Eating Disorders, Depression and IV Ketamine: What Families Should Know
Eating disorders often come with depression, anxiety and suicidal thoughts. Dr. Jerron Hill reviews the research on IV ketamine, nutrition and why comprehensive care matters.
Depression, anxiety and suicidal thoughts often accompany eating disorders. A physician explains what the research shows about IV ketamine and why comprehensive, whole-person care matters.
By Jerron C. Hill, M.D., Anesthesiologist and Founder of HILLMED
Eating disorders affect both physical and emotional health. Depression, anxiety and suicidal thoughts frequently accompany these illnesses. Patients and families deserve comprehensive support. [1-3]
IV ketamine can help some patients with treatment-resistant depression, including patients who also have an eating disorder. Evidence that it treats the eating disorder itself remains preliminary. Here is what families should know.
How common are eating disorders?
These National Institute of Mental Health (NIMH) benchmarks come from national surveys conducted in 2001-2004 using older diagnostic criteria. They are historical estimates, not current annual counts, and do not include every eating-disorder diagnosis. [1]
Measure | U.S. estimate |
|---|---|
Lifetime eating-disorder prevalence, ages 13-18 | 2.7% |
Ages 13-14 / 15-16 / 17-18 | 2.4% / 2.8% / 3.0% |
Adolescent females / males | 3.8% / 1.5% |
Median onset: anorexia / bulimia | 18 years / 18 years |
Median onset: binge-eating disorder | 21 years |
Adult lifetime prevalence: anorexia | 0.6% |
Adult lifetime prevalence: bulimia | 1.0% |
Adult lifetime prevalence: binge-eating disorder | 2.8% |
Eating disorders rarely occur alone
Among adults with an eating disorder, anxiety and mood disorders are common. Percentages represent lifetime co-occurrence. Mood disorders include depression and bipolar disorders. [1]
Adult eating disorder | Any anxiety disorder | Any mood disorder |
|---|---|---|
Anorexia nervosa | 47.9% | 42.1% |
Bulimia nervosa | 80.6% | 70.7% |
Binge-eating disorder | 65.1% | 46.4% |
A separate study of 36,309 U.S. adults, published in 2019, found major depressive disorder was the most common co-occurring psychiatric diagnosis across all three eating disorders. [2]
Suicidal thoughts among adolescents
A national study of 10,123 adolescents ages 13-18 reported the following lifetime experiences. These historical estimates have uncertainty, particularly in small diagnostic subgroups, and are not predictions for an individual patient. [3]
Eating disorder | Suicidal ideation | Suicide attempt |
|---|---|---|
Anorexia nervosa | 31.4% | 8.2% |
Bulimia nervosa | 53.0% | 35.1% |
Binge-eating disorder | 34.4% | 15.1% |
No eating disorder | 11.2% | 3.0% |
Where IV ketamine fits
Depression and suicidal thoughts. In a randomized trial of 80 adults with major depression and significant suicidal thoughts, 55% receiving IV ketamine had at least a 50% reduction in suicidal-thought scores at 24 hours, compared with 30% receiving midazolam. This was not an eating-disorder trial. Reducing suicidal thoughts does not establish prevention of suicide attempts or deaths. [4]
Eating-disorder symptoms. A 2025 uncontrolled series of eight patients receiving IV ketamine alongside usual care reported improved BMI and weight restoration. Its small size and lack of a control group prevent conclusions about ketamine's independent benefit. [5]
Results are mixed. A separate 2025 study compared 85 adults receiving intranasal generic ketamine with 85 matched controls in intensive eating-disorder treatment. Both groups improved, without significant additional benefit from ketamine. This was not IV treatment, but it underscores the need for stronger evidence. [6]
Learn more about IV ketamine for treatment-resistant depression and what to expect at your first infusion.
Nutrition is part of whole-person care
Nutritional rehabilitation is central to recovery from an eating disorder, and it should be guided by the patient's treatment team. [8] In my practice, I consider nutrition with vitamin D, zinc and healthy fats from fish oil an integral component of whole-person health for these patients.
