I have been reading over the last week about the latest research regarding Medical Marijuana and anorexia. While I do not have first hand experience of the effects of smoking pot on anorexia. I find the scientific study of it fascinating. (I never tired marijuana when I was a sufferer- maybe I should have!) That said, thus far, all scientific studies in this area has been conducted on lab mice, and effects, when translated to humans, are bound to differ.
Anorexia has not only physiological implications and affect, but psychological and behavioral impacts to negate and overcome. That said, all research is valuable at helping our understanding of the way the human body operates and how we can help it do what it needs to do to survive.
Some researchers believe that anorexia is influenced by a dysfunctional endocannabinoid system (ECS). The ECS is a group of lipids and receptors that are involved in many physiological processes including appetite, pain sensation and memory. I quote researcher Cindy Casteels “The endocannabinoid system (ECS), a major neurotransmission system, is involved in numerous physiological processes often related to homeostatic balance but also in neuro-protection, motor behavior, memory regulation, addiction and cognition. It consists of a family of naturally occurring lipids, the endocannabinoids, of degradation proteins and of cannabinoid receptors.”
The recent research by Cindy Casteels and her team looked at the effects of cannabinoids in rodents . Cannabinoids are a class of diverse chemical compounds that activate cannabinoid receptors on cells that repress neurotransmitter release in the brain. These receptor proteins include the endocannabinoids that are produced naturally in humans as well as the phytocannabinoids that are found in cannabis and some other plants. In the cannabis plant at least 85 different types of cannabinoids have been found. It is the cannabinoids that are responsible for the therapeutic effects of cannabis. One of these is Delta- 9- Tetrahydrocannabinol (THC) which is a proactive cannabinoid responsible for many of the effects that cannabis has and has been linked to moderate pain relief and anti- depressant effects. Interestingly this cannabinoid has been shown to be not so great for anxiety disorders, which interests me as with anorexia often comes anxiety.
Emerging research is suggesting that THC directly influences appetite . A related study (De Luca et al 2002) on rodents examined THC and the hedonistic value of food and found that dopamine release is enhanced and increased pleasure is shown after a sugar solution is given. As we are wired to pleasure seek, enhanced pleasure when we eat food means that we will seek food more- therefore more appetite. As shown in lab studies- Taste reactivity studies show that THC administration increases the hedonic reactions to sucrose taste and reduces the aversive reactions to quinine, consistently with an increase in palatability (Jarrett et al., 2005, 2007). So in short, that THC stuff that is found in cannabis makes food taste better to rats and gives them higher reward than normal when they eat. Munchies.
Relating this to the endocannabinoid system, the main receptor for THC is called CB1. So be be very clear, the cannabinoid is THC and the receptor for this is CBI. The reason that this is interesting is because CB1 is the same receptor that is linked to food intake and enjoyment. As soon as I read this I remembered all my pot smoking friends at school getting “The munchies” little did I know then that I would be writing a blog post ten years later on the munchie effect and anorexia!
Researchers are interested to see if it is a defect in the EDS that leads to anorexia and other eating disorders (it is my personal opinion that all eating disorders are different and that they should not be grouped and generalized, but …..ho-hum…) so they worked out how to take out the CB1 receptor in mice. This lead to skinner mice than the controls that had functioning CB1 receptors.
This study looked into the activity based anorexia (ABA) model, which incidentally is the type that I suffered from. I developed an excessive exercise routine often running as much as 6 hours in a single day! The study mimicked this by giving the rats bred to be anorexic access to running wheels and restricted diet. There were four groups of rodents in total:
- Anorexic bred rats with restricted diet and running wheel access
- Anorexic bred rats with no access to running wheels
- Normal diet rats with no access to running wheels
- Control group- normally fed with access to running wheel
So they ‘mimicked’ anorexia in and group of rats, and then they split the group and put them in recovery by allowing normal access to food and exercise. One section of this split was given cannabinoids in the food, and the other were not. The group that were not given cannabinoids did not regain their appetite, and the group that was did.
This is interesting, but human brains are wired differently than those of rodents, so I hate to get anyone too excited just yet.
