Anorexia Nervosa and Cannabis
According to NEDA, anorexia nervosa is “a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.” Extremely low body weight, body dysmorphia (a distorted perception in body image), an obsession with counting calories, and an excessive need to control one’s environment are all common among sufferers. Individuals also often base their sense of self-worth on their body weight and shape, and have difficulty finding pleasure in activities that most people consider enjoyable.
Historically, the causes of anorexia have been attributed to sociocultural factors such as childhood trauma or family members’ (and society’s) attitudes towards the desirability of thinness and slimness. However, evidence has emerged in recent years that also underscores the role of genetics and neurobiological factors.
The Endocannabinoid System and Anorexia
The regulation of appetite and feeding behaviors are complex phenomenon involving our brain, peripheral organs and the numerous pathways that connect them. Considerable evidence suggests that the endogenous endocannabinoid system has an important role in signaling rewarding events, such as eating.
Given the research we have accumulated, anecdotal evidence, and the fact the endocannabinoid system — the body’s own cannabinoid system — exerts such a powerful influence on appetite, cannabis as an anorexia treatment is highly plausible.
In 2014, European neuroscientists conducted an important animal study offering another possible explanation on why cannabis (or specifically THC) may be useful in treating anorexia. Anorexia sufferers lose the ability to find pleasure in activities, particularly eating. And, authors of the study found that the way THC activates the endocannabinoid system’s CB1 receptor elevates pleasure in eating by increasing our sensitivity to smells and taste.
According to Tamara Pryor, director of clinical research at the Eating Disorder Center of Denver, individuals suffering from anorexia are empowered by not succumbing to the temptation of eating, so “stimulating their appetite can’t necessarily overcome the neurobiological issues that are also intimately involved with their disorder.” That being said, Pryor notes, “Marijuana may be a helpful tool for some people — in conjunction with therapy.” By therapy, she’s referring to cognitive behavioral therapy (CBT), which is accepted as one of the most effective forms of treatment.
Research Done on Anorexia and Cannabis
This review focuses on recent advances in three important signal systems: leptin, ghrelin, and endocannabinoids toward the identification of potential therapeutical breakthroughs in AN. Our review of the current literature shows that leptin may have therapeutic potentials in promoting restoration of menstrual cycles in weight restored patients, reducing motor restlessness in severely hyperactive patients, and preventing osteoporosis in chronic patients. Ghrelin and endocannabinoids exert orexigenic effects which may facilitate nutritional restoration. Leptin and endocannabinoids may exert antidepressive and anxiolytic effects. Finally, monitoring serum concentration of leptin may be useful in order to prevent refeeding syndrome.
The endocannabinoid system has long been known as a modulator of several physiological functions, among which the homeostatic and hedonic aspects of eating. CB1 receptors are widely expressed in brain regions that control food intake, reward and energy balance. Animal and human studies indicate that CB1 receptor agonists possess orexigenic effects enhancing appetite and increasing the rewarding value of food. Conversely, CB1 antagonists have been shown to inhibit the intake of food. Eating disorders include a range of chronic and disabling related pathological illnesses that are characterized by aberrant patterns of feeding behaviour and weight regulation, and by abnormal attitudes and perceptions toward body shape image. The psychological and biological factors underlying eating disorders are complex and not yet completely understood. However in the last decades, converging evidence have led to hypothesise a link between defects in the endocannabinoid system and eating disorders, including obesity.
Anorexia and cachexia are diagnosed in more than two-thirds of all cancer patients with advanced disease, and are independent risk factors for morbidity and mortality. Anorexia, nausea and vomiting often are described as more significant inhibiting factors for quality of life of cancer patients than even intense pain. In 1986, delta-9-tetrahydrocannabinol (THC), the main effective constituent of cannabis, was licensed as an anti-emetic drug in cancer patients receiving chemotherapy. In addition, in clinical studies THC has shown significant stimulation of appetite and increase of body weight in HIV-positive and cancer patients. The appetite-stimulating effect of cannabis itself has also been well documented in many anecdotal cases. There are strong indications that cannabis is better tolerated than THC alone, because cannabis contains several additional cannabinoids, like cannabidiol (CBD), which antagonize the psychotropic actions of THC, but do not inhibit the appetite-stimulating effect.
While cannabis may provide a valuable alternative treatment for anorexia, cannabis should not be seen as a panacea. It may serve a role, but given the seriousness of the condition (including the high mortality rates), consulting a specialist and enlisting support through peer groups is vital. Two organizations, National Eating Disorders Association (NEDA) and National Association of Anorexia Nervosa and Associated Disorders (ANAD), provide valuable online resources to individuals or loved ones impacted by anorexia.
There is no shortage of people who credit cannabis with helping them overcome anorexia. A clinical cannabis patient from Los Angeles, Sarah told Leafly that for years she struggled with anorexia. Doctors gave her antidepressants and anti-anxiety drugs, which she says helped her with some of her issues, but did nothing to help her kick anorexia to the curb.
“I tried for years to overcome anorexia and bulimia. For me, anorexia was a way to fulfill my need for control over my life. I was never much of a pot user, but recalling how cannabis gives you the munchies, I decided to give it a shot,” says Sarah. “It worked remarkably well. I became less self conscious, I lost my obsession over counting calories, and I started enjoying food again.”
Sarah claims cannabis provided a “short-term solution to a long-term problem.” She claims that within six months she beat anorexia. She now consumes only occasionally. “I haven’t totally gotten over my body issues, and that most often becomes an issue during intimacy with my fiancé. So now I’ll occasionally medicate and I’ve found that I’m far less self-conscious and it brings us closer.”
Cannabis Treatment for Anorexia
Although there isn't enough research done to say exactly how much cannabis is needed for treatment, we have to start somewhere. If you live in a legal state, it is recommended to start off with small micro-dosing. You can use a tincture with a CBD-THC ratio of 1:1 or a slightly different ratio with more CBD than THC such as 20:1. THC is known to give users a "high" feeling. However, with micro-dosing those effects can be very little. One site suggests starting off with micro-dosing throughout the day with a total of 5mg and eventually leading up to a total of 20mg in one day. If the effects of THC are unwanted from the patient, a medication with higher amounts of CBD would be better. If you decide to smoke or vape, and are not THC tolerant, it is suggested to take just 1 puff. An Oil, high in CBD is recommended as well. With that you can start with a small amount, micro-dose, in the morning, and again later in the day. Possibly taking a bigger dose as time goes on.
For more information on Dosing Guidelines - click here -
It is important and strongly encouraged to talk with a trusted medical marijuana doctor who can help provide alternative therapy to the patient, along with counseling therapy. The purpose of adding cannabis to therapy treatment is to help the AN sufferer, suffer less.
Cannabis has a way of changing old patterns of thought and creating new connections in the brain through the synapsis. A patient may feel so much as ease, that they completely forget about worrying about food, calories, or their own body image.
It is best to connect with a group, online or in your own hometown, to find other people who are going through the same issues and to see how they overcome.
Support Groups for Anorexia and Cannabis:
Resources:
https://www.projectcbd.org/condition/8/Anorexia
https://www.ncbi.nlm.nih.gov/pubmed/18926548
https://www.ncbi.nlm.nih.gov/pubmed/23829365
https://www.ncbi.nlm.nih.gov/pubmed/10575285
https://www.psychologytoday.com/blog/your-brain-food/201204/the-connection-between-anorexia-bulimia-and-marijuana
