Anorexia nervosa is one of the most challenging eating disorders to treat, with high relapse rates and limited pharmaceutical options. As researchers explore new treatment avenues, cannabis has emerged as a potential therapeutic tool.
But does the evidence support using weed for anorexia, or could it potentially worsen eating disorders? Let’s explore what science tells us about this complex relationship.
The Endocannabinoid System and Anorexia
Research has revealed that people with anorexia often show abnormalities in their endocannabinoid system (ECS), a complex cell-signaling network that helps regulate various bodily functions including appetite, mood, and stress response.
Studies have found differences in:
- Expression of cannabinoid-related genes and alleles
- Availability of cannabinoid receptors
- Circulating levels of endocannabinoids (the body’s natural cannabis-like compounds)
These abnormalities may contribute to the persistent food restriction and distorted body image characteristic of anorexia. They also suggest that targeting the ECS with cannabis or cannabinoids might help address some underlying biological factors of the disorder.
Rogers & Pacanowski’s scoping review (2023) provides comprehensive evidence of these ECS abnormalities in anorexia patients.
How Cannabis Might Help Anorexia
Appetite Stimulation
Perhaps the most well-known effect of cannabis is its ability to increase appetite, commonly called “the munchies.” This occurs primarily through THC (tetrahydrocannabinol), which:
- Boosts production of ghrelin, a hormone that signals hunger to the brain.
- Activates CB1 receptors in the hypothalamus, promoting food-seeking behaviors.
- Can make food taste more appealing, potentially helping those who have lost pleasure in eating.
One study found that anorexia patients experienced increased weight gain and improved overall symptoms using minimal amounts (2mg) of dronabinol, a synthetic form of THC.
Farokhnia et al. (2020) demonstrated how different cannabis consumption methods affect endocrine pathways related to appetite and metabolism, providing valuable insights for potential therapeutic applications.
Nausea Relief
Many anorexia patients experience significant gastrointestinal discomfort and nausea, especially during meals, which can reinforce food avoidance behaviors. Cannabis has potent anti-nausea properties that may help make the eating experience more comfortable.
THC specifically interacts with the brain’s chemoreceptor trigger zone and reduces the release of serotonin from the small intestine, both of which help control nausea and vomiting.
For anorexia patients, this relief can be crucial in making mealtimes less physically distressing, potentially breaking the cycle of food avoidance.
Anxiety and Mood Regulation
Many people with anorexia also experience anxiety and depression, which can worsen their relationship with food. Cannabis, particularly CBD (cannabidiol), has shown promise for:
- Reducing anxiety levels
- Improving mood
- Slowing racing thoughts that might contribute to food avoidance
One patient reported that medical cannabis helped “slow down her mind, allowing her to observe her irrational thoughts surrounding food. Food began to taste better, making her mealtimes an enjoyable experience.”
Pain Management
Anorexia can lead to various physical complications due to nutritional deficiencies, including muscle pain, joint discomfort, and gastrointestinal issues. The analgesic (pain-relieving) properties of cannabis may help alleviate these physical symptoms, improving overall comfort and quality of life during recovery.
Both THC and CBD have demonstrated pain-relieving effects through different mechanisms. THC binds directly to cannabinoid receptors involved in pain signaling, while CBD reduces inflammation and interacts with non-cannabinoid receptors that regulate pain perception.
Potential Risks and Concerns
Despite potential benefits, cannabis use in eating disorder treatment comes with important considerations:
Co-occurring Substance Use Disorders
Eating disorders and substance use disorders frequently co-occur. Some treatment centers report that 7-9% of their eating disorder patients who use cannabis show signs of dependency.
This raises concerns about introducing cannabis as a treatment option without careful monitoring.
Paradoxical Effects
While cannabis can stimulate appetite in some cases, its effects aren’t universal. People with anorexia often feel empowered by resisting hunger, and the appetite-stimulating properties of cannabis can’t necessarily overcome these deep-seated psychological issues.
