Examining the scientific evidence for cannabinoid therapies in treating a complex eating disorder
Anorexia Nervosa (AN) is a life-threatening eating disorder characterized by an intense fear of gaining weight, a distorted body image, and severe restrictions in food intake. With the highest mortality rate of any psychiatric condition and relapse rates remaining stubbornly high, the limitations of current treatments have spurred researchers to explore unconventional approaches 1 4 .
One of the most surprising and controversial candidates emerging in this space is cannabis—a substance more commonly associated with stimulating appetite than treating complex psychological conditions.
This article delves into the evolving science behind the relationship between cannabis and anorexia nervosa, exploring how the very system in our bodies that interacts with cannabis compounds might hold the key to new therapeutic possibilities. We'll examine the biological mechanisms, review key scientific findings, and consider what this could mean for the future of eating disorder treatment.
To understand why cannabis might be relevant to anorexia treatment, we first need to understand the endocannabinoid system (ECS)—a complex cell-signaling system that plays a crucial role in regulating appetite, mood, pain sensation, and memory 3 4 .
Groundbreaking research has revealed that individuals with anorexia nervosa show significant abnormalities in their endocannabinoid systems 1 3 . Studies have identified differences in cannabinoid receptor availability, circulating levels of endocannabinoids, and the expression of genes related to this system 1 .
These discoveries suggest that ECS dysregulation may be involved in the core symptoms of AN, potentially explaining why traditional treatments often fail to fully restore normal appetite and eating behaviors.
Scientific exploration of cannabinoids for anorexia treatment has produced a complex picture with promising yet mixed results. A 2023 scoping review published in the Journal of Eating Disorders synthesized findings from 17 reports, providing the most comprehensive look at this relationship to date 1 4 .
One particularly illuminating study, published in the Israel Journal of Psychiatry in 2017, offers a closer look at how researchers are testing cannabinoids in anorexia treatment. This pilot study focused specifically on the psychological symptoms of AN—an important focus since weight restoration alone doesn't guarantee full recovery 8 .
9 females with chronic AN (mean age: 45.0±3.2 years, BMI: 16.1±1.6 kg/m²)
Oral Δ9-THC: 1 mg/day (week 1), 2 mg/day (weeks 2-4)
Comprehensive psychological questionnaires before and after treatment
| Reagent/Instrument | Function in Research |
|---|---|
| Δ9-Tetrahydrocannabinol (Δ9-THC) | The primary psychoactive component in cannabis; studied for appetite stimulation and potential psychological benefits |
| Dronabinol | Synthetic THC formulation; allows for standardized dosing in clinical trials |
| Cannabidiol (CBD) | Non-psychoactive cannabis component; investigated for anxiety reduction and neuroprotective effects |
| Endocannabinoid Level Assays | Measure concentrations of natural endocannabinoids like anandamide; used to identify ECS abnormalities |
| Eating Disorder Inventory | Validated psychological assessment tool; measures specific psychological traits in eating disorders |
Beyond controlled clinical studies, valuable insights come from the experiences of people living with eating disorders. A groundbreaking international survey published in JAMA Network Open in 2025 gathered responses from over 7,600 participants across 83 countries—making it the most comprehensive survey ever conducted on this topic 2 6 .
The results were striking: among people who self-medicated with various substances, cannabis and psychedelics were rated as the most effective for alleviating eating disorder symptoms.
The survey revealed that cannabis was particularly valued by respondents with restrictive eating disorders such as anorexia and avoidant/restrictive food intake disorder (ARFID). Researchers theorized this might be because cannabis enhances the rewarding value of food—addressing a core deficit in these conditions 2 6 .
While the potential benefits of cannabis in anorexia treatment are intriguing, researchers emphasize the importance of approaching this therapeutic possibility with caution.
The growing body of evidence, while still preliminary, has been compelling enough to spur more rigorous research initiatives.
A pilot study examining CBD—the non-intoxicating component of cannabis—for treating severe anorexia in young people is nearing completion 2 .
"This research suggests that cannabis and psychedelics hold significant promise for improving quality of life in individuals suffering eating disorders. This is particularly salient since current pharmacological options for these patients are severely limited and current treatment outcomes so disappointing. Of course, rigorous clinical trials are needed to confirm these benefits and better determine safety profiles."
The exploration of cannabis as a potential treatment for anorexia nervosa represents a fascinating convergence of ancient plant medicine and modern neuroscience. While definitive answers are still forthcoming, the current evidence suggests that the endocannabinoid system—and interventions that modulate it—may play an important role in future eating disorder treatment.
The scientific journey to understand this relationship is far from complete, but it offers something crucial: new hope for a patient population that has faced limited treatment options and high rates of relapse.
What makes the cannabis-anorexia research particularly compelling is its basis in biological science—the documented abnormalities in the endocannabinoid systems of people with AN—coupled with the reported experiences of patients who have found relief through cannabis use. Together, these strands of evidence are weaving a new narrative about potential paths to recovery.
As with any emerging treatment, balance is essential: balancing hope with scientific rigor, and optimism about potential benefits with clear-eyed assessment of risks. The path forward lies not in either glorifying or demonizing cannabis, but in carefully, systematically uncovering its proper place in the therapeutic arsenal against anorexia nervosa.
References will be added here in the final publication.