It's common knowledge that weed gives us a good case of the munchies, but is this enough to combat an eating disorder like Anorexia?
We note that the subject contained in this article represents illegal activity in certain jurisdictions. Whilst we do not condone any acts which are contrary to any such laws, we understand that readers in those jurisdictions which have decriminalised cannabis may find this article of interest.
From anxiety and depression to epilepsy and pain-relief, cannabis has developed a solid reputation for combating an array of ailments. Medicinal marijuana is quickly gaining traction in aiding symptoms linked with cancer, Crohn's disease and even Alzheimer's. Support, however, in the effectiveness of using weed to aid eating disorders such as anorexia is still under scrutiny.
It's a common assumption that cannabis is an easy fix in the recovery process of anorexia. This is due to its effect on increasing appetite via the Endocannabinoid System (ECS) while promoting relaxation. The crux of the disorder, however, is not just about eating.
What is Anorexia Nervosa?
Anorexia is a psychological disorder that is associated with a negative relationship with food, eating, and/or body-image. Individuals will restrict their eating habits, develop obsessive-compulsive tendencies surrounding food intake, exercise and how they look. Though it is more common in women, around ten percent of men can also develop the disorder.
Developing anorexia is not restricted to any demographic. It is, however, dependent on a range of psychological, environmental, social and genetic factors; some individuals may already have a genetic predisposition to developing the disorder. This may then be exacerbated by social pressures or an unhealthy lifestyle. Some may be psychologically vulnerable through an existing case of anxiety, substance abuse, depression, or Obsessive-Compulsive Disorder (OCD).
This is where it gets a little complicated. Anorexia has a very high co-morbidity rate (around fifty percent), meaning that a person won't just have anorexia, they'll often have a combination of other disorders as well. This may range from a mild case of anxiety to severe paranoia, body dysmorphia or even bipolar disorder.
This makes each case of anorexia unique and complex to the individual, thus treatment is tailored to the patient on a case-by-case basis. Commonly, a combination of Cognitive Behavioural Therapy (CBT), counselling, and in some cases, anti-depressant medication is used to aid the recovery process.
To make matters more complicated, anorexia is not just about not eating, it's a combination of an imbalance of brain chemistry, control, and anxiety-related symptoms. It's a disorder that instills fear and compulsion towards one's relationship with food or a body-image ideal.
It's not a straightforward diagnosis, and its treatment and recovery are no different.
Weeding Out The Kinks
Clinically, cannabis has been proven to be an effective treatment option for cancer-related weight loss (cachexia). However, this doesn't make it a viable candidate for helping all anorexia patients put the weight back on. Regardless of its anecdotal and clinical success, cannabis is still not considered a 'one-size-fits-all' treatment option – and for a very good reason.
Anorexia is first and foremost a psychological disorder, one that centres around fear, obsession, and control. Weed may be an option to help, but it also has the potential to make things worse.
Firstly, it's important to understand that anorexia patients have an imbalance in their brain chemistry. This poses a problem for our ECS because it can't do its job properly. The ECS loves balance. Its sole responsibility is to make sure that our day-to-day functions like eating and sleeping are balanced and reward-based. However, anorexia patients seem to have an issue in the brain region that associates food and emotion.
Essentially, this makes it difficult for anorexia patients to find pleasure in what they eat. Instead of our ECS making us feel satisfied with eating, there is a lack of activity that takes away the satisfaction, making it very easy for those suffering from anorexia to develop a negative association with food.
This process, when paired with other disorders like OCD, anxiety, and depression enhance this negative association. In some cases, the confluence of disorders can create an overdrive of fear and guilt when eating.
Now, this naturally makes cannabis a viable treatment option for anorexia because of its cannabinoids like Tetrahydrocannabinol (THC) and Cannabidiol (CBD). The cannabinoids will activate the ECS to enhance the satisfaction felt when eating, as well as stimulating the appetite itself. Additionally, cannabis can also boost relaxation and reduce anxiety, depending on the type of cannabis used.
This is because of our CB1 receptor which is responsible for our reward-based feelings associated with our daily functions. When the cannabinoids react with the CB1 receptor, it enhances the pleasure and our other sensory responses to food when we eat.
Can Cannabis Cure Anorexia?
Clinically speaking, there are a few studies (albeit, not many) supporting cannabis and cannabis-based medicines as a safe and effective treatment option. A 2017 case-study found that a regular dosage of Dronabinol, a cannabis-derived medication, was effective in subsiding the obsessive-compulsive urges in an anorexic patient. The twenty-seven-year-old male had failed to respond to several psychotherapy treatments in an attempt to cease his compulsion to excessively exercise.
Another 2017 study found that low doses of THC were also effective in increased self-reported body care while alleviating depressive thoughts in females patients.
For these reasons, cannabis can be a perfect fit to increase reward-based feelings and the need to eat. However, anorexia isn't only about food, it's also about control.
The first issue lies within the psychological vulnerability that patients with anorexia have. This means that cannabis use may help someone regain their appetite, however, it might also hinder other co-morbid conditions. Patients may find themselves wanting to eat but may feel more anxiety or paranoia about eating. This may lead to increased feelings of guilt or shame. Again, this is heavily dependent on the type of cannabis used and the level of psychological vulnerability of the patient.
Secondly, anorexia patients also have a high co-morbidity rate of substance abuse, which might also put the patient at risk of developing an unhealthy dependence on cannabis. In turn, using cannabis to treat anorexia may simply replace one issue for another.
Lastly (and most importantly), the control that an anorexia patient feels is an overwhelming contributing factor in the development of the disorder. Cannabis used as an appetite stimulant also comes at a risk of rushing to a 'quick fix'. This could be counter-productive and lead to greater long-term issues while ignoring the underlying issues with control that likely would remain unresolved.
Cannabis can be a great resource for treating the symptoms of anorexia, however, it's not the answer for everyone. Anorexia is an ingrained psychological disorder with many contributing factors that affect its development, symptoms, and recovery. Each patient is different and in turn, so are the effects that cannabis may have on them.
Anorexia needs a combination of treatments to give the patient the best chance of a full recovery. If cannabis is a potential option, then the process must start with a conversation with your health-care professional.
Different cannabis strains and forms of administration affect people differently. Speak to your health care professional to find the right strain, if any, that is a good fit for your circumstance.
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