When I was 16 years old, I did not consume much food, but food very much consumed me. It was an unwanted house guest in my body that needed to be kept away or kicked out. I’d subsist on carrots and mustard, sneak into the school gym to work out during my lunch period, quietly throw up after enduring a family dinner, and wash it all down with a few laxatives in case any food stuck around. When my friends started drinking, the calories seemed like an absurd premise, so I started smoking weed. It was not intentional or instantaneous, but cannabis green-lit my desire to eat.
I'm not alone. Stella Vance was only 14 years old when she started restricting her calories and soon developed full-blown anorexia for three years, before becoming bulimic—itself a seven-year sentence. “The bulimia was so out of control that I tried to kill myself twice,” says. At the age of 24, she started experimenting with pot recreationally, but not to alleviate her symptoms.
"It was not intentional or instantaneous, but cannabis green-lit my desire to eat."
After trying and failing for so long, she had given up on the idea of getting better and was just smoking to unwind after work, but it manifested as much more. “I just slowly stopped binging," she says. "I realized I had no need or desire for it anymore and the marijuana made me relax. The anxiety was gone.”
So what's going on with Stella and myself?
30 million people in the US live with some form of an eating disorder and the onset of 95 percent of those cases is between the ages of 12 and 25 years old. Individuals with anorexia are 12 times more likely to die, often by suicide, and even with treatment only about 60 percent of people fully recover from it. Anorexia and bulimia are especially difficult to pin down and treat because they are typically intertwined with other mental illnesses such as depression, anxiety, substance abuse, and of course, each other.
The onset is also so young that kids do not always understand they have an illness or anything more than a secret. As poor as the prognosis is, if Stella and I could accidentally find our way out of this disease by getting high, it raises crucial questions: Are we two anomalies? Could cannabis be proactively used for the treatment of eating disorders? And if so, what evidence do we have that this is even a good idea?
The connection between cannabis and eating disorders is not that surprising from a genetic perspective. Scientists suspect that people with anorexia and bulimia may have a variation of the CB1 receptor gene, which could create a type of cannabinoid resistance. Research suggests that this cannabinoid receptor affects how anorexic and bulimic patients perceive their bodies, along with their ability to enjoy food. Other studies conducted with rodents suggest that when this receptor is compromised, it can cause eating disorder symptoms.
Clinical trials looking at the impact of synthetic THC have demonstrated a slight increase in eating and weight gain among anorexic individuals. However, closer analysis indicated that when eating disorder patients used THC, they increased their physical activity. This could mean that cannabis did not alleviate eating disorder symptoms, but simply shifted them, and patients were still getting rid of their calories through exercise. While far from a perfect solution in itself, THC didn’t appear to make their eating disorder symptoms any worse.
“While adverse effects were reported in the study, none of these were deemed to be serious,” Dr. Ceppie Merry, a physician based out of Dublin, Ireland, says. Merry points out that the trial was the only study about eating disorders that was scientifically suitable enough to be included in a recent review of literature on cannabis treatment for mental disorders in general—and it only included 24 people. All this underscores the need for more research on the matter.
“They concluded that more studies with larger sample sizes are needed to replicate these results,” Merry notes. “That is pretty much the state of knowledge that we have on the subject at present.”
Dr. Jordan Tishler, physician and cannabis specialist at Inhale MD, warns that using cannabis to treat eating disorders comes with the same risks as using cannabis to treat obsessive-compulsive disorder.
“While cannabis can help some patients with OCD, it can also be more habit-forming for them, and can quickly escalate into a harmful addiction,” Tishler warns, noting that for some patients it is possible for cannabis to be helpful, but only under close medical supervision.
Based on the similarities between OCD and anorexia nervosa, Tishler would only consider using cannabis to treat a patient with a chronic eating disorder when other options like psychotherapy have been exhausted. For patients with acute symptoms of anorexia, cannabis may do more harm than good.
