Cannabis use among people living with eating disorders

Résumé fourni par la source

There are few effective treatments for eating disorders (EDs). The MED-FED survey queried adults with self-reported EDs about their recent prescription and non-prescription drug use and the perceived benefits and harms of each drug used. Top-line survey responses highlighted benefits of cannabis for managing ED symptoms. Here, we provide a more detailed analysis of the subset of MED-FED data pertaining to cannabis. This study recruited adults self-reporting a diagnosed ED or undiagnosed disordered eating causing distress. The survey quantified frequency of cannabis use, products used, cannabinoid content of products, self-reported effects of cannabis on ED symptoms and general mental health, adverse effects of cannabis products, and use of other drugs. Daily and intermittent cannabis users were compared to non-users. Optional open-ended responses around cannabis use were subjected to thematic analysis. Cannabis was the third most commonly used drug after caffeine and alcohol. Of 5383 respondents, 3018 (56.1%) had used cannabis recently (past 12 months) and many (1270/3018; 42.1%) were daily users, some (732/3018; 24.3%) using several times a day. Cannabis flower (2670/3018; 88.4%), edibles (51.2%), vapes (20.8%) and cannabis oil (18.5%) were the most popular products. Those with avoidant/restrictive food intake disorder (ARFID) were more likely to use cannabis and those with anorexia nervosa (AN) less likely. Cannabis markedly improved self-reported ED symptoms, particularly in those with AN and ARFID, but not in binge eating disorder (BED). General mental health was self-reported as improved by cannabis in most respondents regardless of diagnosis. Daily cannabis use predicted higher rates of comorbid mental health conditions and use of other non-prescription drugs. Many cannabis users (556/3018; 18.4%) believed they “had a problem” with cannabis, with an additional 14.0% believing they “might have a problem”. Analysis of open-ended responses (N=640) revealed contrasting themes of cannabis-related improvements and cannabis-induced exacerbations of ED symptoms and mental health problems. Cannabis is widely used by people with eating disorders and is widely perceived as beneficial in restrictive and food-averse, but not binge, eating disorder subtypes. Future clinical trials of cannabis products are warranted in eating disorders, but cannabis dependence and other adverse effects are of some concern. The MEDication and other drugs For Eating Disorders (“MED-FED”) survey examined the use of prescribed and non-prescribed drugs in adults who self-reported a clinically diagnosed ED, or disordered eating. Amongst 5383 respondents, cannabis was the third most commonly used drug after caffeine and alcohol, with 56% reporting recent use, and around half of these using cannabis daily. The most popular forms were cannabis flower, edibles, vapes, oils and then concentrates. Cannabis was highly rated for improving ED symptoms but this varied by diagnosis. People with restrictive or food-averse conditions, like Anorexia Nervosa (AN) and Avoidant/Restrictive Food Intake Disorder (ARFID), reported that cannabis notably improved symptoms by lowering food anxiety, reducing nausea, and increasing the ability to eat. Conversely, those with Binge Eating Disorder (BED) often reported that cannabis worsened their symptoms, likely by triggering overeating. Most respondents felt cannabis improved their overall mental health. However, daily cannabis users were more likely to report other mental health problems and use of other non-prescription drugs. Overall, cannabis appears to offer potential in the treatment of EDs that are driven by restriction like AN and ARFID. Future clinical trials of cannabis-based medicines are justified, although doctors must monitor patients for potential dependence and other adverse effects.

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