatives or diuretics, or exercising.
Binge Eating
Binge eating is the most common eating disorder in the United States. It is characterized by frequent overeating to the point of discomfort while feeling a loss of control over this behavior. There is no compensatory action, like purging after binging, but those suffering often feel guilt, shame or disgust for their behavior.
ED Risks and Long-Term Effects
Eating disorders pose severe long-term health risks for those who are unable to obtain proper treatment and enter recovery. Anorexia nervosa eventually sends the body into a state of starvation causing vital systems to shut down due to lack of nutrients. This can lead to heart failure, loss of bone density and stroke. The toll of binging and purging severely harms the gastrointestinal system and can lead to stomach and esophageal ruptures. Binge eating also increases the chances for obesity which leads to a myriad of health problems such as heart disease, diabetes and stroke.
Aside from the physical toll that eating disorders take on the human body, individuals with eating disorders are more likely to commit suicide. Studies show that individuals with anorexia nervosa have the highest number of successful suicides and those with bulimia nervosa have the highest number of suicide attempts. Eating disorders, like other mental health disorders, put people under an immense amount of psychosocial stress, therefore diminishing their quality of life.
Ketamine Treatment for Eating Disorders
In the battle for an effective treatment for eating disorders ketamine is a breakthrough because it targets the neural network linked with compulsive eating behaviors and helps block those pathways from activating. Ketamine also facilitates new neural connections and can help individuals with eating disorders reestablish neural communication outside of their compulsive eating behaviors.
An Early Trial
While ketamine treatments for depression began in the early 21st century, ketamine was introduced as a potential treatment for eating disorders as early as 1998. The first trial included 15 female participants experiencing treatment-resistant anorexia. The participants received intravenous ketamine infusions of 20 mg/hr for 10 hours and then repeated this at interval frequencies ranging from five days to three weeks.
About half of the participants experienced a drop in their anorexic compulsions in regards to eating immediately after treatment. The rest of the participants had no relief from symptoms, but further study has shown that some patients experience relief days and weeks after treatment. While researchers need to conduct further study to establish the cause of this delay, it poses exciting prospects for those that are treatment-resistant.
Follow the Science
The reason ketamine provided relief from the disordered eating compulsions in the previous study is because of ketamine’s ability to block the recollection of a previously excited neural network. A person suffering from an eating disorder has a specific neural network activated when they are thinking about or eating food. Ketamine can stop this network from activating in the first place and allow for the brain to establish new or previously atrophied connections. This change of neural communication presented itself as a drop in anorexic compulsions for patients in the previous study.
Today, researchers have shown that patients with eating disorders have similar compulsive features to those with compulsive disorders such as OCD. This means that the recollection of disordered thoughts around food and body happens involuntarily just as the obsessive, intrusive thoughts characteristic of OCD. Ketamine infusions can help stop this involuntary recollection, lowering the compulsive drive toward disordered eating, and giving patients a chance to think and behave in a different way.
Ketamine clinics are popping up all over the country as more and more researchers explore ketamine’s regenerative and relieving effects. Ketamine therapies for eating disorders have been found most effective when coupled with supervised eating, talk therapy and if necessary, other medications.
Understanding an Eating Disorder
Many people suffering from eating disorders also have to combat the damaging misconceptions and stereotypes surrounding their disease. The stigma around mental health and the normalization of eating disorder culture deters many from seeking lifesaving and psyche-healing treatments. The revolving wheel of new diet trends, emphasis on a ‘summer body’ and fetishization of certain perceived ideal body types all contribute to societal pressures promoting eating disorders. When seeking treatment, eating disorder patients must untangle themselves from more than neurochemical imbalances and a desire to fit society’s standards: they undergo a reconstruction of their relationship to food.
In order to advocate for and support people suffering from eating disorders and those in recovery, it’s necessary to unpack the ideas about eating disorders and understand how words and actions perpetuate damaging rhetorics. Boasting about not eating the whole day in order to get drunk faster on a night out. Praising people for losing weight, therefore equating skinniness with goodness. Flippantly using diagnostic labels for eating disorders as descriptors for people. These seemingly innocuous behaviors normalize disordered eating and perpetuate harmful dialogue surrounding eating disorders and people searching for recovery.
Beyond ketamine treatments, support groups and psychotherapy, we all have the power to transform rhetoric in our own lives allowing us to advocate for and understand people trapped in toxic cycles of disordered eating.
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We understand everyone has their own battles, but you are not alone. If you feel comfortable sharing your story or experience, we invite you to comment below. Sometimes, talking about things and engaging with others helps us feel supported.
RS CONTRIBUTING AUTHOR: HALEY NOBLE
Haley is a writer, artist, and musician based in Southern California. She is passionate about discovering new avenues toward compassion and understanding for self and others. With an academic background in psychology, she hopes to reduce the stigma surrounding plant medicine so more people can find healing and relief, allowing them to tap into the expansiveness of human existence. In her free time, she loves eating breakfast foods, taking in a sunset over the ocean, and laughing with friends.
Disclaimer: Ketamine is potentially categorized as an illegal drug. Reality Sandwich is not encouraging the use of these drugs where prohibited. However, we believe that providing information is imperative for the safety of those who choose to explore these substances. This guide is intended to give educational content and should in no way be viewed as medical recommendations.
