Anorexia is a medical word that, like most, doesn’t necessarily mean what people think it means.  In thinking about what medical cannabis can do for someone, it’s crucial that we understand the various illnesses it can address – and also those it cannot help or even worsen.  

Anorexia actually just means “trouble eating” or poor appetite.  Keep reading to learn more about what kinds of appetite problems exist, the causes, and the utility of cannabis based treatments.

Most people when they hear anorexia think of Anorexia Nervosa (AN), a severe and sometimes lethal eating disorder characterized by restricting of food intake in someone who has normal to low body weight.  This is not the type of anorexia we treat with cannabis.  

AN is a mental health disorder that is very difficult to successfully treat.  In fact, in most successful cases, AN does not resolve, but rather becomes a chronic condition.  It is a constant struggle for patients to overcome their inherent desire to lose weight and actually maintain a healthy body.  

AN is felt to have many common features with Obsessive Compulsive Disorder (OCD).  Some studies have demonstrated that cannabis can be harmful to OCD sufferers.  Other case reports have shown benefit to OCD patients from cannabis.  Presently, given the severity of Anorexia Nervosa, AN is considered a contraindication for cannabis use. 

More commonly, anorexia is just a symptom of some other disease and does benefit from cannabinoid treatment.  There can be many causes of anorexia including cancer or other debilitating diseases including neurodegenerative diseases like ALS or Multiple Sclerosis.  These diseases, often called Wasting Syndromes, alter the patient’s desire for food, ability to tolerate ingesting food, or ability to absorb and process food.  

Other causes of anorexia include treatments for various diseases.  For example, cancer chemotherapy is well-known to cause appetite complications, independent of also often causing nausea with or without active vomiting.  Radiation treatment does similarly.  Often patients undergoing treatment for cancer talk about developing “food aversions” meaning they come to hate foods that previously were favorites. 

Other medications like anti-inflammatory medication for Crohn’s or Ulcerative Colitis or Rheumatologic illness like Rheumatoid Arthritis can all lead to poor appetite.  Opioid medication for pain and even antibiotics can all create similar poor food intake.  

Regardless of the underlying disease, the best approach to anorexia is to try to stimulate appetite.  More food in, and better tolerated, leads to better nutrition overall – even in cases where the food is not optimally absorbed.  

Sadly, there are few medications that stimulate appetite.  Conventional medications like Megace and Mirtazapine have and can be used, but have limited benefit.  In a patient with anorexia, I wouldn’t recommend turning these medications down, but I would not have high expectations of success either.  

Cannabis, for nearly everyone, causes some degree of “the munchies” – comprised of both a desire to eat and also an improved perception of the “yumminess” of food.  This can be very helpful for treating poor appetite from many of the causes discussed above.  Patients have been shown to increase or maintain weight better when treated with cannabis.  Further, maintaining or improving weight has been linked to better quality of life and survival in cancer patients and people with other causes of anorexia.  

Nausea and/or vomiting is not directly related to anorexia, but sure does go along with it.  Many illnesses create nausea as do many medications.  Thankfully, cannabis is also helpful for these symptoms.  In cases where nausea and anorexia coexist, cannabis can be helpful, and perhaps is more helpful than a cocktail of conventional medications aimed at these same symptoms.

Cannabis can be used in many ways but the way it’s used has to be chosen to target the problem at hand.  For example, cannabis edibles (orally ingested) can be very helpful for chronic pain, but are often not the best approach for nausea and vomiting.  For anorexia, the options could include an edible, but that may not be the most effective method and certainly would not be if the anorexia also goes along with nausea.  

The details of dose, frequency, and delivery method are crucial to getting the best relief.  This is precisely the value of working with a Cannabinoid Specialist like Dr. Tishler, here at inhaleMD.  Click here to make an appointment.