Can Cannabis Treat Anorexia?
Apr 13, 2020
Cannabis is known to stimulate appetite, which is why some people use it to help with anorexia. Indeed, it’s a well-established fact that the endocannabinoid system plays a key role in regulating our eating habits.
More importantly, recent research suggests that a dysfunctional endocannabinoid system could be one of the causal or risk factors for anorexia and other eating disorders.
These findings may explain why several studies have found that pure THC can boost appetite and promote weight gain in people with anorexia. There’s even stronger evidence that THC can help those with appetite and weight loss caused by cancer and HIV/AIDS; synthetic THC was approved for the treatment of AIDS-related wasting as early as 1992.
Research also shows that cannabis can help anorexia sufferers in a multitude of other ways, such as improving abdominal pain, sleep, mood and other mental issues. Similarly, CBD may help with anxiety, depression, and sleep-related issues, although it lacks THC’s appetite-stimulating effects.
However, THC’s psychoactive side effects, a lack of randomized studies, and legal issues, have impeded its use.
Research on Anorexia and Cannabis
Most studies of anorexia show improvement in subjects’ body weight and psychological symptoms.
- The key piece of evidence is a 2014 study that examined the effects of the THC-based drug dronabinol on 25 women with anorexia. In addition to standard therapy, the participants took dronabinol (2.5 mg twice daily) or placebo for 4 weeks. The study found that they gained an average of 0.73 kg when taking dronabinol.
- A 2017 study assessed the effects of low-dose THC on appetite and other psychological symptoms of anorexia. Nine women took 1 mg of THC for a week followed by 2 mg for three more weeks. Although their weight did not change, the women reported improvements in body care, depression, and other psychological issues related to anorexia. The research also showed that cannabis improves body weight in people suffering from a loss of appetite and body weight caused by cancer and HIV/AIDS.
- One landmark 1995 study examined the effects of dronabinol on 139 people suffering from AIDS-related wasting. The study found that dronabinol increased appetite by 38% compared to only 8% for placebo and helped people maintain their body weight, with 22% gaining 2 kg or more. In comparison, those who took a placebo lost 0.4 kg, with only 10.5% gaining 2 kg or more. Dronabinol also improved mood and decreased nausea.
- Meanwhile, a 1994 study of people with cancer-associated anorexia found that THC (2.5 mg three times daily) improved appetite in 13 out of 18 patients.
- Similarly, a 2007 study of 10 HIV-positive marijuana smokers found that both marijuana and dronabinol “produced substantial and comparable increases in food intake.“
Apart from this, cannabis can also relieve less-common symptoms of anorexia, such as abdominal pain. The pain-relieving properties of cannabinoids are well established, with a 2017 report concluding that they’re “effective for the treatment of chronic pain in adults.”
CBD and Anorexia
Unlike THC, CBD does not stimulate appetite because it doesn’t interact strongly with the CB1 receptor. Therefore, CBD-rich cannabis preparations such as CBD oil are not a good option for anorexia sufferers looking to improve their appetite.
How Cannabis Works on Anorexia
The endocannabinoid system (ECS) exists in all vertebrates and helps regulate crucial functions such as sleep, pain, and appetite. The human body produces its own cannabinoids, which modulate and activate its various functions, but as its name suggests, the endocannabinoid system can also be modulated and activated by cannabinoids found in the cannabis plant. Because the entire system was only discovered in the past 30 years, scientists still have much to learn about the myriad ways cannabis affects the human body.
One of the endocannabinoid system’s major effects is controlling food intake and appetite. In particular, it’s a well-established fact that endocannabinoids stimulate appetite by activating the cannabinoid type 1 (CB1) receptor.
THC also activates this receptor, which explains the “munchies” associated with cannabis use. This effect is utilized by THC-based drugs to stimulate appetite in people suffering from wasting caused by HIV/AIDS, cancer, and other serious diseases.
Furthermore, the ECS plays a key role in the brain’s reward system, which motivates us to eat and do other things essential to our survival.
Given this, it’s clear that the ECS can be harnessed to help with anorexia. However, some researchers go so far as to suggest that dysfunction of the ECS might even be involved in anorexia and other eating disorders. There’s some evidence to support this theory.
For instance, a 2005 study of women with anorexia, binge-eating disorder (BED), and bulimia found that those with the first two conditions had higher blood levels of the endocannabinoid anandamide than their healthy counterparts.
Similarly, a 2009 study found that compared to healthy women, those with anorexia and bulimia had higher levels of CB1 receptors. These findings were strengthened by a 2011 study that reported that women with anorexia and bulimia had a higher density of CB1 receptors in the brain compared to healthy individuals.
Lastly, there’s some evidence of a link between anorexia and ECS-related genes. This was first demonstrated in a 2004 study, which found that certain types of anorexia were associated with specific variations in the CB1 receptor gene. Similarly, one variation of the CB2 receptor gene was reported to be associated with eating disorders in a 2010 Japanese study. However, some other studies have disputed these results, and more research is needed.
In short, current findings suggest that a dysfunctional endocannabinoid system may be involved in eating disorders such as anorexia and that cannabis could be a promising treatment.
Since THC rather than CBD or whole-plant cannabis seems to hold the most potential for treating anorexia, it’s important to understand its risks.
THC can cause temporary side effects such as impaired memory and reaction time, increased heart rate, red eyes, dry mouth, sleepiness, and dizziness. Some people may also experience feelings of paranoia and anxiety.
