Cannabis and Mental Health: Anorexia Nervosa

Can cannabis be used to help people recover from anorexia nervosa?
Cannabis and Mental Health: Anorexia Nervosa

Anorexia nervosa is an eating disorder that causes a person to obsess over their weight, diet, and body. A person with anorexia nervosa does not stop at an ideal weight or body type like a healthy diet would. Instead, they are prone to changing their goals to increasingly lower weights over time. This seemingly never-ending struggle leads a person to restrict their caloric intake and possibly work out to excess. As a result, over time, they can become gravely underweight and malnourished. 

Struggles with anorexia nervosa can be compounded by comorbid, or accompanying, disorders like depression. Anorexia nervosa patients are prone to taking their own lives, with one in five deaths from the condition caused by suicide. As a result, anorexia nervosa has the highest mortality rate of any mental health condition, according to the Eating Disorders Coalition (EDC). 

The EDC also states that such mental health conditions kill one person every 62 minutes. Contributing to the statistic include bulimia nervosa, binge eating disorder (BED), other specified feeding or eating disorder (OSFED), avoidant/restrictive food intake disorder (ARFID), and diabulimia—a media-created term to describe an eating disorder where a person with type I diabetes restricts their insulin in a bid to lose weight. 

Anorexia nervosa tends to develop during puberty, but it can form at any time in the person’s life, including late adulthood. Gender, ethnicity, sexual preference, or other characteristics play no part in the development of anorexia nervosa or any other eating disorder. 

Despite such a fact, anorexia nervosa is a medical condition largely associated with women; research found that .9% of American women in their lives develop anorexia nervosa. Meanwhile, data from the National Eating Disorders Association (NEDA) stated that 10 million American males will suffer from an eating disorder, not specifically anorexia nervosa, at some point in their lives. 

NEDA’s figure may not reflect an accurate number, according to the association. It is believed that many men do not seek treatment for their condition, making it difficult to report an accurate total. Some have posited that this is due to cultural shame stemming from men believing that eating disorders exclusively affect women, or that their admission makes them appear feminine.

That said, 2012 combination of sources concluded that anywhere between .9% and 2% of women will develop the condition, compared to .1% to .3% of men. 

No definitive causes have been linked to the development of anorexia nervosa. Possible links have been recognized, including genetics. Some believe young people with anorexia nervosa in their family are likely to develop the condition more often. Additional risk factors considered include childhood anxiety disorders, trauma, a negative self-image, and contrary social or cultural views regarding health and beauty. 

Studies through the years have indicated that medical cannabis may be able to, in part, address anorexia symptoms. 

Anorexia Nervosa and Cannabis

A 2003 open study focused on the safety and efficacy of the cannabis-derived drug Dronabinol in Alzheimer’s disease patients with anorexia. The study tracked 48 subjects using the drug. It found that each person gained weight during the study, with 65% reporting a reduction in agitation as well.

A 2007 study also focused on Dronabinol as a possible appetite stimulant for people in long-term care. Overall, 15 of the 28 patients in the study gained weight during the 84-day study. Notably, six participants gained more than 10 pounds, while 10 increased by more than five pounds. That said, the study did not address the underlying mental issues of the condition, leaving room for assumption that a relapse is possible. 

The next year saw an additional study noting improved appetites and a reduction of agitation in patients with hepatitis C. This time, both Dronabinol and Nabilone, a THC-mimicking synthetic cannabinoid, were analyzed. However, the analysis did not address any underlying mental health-related conditions, either.

More recently, a 2017 pilot study of nine adult female patients concluded that THC may improve anorexia symptoms. In this case, the main improvement noted was the patients’ perception of their eating. Researchers stated that subjects reported lower depression levels while caring for their bodies more. The study also found no “significant changes” occurred to any subject’s body mass index (BMI).

Some medical professionals have witnessed mixed results from using cannabis as a treatment option. Lauren M. Canonico is a psychotherapist and consultant with a specialty in eating disorder recovery. Canonico reported that cannabis has impacted her patients in various ways. Positive outcomes included patients eating more or trying a wider variety of food. Additional positive results included increased relaxation levels, and a higher tolerance to discomfort and anxiety. 

Canonico said some patients noted that cannabis helped lower their use of coping strategies like binging and purging, or chewing and spitting their food. “It has been an incredibly useful tool for many patients I’ve worked with over the years,” she stated.

The psychotherapist also pointed out adverse effects a patient may experience. Such outcomes include an increase in anxiety and paranoia over food. Canonico believes this may be due to a patient’s past, unrelated experience with cannabis.

Other effects may be at play, but the psychotherapist is not certain. “Many [patients] have concurrent anxiety or trauma-related disorders, on both sides of the response, so it’s unclear.” 

The uncertainty of cannabis’ outcome has led many to the Internet in search of anecdotal findings. Reddit’s anorexia online forum, or subreddit, has a handful of discussions on the subject. Whether written four years ago or in the past few months, most have stated that cannabis has increased appetites while decreasing obsessions over food. 

One person told High Times about a similar outcome from using medically recommended cannabis.

“Anorexia makes you feel fat, undesirable, weak [and] with a constant headache,” explained “Cathy,” a patient who asked to remain anonymous. Anorexia nervosa began affecting Cathy after years of scoliosis treatments as a teen. After her brace came off, Cathy found herself scrutinizing her body and weight. 

Her career as a model further exacerbated the problem. “I had no energy to work out, but I was called fat regularly. So, I started to cut food more and more,” she explained. At the peak of her illness, the 5’6″ Cathy weighed in at 99 pounds. 

After her diagnosis, doctors prescribed her the antidepressant mirtazapine. The medication and a move across the globe helped add over 40 pounds to Cathy’s frame. However, she claimed she never addressed how the eating disorder made her feel. The failure to do so led to a relapse as she struggled with body dysmorphia upon her return home.

A friend stepped in to offer help as Cathy struggled with the antidepressant. They took her to a dispensary where she could legally obtain cannabis. “I tried cannabis, and I haven’t stopped since,” she reported. Today, she uses the plant as part of her self-care regimen, which includes maintaining healthy eating habits and check-ins with physicians. 

She credits cannabis with getting her off of the antidepressants she struggled with for so long.

Cathy says that she does recommend others like her try cannabis. However, she cautions that it must be part of a larger treatment plan. “…[medical cannabis use] needs to come hand in hand with therapy to treat the cause of the anorexia.”

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