Cannabis and Eating Disorders: Can Weed Help With Anorexia?

Cannabis may help some people with eating disorders like anorexia by stimulating appetite and easing anxiety, and research suggests the endocannabinoid system plays a real role in hunger and eating. But the evidence in eating disorders specifically is thin, the conditions often overlap with substance use problems, and cannabis is at most a complement to therapy, never a replacement. Weed has been known for thousands of years as a way to stimulate appetite and get people eating. But that's not all.

Cannabis has also long been used as a remedy for anorexia and related eating disorders. Now, modern research is finding that the link between the endocannabinoid system and conditions like anorexia runs much deeper than anyone suspected.

What are eating disorders?

Eating disorders are conditions in which a person uses control over food to cope with feelings and emotions. Unhealthy eating behaviors can include eating too much or too little, or obsessing over body weight or shape.

It's worth stressing that each eating disorder needs its own treatment, depending on the condition and the person's history.

Types of eating disorders

Binge eating disorder

This means eating uncontrollably past the point of feeling full, often to the point of feeling sick. Binges are usually followed by guilt and shame. Over time, it can lead to weight gain and obesity.

Bulimia nervosa

This condition combines bingeing with purging afterward, through self-induced vomiting, laxatives or compensating behaviors like fasting or excessive exercise. People with bulimia can be slightly underweight, normal weight or overweight.

Anorexia nervosa

Although it's less common than the other two main disorders, anorexia has one of the highest death rates of any mental illness. People with anorexia feel overweight even when they're dangerously underweight. That leads to severe food restriction and physical wasting.

How anorexia nervosa is treated

Anorexia nervosa is usually treated by a team that includes doctors, mental health professionals and dietitians, all experienced with anorexia and other eating disorders. Ongoing therapy and nutrition education are key to long-term recovery.

What to keep in mind during treatment

• One of the biggest clinical challenges with eating disorders is that they often go hand in hand with a substance use disorder. That includes cannabis use disorder, which can start before, at the same time as or after an eating disorder.

• Another challenge is that people with anorexia often feel stronger when they resist the urge to eat. So cannabis's appetite-stimulating effects won't necessarily overcome the neurobiological issues also tied to the disorder.

Can cannabis help treat eating disorders?

Medical cannabis could be a useful tool for some people alongside therapies like cognitive behavioral therapy (CBT). Cannabis is usually split into three main types: sativa, indica and hybrids.

• Sativa strains: are usually described as energizing, with more of a head high. People use them to ease symptoms of depression, fatigue and mood disorders.

• Indica strains: are generally more sedating, with a relaxing, full-body effect, and they're the ones most often used by patients with eating disorders.

• Hybrids: usually combine the two and are thought to balance out the benefits of both.

Very few studies look specifically at how THC affects appetite in people with eating disorders. There are, however, plenty of studies on cannabis and cannabinoids for appetite loss and wasting in people with debilitating illnesses like cancer, AIDS or hepatitis.

Results vary a lot from study to study, but it's safe to say the endocannabinoid system plays an important role in appetite and eating. This research is helping scientists better understand how the endocannabinoid system works and how it regulates things like appetite, food intake and feeling full.

Eating disorders and the endocannabinoid system

The endocannabinoid system (ECS) is a network of receptors, enzymes and endocannabinoid molecules that keeps the body in balance (homeostasis) across a range of functions. CB1 receptors, found in the central nervous system, send a "calm down" signal to overactive neurons. Since these receptors sit in the brain regions that control food intake, researchers think there may be a link between a malfunctioning ECS and the development of an eating disorder.

Because of the way they bind to CB1 receptors, cannabinoids may help reduce patients' anxiety and increase (or, with high-CBD strains, decrease) how much food they eat.

So should cannabis be used to treat eating disorders?

The reality is that because eating disorders can overlap with substance use disorders, not every doctor recommends prescribing cannabis for them, although some argue that with close follow-up and supervised treatment it can bring real benefits for patients' behavioral and cognitive symptoms. 

As with any other condition, what matters is talking to a professional and keeping close tabs on any medications or therapies used as part of treatment. 

Can weed cause eating disorders in teens?

No studies have shown that cannabis use can cause anorexia or make it easier for people with anorexia to starve themselves. There are, however, signs that cannabis can suppress appetite under certain circumstances. That's notable, because its role as a powerful appetite stimulant in medicine has been well studied.

According to researchers, the appetite-suppressing effect depends on high levels of CBD or THCV, two cannabinoids that studies say can curb appetite. In fact, research by a British pharmaceutical company found that both cannabinoids suppressed appetite when given to mice. This happens because the compounds act as an antagonist and an inverse agonist at cannabinoid receptors, blocking the appetite-boosting effects of agonists like anandamide or THC.

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