“When I was struggling with an eating disorder in high school, I was eating maybe up to 500 calories a day and working out for two hours on top of that,” says Andrea (a pseudonym), 26. “The only time that I stopped worrying about food — when my bad eating habits would go out the window — was when I smoked.”
“Then, when I was in treatment for my eating disorder, while nobody on my treatment team necessarily recommended it, I got myself a medical marijuana card,” Andrea continues. “When I was struggling to get myself to have the willpower to do what I needed to do, weed kind of made that decision for me. But the flip side of that was, I was in the process of undoing one addiction, and smoking became more of a habit through me creating a dependence on it in order to eat confidently. I was thinking of it like training wheels during my treatment, but over time, especially after I left treatment, weed became more of a regular thing for me. I began to lean on smoking in the same ways that I was leaning on treatment to eat what was in front of me at any given point. It was almost like my chemistry had changed a little bit, like my stomach was unprepared to eat unless I had smoked prior to that.”
Andrea, it seemed, needed weed to eat. “My anxiety about food would keep me from eating,” she says. “My stomach would physically feel like it was in knots, and the smoking would untie the knots just enough to take a few bites. I was feeling so stressed that I would get nauseous. If I stopped smoking, sometimes I would even gag trying to eat a piece of toast.”
Andrea is far from alone in this struggle: At any point in time, more than 30 million people in the U.S. are suffering from an eating disorder, and the internet is permeated with stories from people who rely on cannabis to muster up an appetite.
The munchies, of course, are a notorious side effect of consuming weed, and we have some munchie science that explains how ganja impacts our appetite. For instance, Jon Davis, cannabis researcher and assistant professor of integrative physiology and neurosciences at Washington State University, performed a study a couple of years ago, where he and his team dosed rodents with cannabis vapor to examine its effects on the hypothalamus, a brain region that plays a major role in appetite regulation.
“What we found was, the most significant transcript that was changed was the dopamine transporter,” he explains. “Most people are familiar with dopamine due to its motivational effects, but in the hypothalamus, it does the opposite — dopamine released in the hypothalamus has been thought of as an appetite suppressant, so we were kind of scratching our heads. But as it turns out, very recently, it was discovered that a unique population of dopamine neurons in the hypothalamus actually promote food intake, and they promote food intake by working on well-established pathways that are known to stimulate feeding.” Davis and his team also found, in relation to these pathways, that consumption of weed helps release a surge of the hormone ghrelin, which essentially signals the brain to look for food.
Davis has since received a grant to look deeper into this phenomenon and hopefully determine ways in which cannabis-based treatments can be used for the likes of illness-induced anorexia. In its current state, though, while weed has been somewhat accepted as a tool for people who struggle with eating, it poses some problems, too. “In the state of Washington, cannabis is already prescribed for appetite stimulation,” says Davis. “One of the drawbacks of that is, nobody really knows what to prescribe and how the patients should get the best products. They just give them a cannabis prescription, and then those people go to the dispensary, and have to deal with trial and error until they find something that works.”
Davis explains that, in order to use cannabis as a consistent treatment for those with serious appetite issues, we need to characterize how long it takes for weed to stimulate appetite — their study found that feeding in rodents increased after one hour, but he says that different strains could have different effects — and define how much of each kind of cannabinoid is most helpful. Nowadays, the cannabis at dispensaries tends to be relatively high in cannabinoids, particularly THC, and figuring out how much is in each product can be a serious struggle.
In fact, as with Andrea’s example, Davis suggests that extremely potent cannabis could pose some dependency problems that would get in the way of it being an effective treatment. He points to one study of HIV patients, where those who were already cannabis users required more synthetic THC to stimulate their appetite than non-users, suggesting that they’d developed a high tolerance due to the high levels of cannabinoids in the products they were using, therefore needing more and more of the plant to experience results. “What we think, and scientists as a whole think, is that there could be tolerance to the behavioral effects of cannabis,” Davis confirms.
