Anorexia Nervosa and Cannabis Abuse: A Case Report

Karayilan, Semra; Erol, Atila

doi:10.5455/bcp.20121130090627

Cited by 1 publication

(8 citation statements)

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“…Four reports from 4 studies (2 retrospective cohort studies and 2 case reports) reported harms associated with cannabis use in AN [ 35 – 38 ]. Both participants from the case reports identified as women while the gender/sex breakdown of participants with AN could not be determined from the data included in the retrospective cohort studies.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Two case reports, each involving 1 participant with binge/purge type AN reported compensatory behaviors following cannabis use [ 37 , 38 ]. One of these participants was using cannabis daily for at least 7 years [ 37 ], while the other participant was using cannabis daily for at least 3 years [ 38 ]. One participant presented to a treatment facility and was found to be suffering from cannabinoid hyperemesis syndrome (CHS), a condition associated with long term cannabis use causing recurrent vomiting [ 13 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…One participant presented to a treatment facility and was found to be suffering from cannabinoid hyperemesis syndrome (CHS), a condition associated with long term cannabis use causing recurrent vomiting [ 13 , 37 ]. Although the other participant did not have CHS, appetite stimulation from cannabis appeared to encourage the participant to engage in postprandial compensatory behaviors to maintain low weight status, which was supported by a reduced BMI over the span of 3 years of daily use [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…Measured BMI weekly, steps through a pedometer daily, PA urge through a subjective 0–6 scale daily, Eating Disorder Examination questionnaire at baseline and at the end of the intervention, and leptin and cortisol through dexamethasone-suppression-tests at baseline and at week 5 of the intervention Benefits: • Weight gain after dronabinol (BMI 19.5 kg/m 2 pretreatment vs 21.0 kg/m 2 posttreatment) • Decreased ED symptoms after dronabinol (sum score 5.2 pretreatment vs. 2.0 posttreatment) • Decreased PA levels after dronabinol (32,510 steps per day pretreatment vs. 17,493 steps per day posttreatment) • Decreased PA urge after dronabinol (average urge to move rating of 5 pretreatment vs. 3.5 posttreatment) Harms/Null Effects: • No changes in leptin • Dcreased cortisol levels during dronabinol (1.7 mg/dL pretreatment vs. < 1.0 mg/dL posttreatment) Hjorthøj et al, 2019 [ 35 ] Retrospective cohort study *Number of participants with AN could not be determined Investigated polygenic risk scores for AN and CUD from participants followed from birth (between years 1981–2001) until 2017 Harms: • Highest polygenic risk scores for AN were associated with CUD (Hazard Ratio = 1.41, 95% CI 1.27–1.56) Ihm et al, 2023 [ 36 ] Retrospective cohort study 16,992 individuals with AN, 55,525 HC *Gender/sex could not be determined Investigated polygenic risk scores for AN and CUD from participants recruited between 2006–2010 Null effects: • NS interconnections between the polygenic risk scores for AN and polygenic risk scores for CUD Brewerton et al, 2016 [ 37 ] Case report 1 Woman with BPAN Patient presented to a treatment center with AN relapse symptoms. A urinary drug test, physical exam, mental status exam, and laboratory analysis was taken upon admission Harms: • Patient reported using cannabis daily for at least 1 year and chronically for at least 7 years • Patient reported vomiting, which was originally mistaken as a relapse • Patient reported relief in vomiting symptoms after hot showers, which lead to the diagnosis of CHS Karayilan et al, 2013 [ 38 ] Case report 1 Woman with BPAN Patient presented to a treatment center with weight loss, restrictive eating, and nervosity. Physical examination and review of life and medical history were taken upon admission Harms: • Patient reported using cannabis daily for about 3 years • Decrease in BMI over the...…”

Section: Methodsmentioning

confidence: 99%

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The relationship between cannabis and anorexia nervosa: a scoping review

Rogers,

Pacanowski

2023

J Eat Disord

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Background Relapse rates in Anorexia Nervosa (AN) remain high, warranting exploration of further treatments. Cannabinoid agonists are of interest as they have shown successful outcomes in the treatment of associated conditions, such as post-traumatic stress disorder. This scoping review explores the endocannabinoid system (ECS), benefits/harms/null effects of cannabinoid treatment, and harms of cannabis use in AN. Methods PubMed, PsycINFO, Cochrane, and Web of Science were searched for studies published between 2010 and August 2023, with human participants that explored the ECS, cannabinoid treatment, or cannabis use, and included 1 or more keywords for both cannabis and AN in the title and or abstract. Reports describing secondary anorexia, reports not available in English, grey literature, reports combining data from AN with other conditions, and reports only reporting the prevalence of cannabis abuse/dependence were excluded. Data were extracted from 17 reports (n = 15 studies). For the ECS, outcomes included genetics such as allele expression related to the ECS, cannabinoid receptor availability, and circulating levels of endocannabinoids. For benefits/harms/null effects of cannabinoid treatment, outcomes included changes in weight, eating disorder (ED) symptoms, physical activity (PA), and hormones. For harms of cannabis use, outcomes included genetics related to cannabis use disorder and associations between cannabis use and ED symptoms. Results Eight studies (n = 8 reports) found abnormalities in the ECS in AN including expression of related alleles, genotypes, and haplotypes, availability of cannabinoid receptors, and levels of endocannabinoids. Three studies (n = 5 reports) found benefits/harms/null effects of cannabinoid treatment. Benefits included weight gain, improved ED symptoms and reduced PA, while null effects included no changes in weight or ED symptoms, and harms included increased PA and lowered adipose hormones. Four studies (n = 4 reports) expanded upon harms of cannabis use, including genetic predispositions to cannabis use disorder, and compensatory behaviors related to cannabis use. Conclusion Limited evidence suggests that abnormalities in the ECS in AN may render cannabis a potential treatment for weight restoration and associated symptoms. Future research may wish to investigate individualized dosing approaches to maximize beneficial effects while minimizing harms. Level II Evidence: Scoping Review.

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Section: Resultsmentioning

confidence: 99%