Supporting Recovery Beyond Conventional Care: The Promise of Ketamine-Assisted Psychotherapy for Eating Disorders
"The alignment between the core blockers in eating disorder recovery and the unique benefits of Ketamine-Assisted Psychotherapy is striking—and offers a profound sense of hope. While KAP is not a panacea, this integrative approach creates real opportunities for healing. I’m passionate about making it a viable option for those who feel stuck in the throes of an eating disorder."
- Emma Curtis, LMFT
As a clinician specializing in eating disorders, I’ve witnessed how patients can struggle with these illnesses for years—often without finding sustained recovery. Eating disorders are among the deadliest mental health conditions, second only to opioid use disorder. Beyond the physical and psychological harm, they can deeply erode quality of life. Patients and their loved ones are often left grieving the life the disorder has taken from them.
Recovery is often a long and difficult process. Many patients cycle in and out of treatment, making progress only to relapse. The entrenched thought and behavior patterns that define eating disorders are incredibly difficult to disrupt. Even with evidence-based care, conventional approaches can sometimes fall short—especially for those with severe, long-standing illness.
Eating disorders are uniquely complex, involving both psychological and physiological disruption. Patients often experience rigid, ruminative thought patterns similar to those seen in depression, anxiety, and OCD. What sets eating disorders apart is the impact of malnutrition on brain function. Regardless of body size, malnourishment is common and significantly impairs cognitive flexibility—the brain’s ability to adapt and shift perspectives. When that flexibility is reduced, it becomes harder to break out of rigid patterns and engage in the deeper emotional work needed for healing.
While talk therapy and nutritional counseling can be effective, many patients—particularly those with severe and refractory presentations—return to care feeling discouraged. They often describe previous gains as superficial or short-lived. The chronic strain of battling obsessive thoughts and compulsive behaviors wears them down, and the hope of full recovery can begin to feel out of reach. For these individuals, we must consider new therapeutic possibilities. One such option is Ketamine-Assisted Psychotherapy (KAP).
The Promise of KAP in Eating Disorder Treatment
Emerging research and clinical observations point to the value of KAP in treating eating disorders. One key contributor in this space is our colleague Erika Malm, LCSW, who has been a leader in adapting KAP protocols for ED populations. During her recent presentation at the International Association of Eating Disorder Professionals (IAEDP) she emphasized the importance of creating a safe container for clients to explore their inner experience while in a ketamine-assisted state, allowing for deep emotional processing that is often inaccessible through talk therapy alone.
In her clinical practice, Malm has observed that KAP can help clients shift from self-punishment to self-compassion—a critical transformation in eating disorder recovery. She also highlights the importance of body-centered therapeutic work during integration sessions, helping clients reconnect to their physical selves in a safe and empowering way.
Lasting change is supported by neuroplasticity—the brain’s ability to form new connections and reorganize itself.
Recovery depends on the capacity to learn, practice, and internalize new ways of thinking and relating. However, this process can be especially challenging when the brain is both undernourished and burdened by trauma.
Eating disorders often function as psychological protectors, dulling awareness and making it harder to access emotional material. Even when patients can identify their feelings, they may still struggle to connect with the deeper roots of those emotions through conventional talk therapy alone.
Our Approach at New York Integrative Psychiatry
At New York Integrative Psychiatry, we offer intramuscular KAP as part of a comprehensive, integrative model. The KAP experience brings together three distinct therapeutic benefits:
Rapid Antidepressant Effect
Patients often report immediate relief from depressive symptoms, helping to restore motivation and hope early in the recovery process.Enhanced Neuroplasticity
Ketamine supports the brain in forming new neural pathways, allowing patients to move away from entrenched behaviors and toward more adaptive, recovery-oriented thinking.Individualized Dosing for Targeted Goals:
Dosing is tailored to each session’s goals, ranging from psycholytic (low-dose) sessions that support emotional processing with a therapist, to psychedelic (higher-dose) experiences. For patients with overcontrolled traits—a common feature in eating disorders—these higher-dose sessions can be challenging but transformative. They may promote acceptance, emotional release, and access to insights that are otherwise difficult to reach. Patients have described connecting with ancestral narratives, releasing intergenerational trauma, or deepening their awareness of their bodies—helping to counter the fragmentation often associated with eating disorders.
Is KAP the Right Fit?
It’s important to remember that KAP isn’t the right fit for everyone. A thoughtful evaluation with an experienced clinician helps determine whether this approach is appropriate. In general, KAP may be a good option for people who meet the following considerations:
Intrinsic Motivation
The individual is seeking treatment for themselves, rather than feeling pressured by others.Previous Treatment Attempts
They’ve engaged in therapy, nutritional support, and psychiatric care but still feel stuck or haven’t found lasting progress.Supportive Environment
They have access to a safe space for integration—or are open to working with a clinician to help build that support.Medical Clearance
They’ve completed necessary medical screening and are deemed physically safe for ketamine treatment.
A key benefit of receiving care at New York Integrative Psychiatry is the opportunity to explore KAP as part of a comprehensive treatment plan that also includes psychotherapy, psychiatry, and nutritional counseling—all in one setting.
Patients who are unsure whether KAP is the right fit can start treatment with our team, build trust with their providers, and explore their options at a pace that feels right for them. If KAP becomes part of their care, they can engage in the experience within the safety of an established therapeutic relationship.
Acknowledgments
We’re grateful to Erika Malm, LCSW, for her impactful work contributing to the field of Ketamine-Assisted Psychotherapy for eating disorders. Her clinical expertise and thoughtful contributions have meaningfully shaped our approach and continue to influence the field. To learn more, visit Erika Malm Collective.