Impact of Marijuana on Eating Patterns and Disordered Eating

Impact of Marijuana on Eating Patterns and Disordered Eating

By: Kinga Balogh, Registered Dietitian, CDE, Reviewed & Edited by JM Nutrition Team

 

In this post:

• Marijuana use in Canada

• The mechanism of Cannabis

• Cannabis products on the market

• Variables that impact the effect of THC

• Method of administration

• Other considerations re: the impact of marijuana on eating patterns

• A word of caution

• Clinical use of THC for eating disorders

• The impact of marijuana on eating disorders

• Public perception vs. personal choice

• Marijuana and recovery from disordered eating

• Strategies for overcoming the munchies or binge eating

• Parting words about the impact of marijuana on eating patterns

 

Does marijuana impact our eating patterns? Does marijuana have an impact on eating disorders and disordered eating?

Let’s take a deeper dive.

Five years ago, Canada became the second country in the world to legalize marijuana sales, possession and recreational use. Medical use of marijuana has been in effect for about twenty years prior to this. In this post, our aim is for the reader to gain further insight into the impact of marijuana on eating behaviours, with a special focus on people affected by disordered eating or full-blown eating disorders.

 

Prevalence of Marijuana Use in Canada

The National Cannabis Survey, conducted by Statistics Canada has been collecting self-reported data about Canada’s cannabis use since legalization in 2018.

Facts:

By 2019, more than 5.1 million people or 16.8 % of the population of Canada, aged 15 and older reported using cannabis in the past three months before the survey was conducted.

If we take a more in-depth look, we find highest use patterns in the 15- to 24-year-old age group, where 26.4% report using unspecified amounts of marijuana in the past 3 months. Up to 7.7% of those surveyed reported daily or almost daily use.

Patterns of decreased consumption can be noticed with increase in age, where 24.4% of the 25–44-year age group, 11.9% of the 45–64-year-old group, and a mere 5.9% of the 65 and older group relied on cannabis in the past three months.

Daily or almost daily use patterns also showed decline with advanced age, namely 8.9% in the 25–44-year segment, 4.4% in the 45–64-year age group and 2.6% in the 65 and older group.

A review of Statistics Canada findings also suggests that legalization did not have a significant impact on usage patterns. Infrequent users showed a slight increase in accessing marijuana, whereas frequent daily users continued with similar consumption patterns despite increased availability.

 

The Mechanism of Cannabis

THC

The word cannabis refers to several plants in the Cannabis genus, including sativa, indica and ruderalis. The cannabinoid compound tetrahydrocannabinol or TCH in its short form, refers to one active ingredient.

CBD

While cannabis has hundreds of cannabinoid compounds, another main ingredient is cannabidiol or CBD. This compound does not have psychoactive side effects, such as feeling high and does not seem to increase appetite the same way as THC.

Both CBD and THC are naturally present in the cannabis plant.

How does it work?

How does marijuana impact eating behaviours?

Let’s take a closer look.

Once ingested, inhaled, or smoked, THC will bind cannabinoid receptors in various parts of the brain and digestive system, namely the stomach and small intestines. This is also the chemical that causes the “high” that goes along with marijuana consumption. Aside from the euphoria, people often refer to the “munchies” as a side effect of being high. Having a compulsive or intense urge to eat can certainly pose challenges for many people.

The impact of marijuana on eating

Alterations in consciousness–because of THC intake–can impact feeding behaviours, where one becomes less restrictive or inhibited in making food choices. Hitting up the meal delivery app, picking up a box of donuts, scavenging through the freezer for cake or ice cream becomes a viable and permissible option even in the middle of the night.

A deeper look at the impact of marijuana on eating

The impact of marijuana on eating behaviours cannot be underestimated.

As per our current understanding, cannabis stimulates food cravings through enhanced eating pleasures and enhanced food palatability, thereby making the consumption of certain foods highly rewarding.

Cannabis also acts on the stomach and small intestines. It is here that it  regulates ghrelin production, an appetite stimulating hormone that speeds digestion. With an increased rate of digestion, you can consume a larger amount of food, without the feeling of getting uncomfortably full.

Unquestionably, you can you consume more higher caloric density food choices, such as high fat, high carbohydrate, and higher salt content foods. One’s metabolism, however, is also encouraged to store excess nutrients in fat tissue more readily in the presence of marijuana. Unless underweight and malnourished, this can be a diabolical situation for many people.

 

A Plethora of Cannabis Products on the Market

Typically, when consumers choose a cannabis product, they can decide on what active ingredients they would like to include and in what form. This is quite straightforward.

CBD & THC products

CBD tends to be offered in oils, gummies, capsules, tinctures and so on. THC, on the other hand, comes as smokable products, oils, tinctures, as well as edibles.

For the purposes of this post, we will discuss the general impact of marijuana, without emphasis on the therapeutic use of various formulations (different THC and CBD content).

A research publication by Farokhnia et al. in 2020 constitutes the first human laboratory investigation, observing the impact of cannabis on the endocrine system in humans, namely appetite regulation and metabolism.

Researchers looked at the impact of oral, smoked, and vaporized intake with participants and observed their blood values of appetite regulating hormones, namely ghrelin, leptin, GLP-1 and insulin.

Leptin & Ghrelin

Leptin is a hormone, made by fat cells. It decreases your appetite at the end of the meal. It does so by sending signals to the brain helping on you acknowledge that you have eaten enough and that you are full.

Ghrelin, on the other hand, helps initiate eating and is secreted by the stomach predominantly. It sends signals to your brain that you are hungry and should initiate or continue to eat.

 

Variables That Impact the Effect of THC

We cannot talk about the impact of marijuana on eating without considering the method of administration and potency of the substance.

