Can Cannabis Treat Anorexia?

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.

However, research suggests that CBD can still be beneficial by improving other mental issues that can occur in anorexia, such as depression, anxiety, and sleep issues.

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.

Potential side effects of cannabis use

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.