It interests me that THC is considered to not be great for anxiety disorders, and also that another cannabinoid, called cannabidiol (CBD)which is not psychoactive and is thought not to affect the psychoactivity of THC is considered to be affective in reducing anxiety (Bergamaschi et al 2011) This effect has been supported by psychological tests, in which participants experience less intense psychotic-like effects when intravenous THC was co-administered with CBD. (This video helped me understand this)The receptors in the EDS are different for THC and CBD as CBD has a greater affinity for the CB2 receptor. Many people claim to find relief from anxiety with marijuana while others say the opposite. It appears CBD content may be the deciding variable.This makes me wish that I knew anything about cannabis and the different strands available and their properties. I wonder if it is important that the cannabis used is relatively higher in CBD than THC.
I read a report written this year that states that CBD is not a popular as THC as it doesn’t illicit such a ‘high’ and for this reason CBD is being bred out of strains.
More research is needed but the current thinking is that cannabinoids activity in the hypothalamus is related to appetite and food seeking behavior (Kirkham 2006). This I guess is the take home information that I have from all of this research, and its seconded by the less scientific but equally as convincing concept of “the munchies”
I am also interested in the prolonged systematic exposure to cannabinoids that is linked with anti -social behavior. I have read that the research here is pretty inconclusive but does suggest that the EDS is an important control system for investigatory drive, and investigatory drive is what makes us humans social. In studies, contradictory results have been obtained and differ with drug concentration and experimental conditions. I am interested in this as I have my own theories about introversion and anorexia, and I wonder if the cannabis thing would worsen anti- social behavior in introverts.
I want to just touch on this. In studies with rats THC administered during adolescence led to decreased social interaction- or the rats seemed more introvert. I have also read studies that show social play in rats is decreased by hunger- and the theory is that although social play in adolescent rats is an important developmental behavior, it is secondary to higher physiological needs- like seeking food (Siviy and Panksepp 1985). In short, hungry rats don’t go out as much. Many this is why cannabis gets linked to anti- social behavior, as the smokers appetite is increased and the drive to seek outside stimulus is decreased?
Either way, I think that if cannabis can increase the appetite and aid recovery in anorexics that it is a pretty low risk form of treatment, had I known this in recovery I think I would have tried it out. I know that drinking alcohol would make me less conscious about what I ate when I was in recovery and hence it helped me to ‘let go’ every now and them, although far from ideal as the day after would present a hangover and anxiety related to losing control and over- eating the night before.
I also know that the stress present in the anorexic is very influential on decision making and rational thought, as well as the physical ability to digest food even if it is eaten. Seeing as cannabis is meant to reduce stress and place one in ones parasympathetic nervous system (the chilled out one where we can digest food and relax) it means that any food eaten will be better digested in theory. I found yoga incredibly effective for recovery as it allowed my to access my parasympathetic nervous system, get some rest and think more clearly rather than my usual stressed out state of anxiety that clouded my brain. One finds oneself in a cycle of stress, not eating, not thinking clearly and making rational decisions as a result of not eating and so on and so forth.
I agree that re- feeding the anorexic is important due to the cognitive effects of malnutrition but due to the stress it placed on me when I was suffering it honestly did more harm than good. If cannabis had allowed me to feel that stress less I think my re- feeding and therefore recovery would have been improved.
As a weed smoking anorexia sufferer (certainly not ABA though), my experience is that it can help if you are ready to let it. It is not stronger than anorexia. HOWEVER, I find myself more able to see the disorder in my thoughts and out-think them whilst high. Partly there is the increased drive to seek food, but any anorexia sufferer knows that responding to hunger (and especially without using compensatory behaviours) is not as simple as feeling it. But there is some psychological distance created- which I think may be related the mild ego dissolution effects, since it is psychedelic. I see my thought processes from an altered perspective, and am prompted to think more deeply and make different connections. For me, this seems to reduce anosognosia, and loosen the grip of habitual behaviour patterns for the duration of the high. That probably means a pure CBD strain would not produce this, but may have its own way of helping. Certainly, not being so on edge makes it much easier to make and enact healthy decisions. But, like I said, there must be a level of willingness to work with these helpful effects and not resist them. I also think that it should be used on a short-term or as-needed basis, in the same was people use benzodiazepines, and effort should be undertaken to eat without the aid of marijuana as soon/as much as possible to offset the chance of developing a psychological dependence on being stoned in order to eat, and because smoking frequently and stopping suddenly has such drastic appetite reduction effects. While these are only active for a couple of days, that can deliver a devastating blow to a fragile recovery. But, anything that can improve nutritional intake is a potential weapon against the stuckness and inability to think clearly that not eating itself causes. And my god, I’d rather smoke weed than take olanzapine.