Cbd oil for bulimia

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Budding New Considerations about the Use of Cannabis in Eating Disorder Treatment

Eating Disorders and Co-Occurring Substance Dependency

Eating disorders are complex psychopathologies, which present clinical challenges for many reasons. A major one is that eating disorders often co-occur with a Substance Use Disorder (SUD). This includes cannabis abuse, which can begin before, concurrently with, or after the onset of an eating disorder. Given this, EDCare uses an integrative model in treating the SUD, along with other eating disorders symptoms such as anxiety, OCD, and depression.

Another challenge is that individuals with anorexia are empowered by resisting the temptation of eating. Therefore, the appetite-stimulating properties of cannabis can’t necessarily overcome the neurobiological issues that are also intimately involved with their eating disorder.

That being said, medical cannabis might be a helpful tool for some people in conjunction with therapies such as Cognitive Behavioral Therapy (CBT). There are three primary strains of cannabis: sativa, indica, and hybrids.

  • Sativa is the activating strain of cannabis that tends to energize the user and produced the “high”. It can be used to relieve the symptoms of depression, fatigue, and mood disorders.
  • Indica is a more sedating strain that produces relaxation and full-body effects and is preferred by the majority of our eating disorder patients.
  • Hybrids are varying functions of these two strains that are thought to balance the positive effects of both.
Cannabis and Eating Disorder Treatment

One EDCare patient reported that medical cannabis helped slow down her mind, allowing her to observe her irrational thoughts surrounding food. Food began to taste better making her mealtimes an enjoyable experience.

Substance abuse of course, is a big concern. In Denver, between 7 and 9% of our eating disorder patients who use cannabis show signs of substance dependency. With 364 legal dispensaries in Denver and 1,021 in Colorado, we can clearly expect that up 50% of our eating disorder patients are using. Moreover, testing an individual’s level of intoxication has proven to be a challenge due to the length of time THC takes to clear the body.

How do we deal with this dilemma? We begin with a very extensive physical and psychological diagnostic assessment for the history of the eating disorder and substances use/abuse. We need to determine whether the patient can participate in our program, and whether they are using edibles, tinctures, or smoking. Are they using Indica or Sativa? Can we wean them off the higher levels of THC with a mix of CBD and a much lower percentage of THC? And finally, what withdrawal effects such as irritability, insomnia and changes in appetite need to be treated while still focusing upon their compromised emotional and medical state due to their eating disorder?

There are many unanswered questions concerning medical cannabis usage in eating disorders. We have learned to practice “beginner’s mind” with an attitude of openness, curiosity, and lack of preconceptions or judgment when learning the adaptive function of both the eating disorder and the cannabis use.

Why I Turned to Cannabis to Manage My Eating Disorder

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.

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.

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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. 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.”

What next?

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.

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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 d ealing 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 .

Lauren Vino is a comedian and writer based out of New York City, by way of Chicago. She writes about health, psychology, and men, and performs stand up at her show Mid Riff Comedy in Brooklyn.

Cannabis for Eating Disorders

Can medical marijuana help people with eating disorders like anorexia and bulimia? Cannabis is often used to increase appetite in people suffering from conditions such as cancer or AIDS/HIV. The idea of using cannabis for those with eating disorders is not exactly new, and in many ways the logic is entirely sound. However, eating disorders have several key differences to wasting developing from other chronic illnesses, meaning that treating them requires slightly different approaches.

Using cannabis for eating disorders is a subject we have written about before here at Leafwell. Today we’ll learn all about the potential of cannabis as a medication for a variety of eating disorders.

What is an eating disorder?

One of the key defining symptoms of an eating disorder is an unhealthy attitude towards food and eating either too much or too little. Other symptoms include an unhealthy obsession with weight and body shape, over-exercising, obsessive dieting, binge-eating (sometimes followed by intentional vomiting, or “purging”), extreme dissatisfaction with one’s own appearance (Body Dysmorphic Disorder, or BDD) depression, anxiety and extreme feelings of guilt, regret and/or worthlessness.

