Anorexia is a medical term that simply means “poor appetite” or “difficulty eating”. The use of cannabinoids to treat general anorexia has been well established and will be covered in another blog post. Anorexia Nervosa is a specific type of difficulty eating that is different from, and cannot be treated the same way, as general anorexia. Let’s see how medical marijuana and anorexia nervosa can be paired in eating disorder treatment.
Anorexia nervosa (AN), a severe eating disorder characterized by an intense fear of gaining weight and a distorted body image,
continues to be one of the most challenging conditions to treat. Traditional treatments include nutritional counseling, psychotherapy, and medications. However, the efficacy of these treatments varies, and many patients experience relapses.
Many people ask about using cannabis or cannabinoids to treat AN. Here we will review what is known and not known about using cannabinoids for this illness and reach a conclusion on what to do with our current knowledge.
The current data on the use of cannabis as a therapy for anorexia nervosa are limited and somewhat mixed. While there is some evidence suggesting potential benefit, particularly in terms of appetite stimulation, the data do not yet provide support for cannabis as a therapy for anorexia nervosa. Here are some key points from the existing research:
Appetite Stimulation
Tetrahydrocannabinol (THC): THC is known to stimulate appetite, which could theoretically benefit patients with anorexia nervosa who struggle with eating. Some studies, such as those involving dronabinol (a synthetic form of THC), have shown that THC can lead to weight gain in patients with AN. For instance, a study by Hebebrand et al. (2003) found that THC led to modest weight gain in anorexia patients, suggesting its potential utility in encouraging food intake.
Limited and Preliminary Evidence
Clinical Trials: Most existing studies on cannabis and its components have not specifically targeted anorexia nervosa. Instead, they have focused on general effects on appetite. The problem is that general anorexia or loss of appetite usually stems from an illness in the body like cancer, HIV/AIDS, or neurodegenerative diseases like Multiple Sclerosis or ALS. These diseases have in common that they blunt appetite and cause wasting of body mass, but they are physical diseases.
Anorexia nervosa, on the other hand, is a psychological disease without underlying (known) physical cause. It is a complex problem, as mentioned above, of phobias and perceptual distortions. Many proposed treatments fail because the disease weaves the treatment into the problem and can even worsen the weight loss and associated metabolic derangement.
As a result, it is unreasonable to infer from the success of cannabis for general anorexia to the case of AN. Anorexia nervosa, at its worst, can be severe and life-threatening. Any proposed treatment must be shown not only to potentially help, but to not have a significant likelihood of worsening the problem.
The few specific studies that we have on AN, such as those reviewed by Andries et al. (2014), suggest that while there are potential benefits, the evidence is not conclusive.
More rigorous, controlled clinical trials are necessary to determine the efficacy and safety of cannabis specifically for anorexia nervosa.
Risks and Concerns
Parallels to Obsessive-Compulsive Disorder (OCD): While anorexia nervosa bears little obvious relationship to OCD, the slavish devotion to a set of harmful behaviors (not eating, in this case) has led to comparisons of AN to OCD in the medical literature. This raises the reasonable concern that, in addition to the risk of addiction posed by cannabis itself, AN patients could become hyper focused on cannabis use and/or increasing doses. This is another reason to approach AN treatment with cannabinoids with great caution.
Side Effects: THC, like any medication, can have side effects. In the case of THC, these include dizziness, anxiety, paranoia, and intoxication (being stoned). Since AN is inherently a distorted perception of reality, these side effects could potentially exacerbate the underlying psychological causes of anorexia nervosa.
Dependency and Cognitive Effects: There are data-backed concern about the long-term use of cannabis, particularly in younger patients. The risk of dependence or addiction has been demonstrated to be significantly higher in teens and young adults – just the age group who develop AN. There are also data that imply that cannabis use in teens and young adults can impact cognitive development.
Conclusion
While there are a few indications that cannabis, particularly THC, might offer some benefit for patients with anorexia nervosa, the potential risk in this specific illness is great. The current data are not strong enough to support cannabis as a therapy for this condition. More focused research, including randomized controlled trials, is needed to better understand the potential benefits and risks.
Given the severity of AN, the very real risk of making it worse, the additional risks associated with patients in younger age groups, and the lack of safety data specific to this illness should lead healthcare providers to avoid cannabis in this particular disease until more is known.
Consult with a Qualified Massachusetts Medical Marijuana Expert Today
Those considering using THC, CBD, or any type of medicine found in cannabis to help manage their condition should consider speaking to a trained medical expert who is knowledgeable about using cannabis therapeutically.
Massachusetts medical marijuana doctor Jordan Tishler, M.D. sits on the faculty of Harvard Medical School and has years of experience helping patients treat pain and other ailments using cannabis. He and the team at InhaleMD stand ready to assist patients in determining whether medical marijuana is right for them.
For more information, or to set up a virtual consultation with the team at InhaleMD, call us at (617) 477-8886 today.