Eating Disorders (e.g. Bulimia, Anorexia and Obesity) and Medical Cannabis
An eating disorder is any range of psychological disorders that are characterized by abnormal or disturbed eating habits and/or an unhealthy relationship with food. Eating disorders are usually referred to in terms of conditions such as bulimia and anorexia nervosa, but can also include obesity and binge eating disorder (BED).
Potential Efficacy / Quality of Evidence (Low, Average, High) of Medical Marijuana for Eating Disorders (e.g. Bulimia, Anorexia and Obesity)
Average – much of the evidence is anecdotal and low in number, but promising.
Cannabinoids, Terpenes/Terpenoids, Strains and Ratios that May Help
Depending on the type of eating disorder. For bulimia/anorexia, THC may be of particular use; for obesity, THCV. Limonene may help improve the mood. However, care must be taken with high doses of THC, lest it make depressive episodes potentially worse.
Medical Cannabis Pros
CBD may help regulate insulin levels.
In those with anorexia or bulimia, THC may increase hunger.
Euphoria can help overcome the anxiety and depression associated with eating disorders.
Medical Cannabis Cons
Although the evidence so far is convincing, with a logical theoretical framework, more research is needed.
May increase paranoia, anxiety and depressive episodes in some, which can be an issue for eating disorders of all types.
More About the Condition
One of the most well-known side-effects of cannabis is that it can give a person the “munchies” – an urge to eat. This makes cannabis and cannabinoids a perfect candidate for the treatment of eating disorders of many kinds. When it comes to obesity – which is often also considered an eating disorder – it comes as a shock that cannabis may help. However, cannabis users tend to have a lower body mass index (BMI) and lower rates of obesity compared to the general population.
Eating disorders of various types could be due to a dysfunctional endocannabinoid system (ECS). Leptin and ghrelin levels are lower in those with eating disorders, and cannabinoids may actually help induce the production of these two hunger-causing hormones. As for those with obesity, there is an increase in the concentration of cannabinoids made available in the body. This increased availability of cannabinoids can stimulate hunger. Cannabinoids such as THCV and CBD may help curb this hunger and help regulate insulin levels.
Obesity costs the US approximately $117 billion in direct health costs, making up between 6% to 12% of national healthcare expenditure in the US. In the developing world in general, obesity is becoming a bigger-and-bigger problem, as refined sugars and processed foods start becoming a part of a greater number of people’s diets. Obesity affects an estimated 600 million adults and 100 million children worldwide.
Eating disorders such as anorexia and bulimia, meanwhile, have an extremely high mortality rate, and treatment methods are complex. Treating eating disorders of all kinds is therefore a matter of utmost importance, and effective treatment could help prevent a number of other conditions as well.
Quotes from Experts
“Anorexia nervosa (AN) is characterized by anhedonia whereby patients experience little pleasure or reward in many aspects of their lives. Reward pathways and the endocannabinoid system have been implicated in the mediation of food intake.” Source: Verty, Aaron N A et al. ‘The cannabinoid receptor agonist THC attenuates weight loss in a rodent model of activity-based anorexia.’ Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology vol. 36,7 (2011): 1349-58. doi:10.1038/npp.2011.19
Case Studies – Patient Stories