Eating disorders are classified as disorders that affect normal feeding behaviors leading to a variety of issues such as: abnormal loss or increase in appetite; extreme over or under-eating; extreme weight gain or loss; addiction to certain foods; disruption of regular meal times and even problems in perceived self-image.
Some common examples of eating disorders include food addiction/extreme-overeating, bulimia and anorexia nervosa (AN).
Although it is still not completely clear how eating disorders start in the first place, science points to a mix of factors including hormonal imbalances, stress and psychological/psychiatric issues. For this reason, health care providers usually approach eating disorders from multiple angles using tools such as mental health counseling, drug therapy and cognitive behavioral therapy. In particular, cognitive behavioral theory helps individuals suffering from eating disorders to identify and control external triggers that may lead to irregular feeding patterns.
Eating disorders can create another host of problems that are much more severe. For example, in the case of anorexia nervosa and bulimia, a deficiency in various nutrients can result in organ failure.
Specifically, because patients undergo long periods of self-induced starvation, extreme muscle loss can occur in very important muscles such as the heart. Furthermore, self-induced vomiting in bulimic patients can cause esophageal tears or even tooth decay. On the other hand, extreme overeating can lead to obesity and other obesity related chronic conditions.
Even though health care professionals generally possess certain tools to treat, control and improve eating disorders, these tools are not always efficient at treating the underlying causes of the condition.
It has long been reported that the recreational use of cannabis (mainly in the form of smoking) affects eating patterns. This often manifests itself as an increase in appetite, colloquially known as the “munchies”. This specific increase in appetite has been mainly attributed to the most abundant cannabinoid in cannabis, THC. However, this has sparked an interest for research into other cannabinoids such as CBD and their potential use as a therapeutic agent for eating disorders.
But there is more…
CBD has been of particular interest for clinicians due to its non-psychoactive nature. That is, CBD conserves many of the therapeutic properties of other cannabinoids such as THC, without the “high”.
What is CBD oil? Cannabidiol or CBD oil is a produced from cannabis. CBD oil contains cannabinoids, which are the compounds naturally found in cannabis plants.
The following sections of this article will review some of the current research regarding the use of CBD oil for eating disorders, the role of the endocannabinoid system in eating disorders and possible recommendations for the future.
Endocannabinoids and cannabinoids regulate eating behavior at different levels in the brain.
According to various studies, endocannabinoids and cannabinoids seem to regulate eating patterns by modulating hypothalamus, hindbrain, limbic system, intestinal system and adipose tissue activity.
Endocannabinoids and cannabinoids do this by mainly interacting with important proteins or hormones that regulate energy expenditure and appetite. These include leptin (known to suppress appetite), ghrelin (known to increase appetite) and other steroids such as melanocortins.
In fact, some researchers have suggested that leptin-deficiency is related in elevated levels of endocannabinoids in the hypothalamus. In turn, administrating leptin led to a decrease in levels of endocannabinoids in the same area. If endocannabinoids decrease when there is a leptin-deficiency, this may mean that endocannabinoids have something to do with increased appetite.
For this same reason, it is thought that endocannabinoid system deficiencies could also be involved in the pathophysiology of eating disorders. Specifically, it is thought that the interaction between the endocannabinoid system and leptin is particularly important. In the case of women with anorexia, it has been seen that endocannabinoid plasma levels of anandamide (an endocannabinoid) are elevated and inversely related to plasma levels of leptin.
The effect of cannabinoids is much more complex. Cannabinoids are said to be biphasic, meaning some cannabinoids work to reduce appetite and food intake, while others work to increase it. As mentioned before, the difference between CBD and THC are a prime example of cannabinoids’ biphasic nature.
Targeting specific receptors for specific purposes.
The whole point of modifying the endocannabinoid system is knowing which receptors are being targeted and for what purposes. Additionally, researchers also have to know whether they are using an agonist or antagonist molecule.
An agonist is a molecule that looks and acts like another molecule. For example, if CBD acts on CB2 receptors to suppress appetite, then an agonist of CBD will act on CB2 receptors and suppress appetite as well.
On the other hand, an antagonist is a molecule that looks like another molecule and blocks (or opposes) the effect of that original molecule. For example, if THC acts on CB1 receptors to increase appetite, then an antagonist of THC will on act on CB1 receptors normalize or decrease appetite.
This concepts has been used in the creation of synthetic antagonists of CB1 receptors to treat obesity in some european countries. Additionally, many studies have pointed out that CBD use in obesity is beneficial in animal studies due to its interaction with CB2 receptors.
If you look back at our CBD and obesity article, you will be able to see that CBD in fact has been efficient in producing significant weight loss in rodents. However, studies further studies must be done to see if these results are translatable to humans.
For anorexia nervosa, there is not much research suggesting that CBD may be beneficial in increasing appetite and weight. This is actually counterintuitive to our knowledge that CBD reduces weight and appetite. As of now, it is not recommended that CBD is used for individuals with anorexia nervosa.
THC may be more promising in the use of anorexia nervosa as it tends to increase appetite and food intake. Nonetheless, its psychoactive effects seem to deter healthcare providers from prescribing it to these types of patients. This is mainly because anorexia nervosa has a psychological component to it that manifests as stress and anxiety. The use of THC could very well worsen these psychological symptoms.
Finally, a syndrome that is often not associated with other eating disorders is known as cachexia syndrome (for more information on cachexia syndrome, please refer back to our article on CBD and cachexia). Cachexia syndrome is usually accompanied by anorexia in patients with cancer or HIV/AIDS. Cachexia is thought to cause weight loss by kicking the person’s metabolism into overdrive.
This overly excited metabolic state is usually produced by elevated levels of pro-inflammatory molecules in the blood. This is a consequence of the immune system trying to fight cancerous cells or the HIV virus. Because of CBD’s anti-inflammatory properties, it has been thought to be promising against cachexia syndrome. However, as in other cases, more research needs to be done on safety, possible side effects and administration routes.
Moving forward in the fight against eating disorders.
The use of CBD hemp oil for eating disorders has only been partially supported in the case of food addiction, overeating and obesity. However CBD oil for eating disorders has been somewhat contradicted in the case of anorexia nervosa because of its appetite suppressant properties. In the case of cachexia, it has only been supported by limited studies and research still needs to be done on the matter to make any concrete recommendations.
Our suggestions in this article are to continue carrying out research that includes bigger case sample size, looks at the possible negative side effects of CBD oil for eating disorders and looks into doses/administration routes.