Nonetheless, it makes sense why someone with an eating disorder or a disease that suppresses appetite would need to turn to cannabis for help. As Davis explains, a healthy body has hormones and an endogenous cannabinoid system that naturally stimulates feeding and the feelings that encourage us to eat on a regular basis. “Those hormones and the endogenous cannabinoid system have to be turned on at a high level when a person is malnourished, because they have a very low body weight and low body fat,” he says. “Those are our physiological, homeostatic systems that are in place to make us eat. So, these people are already kind of maxed out — their bodies should be making them eat constantly, but for some reason, they struggle.” When they use cannabis, though, as Davis has seen, “It has a very effective short-term impact on their food intake, and then they go back to the exact way that they were.”
In fact, a 2011 report in Biological Psychiatry suggests that people with anorexia and bulimia may live with deficits in their endocannabinoid functions, which could be the reason they struggle to eat and keep food down. The study found that women with either anorexia or bulimia had a significantly underactive endocannabinoid neurotransmitter system in the part of the brain responsible for experiencing the taste of food, then connecting that with our emotional response to eating. Essentially, these women were physically unable to fully experience the pleasure of food.
Knowing that, Davis warns about thinking of cannabis as an addiction for those with similar eating problems. “I believe people realize that they need to have cannabis to stimulate appetite,” he says. “But saying that cannabis is addictive takes on a different kind of connotation, because these people aren’t using cannabis for its euphoric effects. Instead, they use it to eat.”
On a more general level, there are also people out there who are seemingly without an eating disorder (or some other kind of biological appetite issue), but who still rely on weed to eat. Psychologist Glenn Livingston, author of Never Binge Again, theorizes that this could be a result of our modern, hyper-palatable food system. “Part of what’s going on is that the industrial foods in today’s society have broken our hungry and full meters,” he explains. “They keep us in this feast or famine cycle, and the way they do that is by targeting our bliss point and targeting it in the reptilian brain without giving us enough nutrition to be satisfied. So, we start to think that the only thing that’s really viable for us, and that gives us any pleasure, are these super-sized stimuli: The bags, boxes and containers of stuff. And every time you look for love at the bottom of one of those, there’s some fat cat in a white suit with a mustache laughing all the way to the bank.”
“You start with that as a hypothesis,” Livingston continues, “and also understand that there’s a phenomenon of downregulation and upregulation. What that means is that, if you’re presented with a super-sized stimuli on a repeated basis — something that’s not really available in nature (we didn’t have chocolate bars in the savanna, or pasta, pizza, Coke, Diet Coke and all these excitotoxins) — your taste buds and the pleasure apparatus associated with food, the stuff that gets you to believe that you’re hungry, that downregulates. It’s just like when I slept under a subway in my 20s in graduate school, I thought I’d never get any sleep the first week, but three weeks later, I couldn’t hear it. So, if you have a chocolate bar every day, eventually an apple doesn’t taste anywhere near as sweet. And you can get to the point where people lose their appetite because their taste apparatus has been blunted so much by all of the industrial foods, and unless they get things that are progressively sweeter and more delicious, they’re just not interested.”
Naturally, because weed seems to encourage the release of hormones that increase the rewarding feelings we get from food, it becomes a tool for people who’ve reached what seems to be the pinnacle of taste. “My speculation is, people who’ve been living in our society and eating that level of food, have had their taste apparatus blunted and the neurological alterations and the response to food that occurs with cannabis is probably compensating for that,” Livingston says.
As for whether using weed as a tool to increase appetite is a good or bad thing — no matter if you have an eating disorder or not — seems to depend. “I don’t think that’s an awful thing,” Livingston says. “That’s maybe a good thing that people can use that. I don’t know if you’d want to use it indefinitely, though. I’d think of it more like training wheels: Try to get more nutritious foods in and get the junk food out.”
Andrea feels similarly. “Smoking weed helped me eat during some really hard times in my life, but I also believe that some sort of dependency on it has developed, which makes me feel uncomfortable when I think about it,” she says. “You put training wheels on when you learn something, but that’s almost counteractive if you can’t take off the training wheels.”