Denisa started to obsess over her weight after a few stressful events when she was sixteen—her closest friends started to isolate her, and a few people whose opinion she valued told her she was fat. In her head, the two events were connected; she reasoned that her friends must have ditched her because she was unattractive and overweight. So, in an attempt to control the situation, she starved herself until she was down to an unfathomable eighty-three pounds. More than a decade later, she’s mostly made it down the road to recovery. She maintains a healthy weight, but eating food can still make her anxious, and she has to remind herself that certain body-bulking activities—like lifting weights—are the mark of a healthy, capable body.
Where do eating disorders come from and how can we treat them? Anorexia has proven to be notoriously difficult to treat with traditional medications and talk therapy. Research suggests that initial unhealthy rituals surrounding food become deeply-ingrained habits similar to drug addictions —even once people understand how their unhealthy patterns are affecting their physical health, people with anorexia often can’t stop the habit. But, according to some researchers, the key is to treat the emotional trauma at the root of the disorder, not just physiological symptoms like weight.
Important clues on how to do that come from research about the role the endocannabinoid system—the neurotransmitting system that the cannabinoids in marijuana bind with—plays in anorexia. Several clinical studies in recent years show that cannabis is an effective treatment to help people with anorexia gain weight. But while gaining weight is often the main marker of success in these studies, digging into the results shows an even more important pattern: cannabis may help relieve some of the stress and anxiety associated with psychological and emotional trauma, making it a potentially unique treatment in the field of mainstream medicine.
Success with Cannabis
Anyone familiar with the “munchies” knows that cannabis can increase appetite and make food taste better. This alone makes it a plausible treatment for anorexia, but studies also show that it may help decrease stress and assuage the unhealthy root behaviors associated with eating disorders.
In a 2013 study from the Center for Eating Disorders in Denmark, twenty-four women with severe anorexia nervosa were treated with dronabinol, a synthetic form of THC in pill form. The results showed that study participants gained weight, but even more interesting were the results of the eating disorder inventory, which measures unhealthy patterns surrounding food and eating.
Overall, the women scored better on mental health ratings when they were taking THC than when the trial began or while taking a placebo. During the four weeks of THC treatment, the women were less driven to be thin, more lenient in their self-disciplinary actions, better at regulating impulses, more capable of trusting other people, and better at distinguishing between sensations (like being hungry or full) versus emotions (like feeling anxious around food). No doubt, all of these effects would help people process trauma and understand their triggers, particularly in a compassionate, therapeutic setting with a counselor.
Another study showed that Alzheimer’s patients over sixty-five with anorexia gained weight while undergoing dronabinol treatment, even though their caloric intake stayed the same. Researchers suggested this might be because less energy was expended on what they termed “disturbed behavior.” The patients experienced less anxiety, nervousness, paranoia, and confusion—expending less energy on these behaviors allowed more calories to go toward nourishing their bodies.
The Role of the Endocannabinoid System
There hasn’t been extensive research into the role of the endocannabinoid system in the brain processes of people with anorexia. But the studies that have been done point to important clues about how psychological processes work in eating disorders like anorexia and why cannabis might be a possible solution.
Studies show that women with anorexia have higher concentrations of endocannabinoid receptors in certain parts of the brain than healthy women do. One is the dorsal striatum, which is related to forming habits. This brain region is more active in women with anorexia, suggesting that a healthy endocannabinoid system plays a part in the deeply-ingrained habits that many people with anorexia struggle to break.
Another is the insula, which regulates body perception, the tasting senses, reward, and emotion—functions known to be abnormal in people with eating disorders. The insula is the place where our emotions and thoughts about food intersect with the physical pleasure from eating. When this region isn’t functioning properly, it seems that people adopt unhealthy rituals that may develop into an eating disorder like anorexia or bulimia.
More research is needed to understand the intricate relationship of the endocannabinoid system with eating disorders like anorexia, but these studies suggest that when your endocannabinoid system is unbalanced, you derive less joy from eating and develop negative emotions and habits surrounding food. It makes sense, then, that activating these regions with cannabis could help people with anorexia replace bad habits with healthy ones.
What It Means for Cannabis as a Treatment for Anorexia
What can we conclude from these studies? First, cannabis can help increase appetite and make eating more enjoyable, providing an acute treatment for someone when they’re at a dangerously low weight. But perhaps more importantly, it also helps stabilize overall mental health, providing a better platform to deal with past traumas, navigate the psychological pitfalls of eating disorders, and let nutrients work more efficiently.
For Denisa, the lingering trauma and reactive mental habits didn’t just go away when she retained a healthy weight. Even after she had successfully overcome the physical symptoms of anorexia, those old thoughts still haunted her. For people like Denisa, cannabis could be a powerful tool to help address lingering trauma and bring balance to brain regions related to deeply-ingrained reactive eating habits, even after the lowest point of the eating disorder has passed. By helping you gain new perspective on past trauma and reducing the resulting emotional and psychological stress, cannabis shows powerful potential to help those suffering from anorexia work toward a healthier lifestyle.