Behavioral Disorders
Ibogaine for eating disorders
Food stopped being food somewhere along the way, and the disorders that grew around it carry some of the highest death rates in psychiatry.
Americans, about 9% of the population, estimated to face an eating disorder in their lifetime.⁶⁸
the expected death rate in anorexia nervosa, among the highest of any psychiatric illness. One in five of those deaths is suicide.⁷⁰
of the calories American adults eat are ultra-processed.⁷¹
of adults meet the research criteria for addiction to ultra-processed food, on par with rates for alcohol and tobacco.⁷²
"Food addiction" is a research framework, not a recognized diagnosis, and researchers genuinely argue about it.⁷² The mortality numbers are not argued about.
One loop, many names
The diagnoses matter medically, and we take them seriously in screening. But under the labels runs the same machinery: a relationship with food that has stopped being about food.
Anorexia nervosa
Restriction as control. The rarest of the major diagnoses and by far the most lethal: nearly six times the expected death rate.⁷⁰
Bulimia nervosa
The binge and purge cycle. Often invisible from the outside, and hard on the heart, which matters for everything on this page.
Binge eating disorder
The most common eating disorder in America, and the least talked about.⁶⁹ Relief, then shame, then the pull to do it again.
Compulsive overeating
Not a formal diagnosis, but it fills the room: grazing that never stops, food noise that never quiets, eating past every signal.
ARFID
Avoidant and restrictive intake with no body-image engine behind it. A different mechanism, included here because families keep asking.
The mixed pictures
Most real cases blur categories, which clinicians file under OSFED. The label matters less than the loop it describes.
Engineered to be finished
A crinkle-cut fry is a designed object. Sugar, fat and salt land in ratios no food in nature reaches, tuned in test kitchens until stopping is harder than starting. More than half of what Americans eat is now built this way.⁷¹
The most common eating disorder in America is not anorexia. It is binge eating disorder,⁶⁹ and it runs on the same reward loop as every other page in this section: relief, then shame, then the pull to do it again. Restriction and purging are the same loop wearing different clothes, with control standing in for relief.
None of this is a failure of willpower. It is a collision between an ancient reward system and an industry that studied it carefully, and then a mind that turned the results on itself.
Lesson One, From the FoundersMost eating disorders come from a lack of acceptance of one's own body. We might call it body dysmorphia, but essentially it is an inability to love oneself.
Our entire program is a way to reassess the physical and energetic body: to begin to find love for yourself exactly as you are, and to recognize your power and potential to change your physical body through effort and belief.
Tatiana Aya Tupinambá, Co-Founder, Nekawa
Practical and spiritual, in the same breath
Our approach is not a meal plan. It rebuilds the relationship with food from the ground up, literally, and none of it happens alone or unsupervised. Which practices a student takes on is matched to their history: what heals one form of this can feed another, and we screen for exactly that.
Grow the food you eat
Students work in the garden and pick their own fruit. Food stops being a product that appears wrapped and starts being something you tended for weeks. It is the slowest possible answer to engineered food, which is the point.
Learn what your body actually needs
Through the teachings of Ayurveda, students study nutrition and learn which foods are right for their own constitution. Not a diet handed down, a framework for reading yourself.
Meet hunger on purpose
Fasting practice, guided and voluntary: as little as 24 hours, up to seven days for the truly intrepid. Met deliberately and with support, hunger becomes something you can study instead of something that runs you. It is how students learn the shape of their own compulsions. Not offered where restriction is the illness.
A new relationship with cleansing
Plant medicine often involves purging, and rather than treating that as an accident, students learn what cleansing the body actually is: deliberate, occasional, and in service of the body rather than against it. For anyone whose disorder made purging a punishment, rebuilding that relationship is critical to healing, and it is done carefully.
Where ibogaine comes in, and where it will not
The direct answer: no clinical trial has tested ibogaine for eating disorders. What exists is the shared reward-circuitry argument⁷⁷ and what we have seen working with compulsive patterns of every kind. We will not dress that up as more than it is.
And this page carries a harder caveat than the others. Ibogaine prolongs the QT interval of the heart, and eating disorders, especially where restriction or purging is active, can leave exactly the electrolyte disturbances that make that dangerous. Screening here is strict: cardiac workup, bloodwork, and an honest medical history, reviewed by the independent licensed Brazilian physicians who administer the treatment in a hospital. Some people will be told no, or not yet. Being willing to say that is the only version of this we are willing to run.
For those who clear screening, the rest is structural: weeks on a rainforest campus where the food is fresh, grown nearby, cooked by people and eaten at a table with other people. Preparation before, integration after, continuing for months through the Window of Wonder. The treatment opens a window. What you practice inside it is a different relationship with food, in a place where that is actually possible.
Citations (6)
[68] Deloitte Access Economics (2020). The Social and Economic Cost of Eating Disorders in the United States of America. Report commissioned by STRIPED (Harvard T.H. Chan School of Public Health) and the Academy for Eating Disorders. Read the source →
Modeled estimate that 9% of the US population, about 28.8 million Americans, will have an eating disorder in their lifetime. Includes subclinical presentations; strict DSM-5 survey prevalence runs lower, so cite as an estimate rather than a count.
[69] Udo T, Grilo CM (2018). Prevalence and Correlates of DSM-5-Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults. Biological Psychiatry, 84(5), 345–354. Read the source →
The largest DSM-5 national survey of eating disorders (36,306 US adults), finding binge eating disorder the most common eating disorder in American adults, ahead of anorexia nervosa and bulimia nervosa. Absolute prevalence figures vary several-fold between surveys, but binge eating disorder ranking first holds across them.
[70] Arcelus J, Mitchell AJ, Wales J, Nielsen S (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: a meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724–731. Read the source →
Meta-analysis finding people with anorexia nervosa die at 5.86 times the expected rate, among the highest mortality of any psychiatric illness, with about one in five of those deaths by suicide. "Among the highest" is the defensible phrasing: mortality in some substance use disorders is of comparable magnitude.
[71] Juul F, Parekh N, Martinez-Steele E, Monteiro CA, Chang VW (2022). Ultra-processed food consumption among US adults from 2001 to 2018. American Journal of Clinical Nutrition, 115(1), 211–221. Read the source →
NHANES analysis showing ultra-processed foods supply about 57% of the calories US adults eat, up from roughly 54% two decades earlier. Based on 24-hour dietary recall and the NOVA classification, which some nutrition researchers contest.
[72] Gearhardt AN, Bueno NB, DiFeliceantonio AG, Roberto CA, Jiménez-Murcia S, Fernandez-Aranda F (2023). Social, clinical, and policy implications of ultra-processed food addiction. BMJ, 383, e075354. Read the source →
Analysis drawing on pooled Yale Food Addiction Scale data estimating that 14% of adults meet criteria for addiction to ultra-processed foods, comparable to prevalence rates for alcohol and tobacco. "Food addiction" is not a recognized diagnosis in DSM-5 or ICD-11; the scale applies substance-use criteria by analogy, and the construct is actively debated.
[77] Grant JE, Potenza MN, Weinstein A, Gorelick DA (2010). Introduction to Behavioral Addictions. American Journal of Drug and Alcohol Abuse, 36(5), 233–241. Read the source →
The standard review showing behavioral addictions produce the same core clinical picture as substance addictions (craving, escalation, loss of control, continued use despite harm) and engage overlapping brain reward circuitry, including altered dopamine signaling in the mesolimbic pathway. The neuroimaging evidence is strongest for gambling; for newer candidates like porn and social media it is suggestive, not conclusive.
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