In some instances, an eating disorder may lead to “refeeding syndrome”, which is when malnourished or starved people take in food too quickly after a fasting period and develop electrolyte disorders. This leads to further pulmonary, cardiac, neuromuscular and blood complications. Refeeding syndrome can be potentially fatal. Other long-term complications include increased likelihood of stress fractures and Raynaud syndrome.

There are various types of eating disorders, including:

  • Anorexia nervosa – keeping your weight as low as possible by purposefully not eating enough food, exercising too much or both.
  • Binge eating disorder (BED) – losing control of your eating and eating too much at once, until you are uncomfortably full. Often followed by feelings of guilt and regret.
  • Bulimia – Binge eating in a small amount of time, then deliberately feeling sick, using laxatives or exercising too much in order to prevent weight gain.
  • Obesity – While not always considered an “eating disorder”, obesity does follow many of the same patterns as other eating disorders, including binge eating and an unhealthy relationship with food. Indeed, it is not unheard of for a person to swing between anorexia and obesity.
  • Other specified feeding or eating disorder (OSFED) – an eating disorder that doesn’t necessarily match all the symptoms of one of the above, and/or has “mixed” symptoms from one or more of the above. OSFED can include atypical anorexia, avoidant/restrictive food intake beyond that of “picky eating”, night eating syndrome, anorexia athletica and eating disorders related to type-I diabetes (e.g. deliberate insulin under use in order to prevent weight gain).

Some statistics on Eating Disorders

Deaths from Eating disorders in 2012 per million persons. Statistics from WHO. Data from World Health Organization Estimated Deaths 2012 Vector map from BlankMap-World6, compact.svg by Canuckguy et al. Source

Eating disorders affect approximately 30 million people in the US. They have the highest mortality rate of any mental illness, and are often comorbid with mood disorders, anxiety disorders and substance misuse disorders (especially alcohol).

Eating disorders affect a wide variety of people. Women aged 50 or over, girls aged between 13 – 17 and women in high-pressured environments such as athletics are the highest risk groups for anorexia and bulimia. Restrictive eating is more likely to be found in boys and men. A 2015-2016 study by the Center for Disease Control and Prevention (CDC) showed that 39.6% of US adults age 20 and older were obese as of 2015-2016 (37.9% for men and 41.1% for women). Other risk factors include:

    to under- and overfeeding of the fetus during pregnancy. Maternal obesity and malnutrition play a huge role in the development of eating disorders among offspring.
  • Adiposity rebound – the “adiposity rebound” refers to the age when the second rise in body-mass index (BMI) occurs, which is between 3 – 7 years old. An early age adiposity rebound is correlated with obesity in later life.
  • Early life malnutrition and/or lack of breastfeeding – early nutrient deprivation can lead to a change in the body’s metabolism, leading to fat storage. This can make people vulnerable to obesity as adolescents and adults. Those who are not breastfed may suffer from stunted growth or grow too fast, leading to an earlier-onset adipose rebound. This is one reason why malnutrition, a lack of access to food and obesity are often linked and found together in impoverished parts of the world.
  • Steroid-based medications such as prednisone can lead to weight-gain.
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What is Cachexia?

While cachexia (which means, “weakness and wasting of the body due to severe chronic illness”) is often associated with conditions such as anorexia, a person who is suffering from cachexia is not necessarily suffering from an eating disorder. Cachexia can be caused by many illnesses and conditions, as well as treatments and medications. Many of those with cachexia may well have a perfectly fine relationship with food, but are unfortunate enough to suffer from a condition that causes them to lose weight and muscle.

Anorexia Athletica

Those in highly competitive environments such as sports and athletics, where extreme fastidiousness is practiced with regards to diet and exercise, eating disorders are not uncommon. Many athletes also need a high intake of calories, meaning they need to learn portion control when training slows down or ceases. Athletes of all types can potentially suffer from eating disorders.

Even boxers and wrestlers, who are considered some of the strongest athletes in the world, often dehydrate, starve and over-exert themselves in order to make weight, which can lead to all sorts of health problems. Gymnasts, dancers, figure skaters, weightlifters, bodybuilders, synchronized swimmers, and endurance runners are other examples of athletes who may suffer from eating disorders due to the emphasis on weight and appearance.