“While there is some discussion of cannabis for weight loss and for weight gain, there is really no discussion yet about how it might affect OCD-like mental illness,” he says.
It’s not just about eating but as much as psychological symptoms persist, even a small amount of weight gain could mean the difference between surviving extreme anorexia or not. While these studies are limited to say the least, they’re encouraging for that reason alone.
*A little weight gain gave me a lot of traction in my recovery, but smoking weed was not a perfect system, to be sure. I’d get the munchies, overeat, punish myself in the gym the next day, and occasionally purge. Throwing up high was comparable to going to the dentist high—a viscerally vivid sensory experience of tastes and sounds no one would wish on their enemies or choose to repeat. So I melted into the couch like the ice cream I was eating and put on weight instead.
"Gaining five pounds felt like the worst thing that could ever happen to me, until it did."
Gaining five pounds felt like the worst thing that could ever happen to me, until it did. Once it showed up, it wasn’t any worse than what I had experienced already. Sure, I was uncomfortable in my changing body, but I was never comfortable in my starving one either. At least this way I was less exhausted, isolated, and miserable, no longer at war with food.
I would get stoned in the grocery store parking lot and wander around the produce section taking in all the colors and possibilities other than carrots and mustard. Like a garden, food was growing on me. Slowly and unintentionally, cannabis quieted the voice in my head screaming for me to starve. And more food meant more brain function; I didn't have the energy to register how untenable my habits were until I stopped obsessing and started eating. It took getting high to see that low.
Clinical research on how weed can treat with bulimia is even harder to come by, but doctors like Tishler believe cannabis treatment for bulimia should be treated like anorexia and not prescribed in acute cases.
“Bulimia is just a variant of anorexia nervosa and the same statements apply.”
Other experts such as Dr. Joseph Rosado speculate that cannabis can help break the cycle of binging and purging. Although it may seem like appetite stimulation would increase the urge to binge, cannabis activates receptors in the insula, the part of the brain that regulates emotions, which might make eating more enjoyable and less stress provoking.
In Stella’s experience, this was entirely true. Even after struggling with bulimia for the better part of a decade, weed helped her enjoy food without overdoing it, because her urge to binge wasn’t about being hungry, it was about stress. And a little pot cleared that up quite nicely.
“Food does taste better on cannabis, especially sweets. I may have enjoyed it more, but never felt a need to binge,” Stella says. “The binging came from stress and I was very relaxed with marijuana and a bit of music.”
Of course, everyone’s experience with eating disorders is completely subjective and unique and the most effective treatment options are often the most individualized.
Cannabis is similar in the sense that different varietals can affect people in different ways. Depending on the balance of THC, CBD, and terpene levels in the particular type of flower, it's entirely possible for weed to make someone with an eating disorder way more anxious about food, or cause them to become dependent on it. There are risks. That’s why any professional (or media outlet) worth its salt would recommend only using it in thoughtfully controlled amounts under the supervision of a medical doctor, and ideally a therapist too.
"It's entirely possible for weed to make someone with an eating disorder way more anxious about food, or cause them to become dependent on it. There are risks."
At its best as a healing tool, cannabis is just one potential piece of the recovery pie, and the others are filled in with therapy, doctor visits, group counselling, holistic activities like yoga, meditation, and a number of other coping strategies.
Unfortunately, medical cannabis treatment for eating disorders is not a reality for most people yet. Although 33 states have legalized medical cannabis, only four states include anorexia among the qualifying conditions, and no states list bulimia.
Research on eating disorders is extremely underfunded, and studies on medical cannabis are still limited and politicized by federal laws—especially in regards to treating minors with it.
A lot more research will need to be done before cannabis can be legitimized as an effective aide in eating disorders. Even if that happens, we can only hope others living with these disorders will get as lucky as Stella and I did. It’s so much better bringing bloodshot eyes to family dinners. The alternative is unbearable.
If you're experiencing disordered eating, call the National Eating Disorders Association helpline on 1-800-931-2237. If you're dealing with self-injury or are experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255.