Vitamin D. In an analysis of 15 studies, people with anorexia nervosa had lower vitamin D levels than healthy comparison groups. [9] Your physician can check whether a vitamin D level is low and recommend an appropriate amount.
Omega-3 fats from fish oil. In an analysis of clinical trials in people with depression, omega-3 formulations high in EPA were associated with improved depressive symptoms. [10] Fish oil supplements should be reviewed with the care team, especially for anyone taking blood thinners or other medications.
Zinc. Zinc supports immune function, wound healing and the senses of taste and smell. Restrictive eating and inadequate calorie intake can increase the risk of zinc deficiency. The treatment team can assess zinc status and recommend zinc-rich foods or supplementation when appropriate. Excessive zinc can cause nausea and copper deficiency, so supplementation should be individualized and medically supervised. [11]
Supplements support, but do not replace, nutritional rehabilitation, psychotherapy and medical monitoring.
Comprehensive care remains essential
IV ketamine is used off-label for depression and eating disorders; it is not FDA-approved for either indication. Eating-disorder care includes nutritional rehabilitation, psychotherapy and medical monitoring. [7, 8]
Before considering an infusion, a physician should assess medical stability, including malnutrition, hydration, electrolytes and cardiac concerns. Ketamine requires appropriate patient selection and monitoring; it does not replace urgent psychiatric care when suicide risk is immediate.
A message for our community
At HILLMED, we listen to each patient and family, recognize the person behind the diagnosis and tailor treatment to their needs.
Throughout the past nine years, I have seen the benefits of IV ketamine in helping to relieve and manage suicidal ideation (SI), depression and anxiety affecting teenagers and young people who suffer with eating disorders. These are my clinical observations, shared to offer hope to patients and families.
Medically supervised IV ketamine can provide rapid relief of depression for some appropriately selected adults. For someone living with both an eating disorder and treatment-resistant depression, addressing depression may be an important part of their recovery plan. [4]
Research on ketamine for eating-disorder symptoms remains preliminary. The adult studies summarized here do not establish its safety or effectiveness in teenagers. Pediatric treatment requires individualized specialist assessment. IV ketamine is off-label and should complement psychotherapy, nutritional support and medical monitoring. [4-8]
You do not have to face these challenges alone. A thorough evaluation can help identify the care that fits your needs.
If you or someone you love is in crisis or thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911.
Start with a conversation
To learn whether IV ketamine may be appropriate as part of a comprehensive care plan, book a complimentary teleconference consultation or call HILLMED at 972.212.4341. Learn more about ketamine infusion therapy at HILLMED.
About the author
Jerron C. Hill, M.D., is an anesthesiologist and the founder of HILLMED in Plano, Texas, and Dr. CBD & Nutrition Centers in University Park. He brings decades of anesthesia experience and nine years of clinical experience treating patients with IV ketamine to individualized, physician-supervised care.
References
NIMH. Eating Disorders: Statistics. National surveys, 2001-2004.
Udo T, Grilo CM. Psychiatric and medical correlates of DSM-5 eating disorders in a nationally representative sample of adults in the United States. Int J Eat Disord. 2019.
Swanson SA, et al. Prevalence and correlates of eating disorders in adolescents. Arch Gen Psychiatry. 2011;68:714-723.
Grunebaum MF, et al. Ketamine for rapid reduction of suicidal thoughts in major depression. Am J Psychiatry. 2018;175:327-335.
Escobedo-Aedo et al. Ketamine as adjuvant treatment in eating disorders. J Eat Disord. 2025;13:48.
Wassenaar et al. Ketamine for treatment resistant depression in individuals with eating disorders: a comparison study. J Eat Disord. 2025;13:280.
FDA. Ketamine Store warning letter, June 23, 2026. Ketamine approval status.
Veronese N, et al. Vitamin D status in anorexia nervosa: a meta-analysis. Int J Eat Disord. 2015;48(7):803-813.
Liao Y, et al. Efficacy of omega-3 PUFAs in depression: a meta-analysis. Transl Psychiatry. 2019;9(1):190.
NIH Office of Dietary Supplements. Zinc: Fact Sheet for Health Professionals.
This article is for education only and is not medical advice. Talk with a physician and your eating-disorder treatment team about your individual situation.