Although these side effects were noted in some studies of anorexia, they were relatively minor and temporary. The only exception is the previously mentioned 1983 study where three out of 11 women withdrew due to psychoactive side effects. However, the doses they were taking were also quite large.
Meanwhile, CBD-rich cannabis products are not intoxicating but can cause other side effects such as diarrhea, low blood pressure (hypotension), dry mouth, lightheadedness, sleepiness, and changes in appetite. The likelihood of suffering these effects is low unless you’re taking high doses.
The Cannigma content is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with an experienced medical professional with a background in cannabis before beginning treatment.
More About Anorexia
Anorexia nervosa, usually just called anorexia, is the most common type of eating disorder after bulimia. When you have anorexia, you have an abnormally low body weight, a distorted perception of your weight which makes you think that you are overweight or fat and an intense fear of gaining weight.
People with anorexia might use different ways to keep their weight down, like drastically reducing the amount of calories they eat, exercising too much or using medications like laxatives, diuretics, or enemas to excrete food from the body.
Anorexia manifests as an eating disorder, but it’s really an unhealthy way to cope with problems and feel a sense of control over your life. Anorexia can affect anyone at any age, but it’s most common among girls and women aged in their mid-teens and early twenties, typically developing around the age of 16-17. It’s thought that at least 30 million Americans and as many as 4 million people in the UK have anorexia, but statistics can be unreliable because many people with anorexia go undiagnosed and don’t seek help.
Anorexia can be treated successfully through therapy, but if it’s not tackled soon enough, it can cause long-term damage to your health or even be fatal.
The main symptoms of anorexia are deliberately keeping your weight down and being obsessed with weight and body image. There are both physical and emotional/behavioral symptoms.
Physical symptoms of anorexia include:
- An unusually low BMI, or having a weight and height that’s lower than expected for your age
- No menstrual period, or not beginning to menstruate at the typical age (for teens)
- Constipation, abdominal pain, and bloating
- Dizziness, headaches, and unusual tiredness
- Feeling very cold, and/or poor circulation that makes the ends of your fingers look bluish
- Hair loss, dry skin, and/or growing fine, downy hair all over your body
- Irregular heartbeat
- Low blood pressure
- Swollen arms or legs
- Reduced sex drive
Emotional or behavioral symptoms include:
- Excessive exercising
- Lying about your food intake
- Fear of gaining weight
- Avoiding eating foods that you think are fattening
- Taking appetite suppressants or diet pills to reduce feelings of hunger, or laxatives, or diuretics to encourage elimination of calories from the body
- Distorted body image, when you think you are fat when you are a normal weight or underweight
- Avoiding eating with other people
- Wearing very baggy clothes to hide how thin you are
- Perfectionists or high achievers at school or at work or anything else in general
Anorexia can have serious complications and can be fatal, even in someone who isn’t seriously underweight, because it affects the rhythm of the heart. It actually carries the highest mortality rate of any psychiatric disease, meaning a higher proportion of anorexics die of the disease than other conditions.
Complications of anorexia can include:
- Damage to every organ of the body, which might not be reversible when your anorexia gets under control
- Heart problems, heart failure, and heart arrhythmia
- Difficulty concentrating and memory loss
- Loss of bone mass (osteoporosis) and muscle mass
- Absence of periods in women
- Kidney problems
- Low blood levels of vital minerals like potassium, sodium, and chloride, which regulate your bodily functions
Anorexia is often accompanied by mental health disorders, including:
- Personality disorders
- Alcohol or substance abuse
- Suicidal thoughts or attempts
It can be difficult to spot the symptoms of anorexia because many people are skilled at hiding the amount they eat, tactics they use to lose weight, and their physical body.
To diagnose anorexia, the doctor will use a combination of:
- Physical exam to check your height, weight, blood pressure, and heartbeat
- Lab tests, including a complete blood count, tests to see levels of minerals in your blood, and testing the function of your liver, kidney, and thyroid
- Psychological evaluation to investigate your thoughts, feelings, and eating habits
- X-rays and other tests for bone density, stress fractures, and heart irregularities
It’s not known exactly what causes anorexia, but there are certain risk factors:
- A family history of eating disorders, depression, or drug or alcohol addiction
- A personal history of dieting, especially extreme dieting (recent studies show that starvation affects the brain and can make it difficult to return to normal eating habits)
- High amounts of stress, especially at times of transition like changing schools, a relationship breakup, or serious illness or death of someone close to you
- A history of being sexually abused
- Getting a lot of criticism for your body shape or weight or eating habits
- Working in a profession that’s focused on body weight and shape, like being a model, a jockey, a ballet dancer or an athlete
- Having a mental health disorder or strong personality traits like anxiety, low self-esteem, an obsessive personality, or being a perfectionist
Anorexia can often be treated successfully, but not always. Treatment takes time. The sooner you get treatment, the higher your chances of success. Treatment includes a combination of therapy, and clinical care.
The first concern is to help you return to a healthy weight, and treat any health issues that were caused by your anorexia. Some people need a period of hospitalization to make sure that their health is stable enough, and might need to be fed through a nasal-gastric tube. Others spend time in residential programs or go to day programs, where they receive therapy as well as regular monitoring of their vital signs.
Once your health has stabilized, or alongside steps to stabilize your physical health, you’ll receive psychological therapy.
There’s no specific medication that is indicated to anorexia, but once you’ve returned to a stable weight, you might be prescribed antidepressants or other psychiatric medication to treat underlying anxiety, depression, or other disorders.