How Does Cannabis Help Eating Disorders?

When it comes to using cannabis for conditions such as anorexia, people see the logic quite easily. However, when it comes to obesity (as well as diabetes), people find the concept of using cannabinoid-based medications to help treat it unusual. Yet, regular use of cannabis is actually linked to lower BMI, even when controlling for diet, exercise and alcohol consumption. While these studies do not prove for sure that cannabis use can help people maintain a healthy weight, there are several sound theories as to why cannabinoids may be used to help maintain a healthy appetite for both over- and under- eaters. These include:

The endocannabinoid system (ECS) plays a role in regulating appetite. Cannabinoids such as tetrahydrocannabinol (THC) stimulate appetite and food intake.

Download Free Guide to the ECS
  • There is some suggestion that those who suffer from eating disorders have a disruption and/or dysregulation in the production of the hormones leptin (which can regulate energy balance by inhibiting hunger) and ghrelin (the “hunger hormone”, which stimulates appetite).
  • Cannabis use in HIV-infected men leads to an increase in plasma levels of ghrelin and leptin. THC in particular seems to have this effect.

Repeated exposure to THC may initially stimulate appetite, but use over the long-term could dampen CB1 receptor sensitivity, thus dampening hunger signals.

Some suggest that cannabis “supercharges” the body’s metabolism, meaning that fat is burnt off faster and levels of fasting insulin are lower. The body may be more sensitive to the effects of sugar while using cannabinoids, meaning that the brain sends signals to stop eating sooner than it usually would. So, while cannabis users may get the “munchies”, they may also have a tendency to stop eating sooner and only until they are full, rather than over-full.

There is much interest in the cannabinoid tetrahydrocannabivarin (THCV) for obesity and diabetes. THCV is a CB1 receptor antagonist, meaning that it has the opposite effect as THC when in low doses (THCV is a CB1 receptor agonist in high doses) and curbs hunger. In studies on mice, researchers found that THCV did not significantly affect food intake or body weight gain. THCV did, however, reduce glucose intolerance and improve insulin sensitivity. Such studies could offer hope to diabetics, but research on humans is necessary before making any assertions.

Cannabidiol (CBD) can also help control blood-sugar levels and reduce the production of fat while also reducing inflammation caused by insulin resistance.
Cannabis can potentially help with the depression and anxiety often associated with eating disorders. In turn, this may lead to an easier, less stressful relationship with food.

Are There Any Potential Negatives with Using Cannabinoids for Eating Disorders?

While cannabis can help improve the mood for many, for some using too much THC may lead to increased anxiety or paranoia. Also, if a person has been starving themselves for too long, care must be taken not to binge on food, lest refeeding syndrome occurs. Some may also be attracted to the idea that cannabis can help lose weight, which is beneficial for some but not necessarily others. Therefore, care must be taken to prevent misuse.

Those suffering from eating disorders such as anorexia or bulimia may be interested in low doses of THC and CBD, whereas those who are obese (or just plain overweight) may look into a combination of low doses of THC and THCV, combined with CBD. However, this is only theoretical, and has not been tested clinically. As there are few effective medications for eating disorders, cannabinoids represent an extremely promising avenue to look at as a potential therapeutic target.

There has been a look into other cannabis-based treatments for obesity in the past, namely Rimonabant. However, Rimonabant was not approved for usage due to its psychiatric side effects. Rimonabant has also been reported to cause partial seizures in those who suffer from epilepsy. It must also be noted that Rimonabant is a synthetic cannabinoid. We here at Leafwell have looked at the pros and cons of synthetic cannabinoids before, and as such we recommend being highly cautious of using them.

Remember: the endocannabinoid system is very powerful, and our efforts to replicate the safety margins of phytocannabinoids have generally not been successful so far. In short, the natural form of the cannabis plant is probably best for eating disorders and other conditions.

If you are suffering from an eating disorder and think you may be helped by cannabinoid-based medications, feel free to check out our medical card page and set up an appointment with one of our physicians.