As for post-munchies guilt, Jessica hasn’t experienced it when the high wears off. “I don’t have the body image distortion issues that some people with eating disorders have,” she explains. “Anorexia is a control thing for me — excessive perfectionism — so it’s a relief to have something that allows me to let go and be more flexible.”
Claire*, 21, a college student in Seattle, also credits marijuana for helping her let go of the obsessive calorie counting that drove her eating disorder. The first time she smoked, she got the munchies and ate, but the drug re-sorted her memory in a way that made it impossible to remember her calorie counts the next day. “I felt bad and guilty at first, but I noticed I felt good physically and it also felt good to rebel against my harmful thoughts,” Claire says. “Since I’d already lost track, I figured it couldn’t hurt to go two days without counting, and so I started smoking more regularly and I haven’t counted calories since.”
These stories don’t surprise Sona Patel, an L.A.-based physician who has been recommending medical marijuana for nine years under California Proposition 215. (Her website is Doc420.) “Treating anorexia involves many components, one of which is restoring the person to a healthy weight, and medical marijuana can help by increasing the patient’s appetite,” she says, adding that it also helps alleviate anxiety for people with eating disorders. Patel has seen a rise in the number of anorexia patients seeking help from marijuana in recent years. “Their success stories have become inspiration for other patients with anorexia who now feel confident in turning to medical marijuana as a cure,” she says.
Medical marijuana is now legal in 23 states and the District of Columbia. (Only four of these states explicitly list anorexia as a qualifying condition, but all include health issues associated with the eating disorder such as nausea, anxiety, and uncontrolled weight loss.) What’s more, a record 53 percent of Americans now favor the legalization of marijuana, according to a Pew Research Center study.
This change in public opinion has coincided with a growing body of research that supports the medicinal properties of the plant. New studies suggest cannabis may be effective in treating epilepsy seizures, neuropathic pain, and glaucoma, reducing multiple sclerosis stiffness, and even shrinking aggressive brain tumors.
While stoner movies have long portrayed the power of “the munchies,” it was only recently researchers discovered why the drug has this effect. A 2014 animal study in Nature Neuroscience suggests an active ingredient in the cannabis plant that makes you feel high, known as tetrahydrocannabinol (or THC), activates receptors in the brain linked to odor processing, which may increase our ability to smell and taste.
The “munchies” effect is the reason medicinal marijuana gained acceptance as an alternative treatment for cancer and HIV patients struggling with nausea and loss of appetite, but its role in treating anorexia nervosa may be more complicated. In addition to lack of appetite, sufferers often have a deep fear of food, severe body distortions, and an excessive need for control. “They feel power in not giving in to the desire to eat, so stimulating their appetite can’t necessarily overcome the neurobiological issues that are also intimately involved with their disorder,” says Tamara Pryor, director of clinical research at theEating Disorder Center of Denver. “That said, marijuana may be a helpful tool for some people — in conjunction with therapy.”
So far, research on marijuana and anorexia nervosa is scarce. A 30-year-old study found cannabis was not an effective treatment and could even cause psychic disturbances in some patients, but a 2013 Danish study found the use of a synthetic cannabinoid, dronabinol, led to small but significant weight gain in anorexia nervosa patients, and a 2013 study from Katholieke University in Brussels found cannabinoids helped anorexia-stricken mice recover and return to a healthy weight.
Though the anorexia sufferers say they use the drug to calm anxiety so they can eat, Gina Bongiorno, an adult program therapist at the University of California San Diego Eating Disorders Treatment programremains skeptical of this strategy. “If someone has to rely on marijuana to reduce their anxiety and get through a meal, then they are never learning how to regulate their emotions and lose the opportunity to heal their primary issues.”