Variable Effects by Strain and Consumption Method
Different cannabis strains and consumption methods may produce varying effects:
- Sativa strains tend to be more energizing and may help with depression
- Indica strains are more sedating and may help with anxiety and sleep
- Hybrids combine effects of both
- Terpenes like linalool may stimulate appetite, while others like humulene might suppress it
Cannabis can be administered through various methods, each with different onset times and durations:
- Vaping or smoking provides rapid relief but shorter duration
- Edibles offer longer-lasting effects but delayed onset
- Tinctures provide a middle ground between rapid onset and duration
- Topicals may help with localized pain but have minimal systemic effects
Current Research Status
The relationship between cannabis and anorexia is still being explored, with limited but promising evidence. A recent scoping review found:
- Eight studies identifying abnormalities in the ECS in anorexia patients
- Three studies showing mixed results (benefits, harms, and null effects) of cannabinoid treatment
- Four studies examining potential harms of cannabis use in eating disorders
Benefits included weight gain and improved eating disorder symptoms, while potential harms included increased physical activity in some patients and concerns about compensatory behaviors related to cannabis use.
Practical Considerations for Patients
If you’re considering cannabis for anorexia or another eating disorder:
Medical Supervision
Always work with healthcare providers who:
- Understand both eating disorders and cannabis
- Can help determine appropriate dosing
- Will monitor for both benefits and adverse effects
- Can integrate cannabis with your overall treatment plan
Start Low, Go Slow
If approved by your healthcare provider:
- Begin with minimal doses
- Gradually increase only if needed
- Pay attention to how different strains affect you
- Consider CBD-dominant products if anxiety is a major concern
Legal Considerations and Certification Process
Check your state’s laws regarding:
- Whether eating disorders qualify for medical cannabis
- Requirements for obtaining a medical cannabis card
- Legal consumption methods in your area
The certification process typically involves:
- Consultation with a qualified healthcare provider
- Review of your medical history and current symptoms
- Discussion of potential benefits and risks
- Completion and submission of state-required paperwork
- Regular follow-up appointments to monitor progress
MMTC offers telehealth options for initial consultations and follow-up appointments, making the certification process more accessible, especially for those with mobility issues or those living in remote areas.
Conclusion
The relationship between cannabis and anorexia represents a promising but complex area of research. While evidence suggests cannabis may help some patients with weight restoration, nausea relief, pain management, and symptom management, treatment must be individualized and carefully monitored.
For those struggling with anorexia or other eating disorders, cannabis should be viewed as one potential tool within a comprehensive treatment approach, not a standalone solution. As research advances, we may develop more targeted cannabinoid therapies specifically designed for eating disorder treatment.
If you’re considering cannabis for an eating disorder, speak with healthcare provider about both conditions to determine if it might be appropriate for your specific situation.
Frequently Asked Questions
Do edibles work if you have an eating disorder?
Cannabis edibles may benefit some people with eating disorders. Beyond being higher-calorie food items themselves, they can help increase appetite like other cannabis consumption methods. However, effects vary by individual, and edibles should only be used under medical supervision. The delayed onset (typically 30-90 minutes) should be considered when using edibles to stimulate appetite for planned meals.
Can CBD alone help with eating disorders?
While CBD hasn’t shown significant appetite-stimulating effects like THC, it may help reduce anxiety that often accompanies eating disorders.
This anxiety reduction might indirectly help with meal avoidance and other disordered eating behaviors. CBD may also help with pain and inflammation associated with malnutrition.
Is cannabis helpful for all types of eating disorders?
Cannabis affects eating disorders differently. It may be most helpful for conditions involving appetite loss or high anxiety around food, but less beneficial for disorders involving binge eating. Every individual responds differently, and more research is needed.
What amount of cannabis should I take to improve appetite?
Appropriate dosing varies significantly between individuals. If considering cannabis for appetite stimulation, consult with a healthcare provider familiar with cannabis medicine. The general principle is to start with very low doses and increase gradually only if needed. Many anorexia patients report benefits from minimal doses (as low as 2mg of THC).
Can cannabis cure eating disorders?
While cannabis may help manage some symptoms of eating disorders, it’s not a cure. Effective treatment typically requires a comprehensive approach including therapy, nutritional counseling, and sometimes medication. Cannabis might be one component of treatment for some patients.