Furthermore, clients may demonstrate various levels of tolerance depending on frequency of relying on marijuana and may have co-consumption patterns with other substances.

Method of administration

When analyzing the impact of marijuana in eating patterns, we cannot overlook the method of administration.

Farokhia et al. report that oral cannabis intake has a more pronounced effect on ghrelin production. Hence, it increases appetite and food intake, compared with smoked and vaporized cannabis reliance.

Since legalization in Canada, recreational use of cannabis has led to a greater reliance on oral and vaporized use, compared to more traditional smoking practices.

Hypothetically speaking, clients who consume marijuana in the form of edibles may be more plagued by the munchies. Anecdotal evidence also suggests that the strain of marijuana may also play a role in this.

Other considerations

1. Differences in cannabis potency and rate of absorption will also impact one’s response to the appetite stimulating effect of marijuana. Inhaled marijuana tends to manifest its impact within 1-4 hours, whereas oral consumption tends to have a delayed response due to slower absorption, namely within 5-8 hours as per the following source.

2. Co-consumption of marijuana with other substances, although rare, can alter its impact. It is, however, beyond the scope of this post to delve further into the topic of co-consumption.

3. Tolerance to marijuana can develop through consumption patterns. This should also be factored in when assessing the impact on eating behaviours.

4. Epidemiological studies suggest that occasional use of cannabis tends to stimulate food cravings and intake. Furthermore, the reward value of foods can also increase. These patterns lead to excess intake and the need to store excess calories in fat tissue.

5. On the other hand, chronic or almost daily usage in animal studies tends to suggest the opposite. THC suppressed weight gain, fat accumulation and overall caloric intake.

6. Human studies also suggest lower prevalence of obesity and diabetes in chronic users. The evidence, however, is weak and clearly does not warrant medical recommendations to rely on marijuana.

A word of caution

That said, a word of caution is required.

Observational studies suggest that one in nine people who smoke marijuana regularly become dependent on it.

It’s also worthwhile to note that eating disorders often co-occur with substance use. As a result, comprehensive and holistic counselling of eating disorders or disordered eating behaviours requires a careful review of substance use patterns as well.

Frequently, recovery from eating disorders requires concurrent commitment to address substance use by addiction specialists.

 

The Impact of Marijuana on Eating, Disordered Eating & Eating Disorders

Clinical Use of THC for Eating Disorders

We must now take a more in-depth examination on the connection of marijuana and disordered eating, as well as eating disorders. 

As marijuana is legalized in Canada, and many clients affected by eating disorders may rely on it, JM Nutrition has taken the initiative to review the latest research on this emerging topic.

In this post, the review will focus on the impact of marijuana, assuming intake of both THC and CBD, rather than reliance on uniquely formulated products to address specific medical conditions.

Anorexia

Clients affected by anorexia are often not in touch with their natural hunger cues and report minimal satisfaction from eating foods. We can hypothesize that THC may offer some relief, particularly in the early phases when underweight clients need significant weight restoration to commence nutritional rehabilitation.

Research is still evolving in this area.

In 2013, Andries et al. reported findings that synthetic THC administration for clients with longstanding anorexia nervosa over four weeks, brought about a 1–2-pound extra weight gain over four weeks. This is compared to participants that did not receive pharmacological support with hospital feeding protocols.

What’s more, Dr. Jordan Tishler, a professor at Harvard Medical School and cannabis specialist, warns for close medical monitoring, when considering cannabis administration.

While clients with chronic anorexia not responding to multidisciplinary care may be good candidates, clients newly diagnosed should not be offered this option right away, particularly if they are not users to begin with. Given the habit-forming nature of cannabis, it’s important to exercise caution as risks and benefits are evaluated.

Related: Support of a dietitian for Anorexia Nervosa

Bulimia

It is even harder to come by studies evaluating the impact of marijuana for clients affected by bulimia. Perhaps int he future we will have more research about the impact of marijuana on eating disorders. 

Dr. Tishler again states to avoid relying on marijuana during the acute stage, when clients regularly binge and purge.

It could be worthwhile to explore clients’ motivation to binge and purge.

What triggers overeating?

What triggers purging?

Emotional dysregulation secondary to trauma history, social isolation, or mood disorders could be culprits worth exploring. Despite widespread belief, clients often overeat while drawing minimal satisfaction from the process, or purge in the absence of a distended belly.

Related: Registered dietitian for Bulimia support

Binge Eating Disorders (BED)

Undoubtedly, binge eating is the most commonly occurring eating disorder. Yet, this condition tends to be the most misunderstood ailment.

Clients with BED find themselves eating larger than usual servings of food compulsively, while feeling out of control. They also describe a sense of shame following an episode of overeating. In addition, eating tends to be initiated without feeling physically hungry, the pace of eating is usually ravenous, and the behaviour tends to be secretive.

Similarities between binge eating and the munchies

Clients often report feeling out of control with both the munchies and when engaging in binge eating. They may eat when not hungry and consume more than what they intend to eat, often feeling uncomfortably full once the eating frenzy is over.

Both behaviours also share characteristics of reaching for the proverbial “forbidden food.”

With a binge or while being “high,” clients report noticing how the floodgates open. They report how they are drawn to foods they would typically restrict or avoid otherwise. Clients also share similar experiences following an overeating episode. In the aftermath of a binge, they are left to sort through shame, guilt and embarrassment.

Lastly, momentary euphoria is typical while consuming “forbidden foods”. The synergistic effect of consuming “forbidden food” with enhanced sensory properties secondary to marijuana often creates a divine eating experience. It is important to note that this is a very short-lived experience with significant drawbacks.

Related: Dietitian for binge eating

Differences: Public perceptions and personal choice

Frequently, our society portrays binge eating, while under the influence, as funny. At the same time, it evaluates BED as immoral and shameful.

Certainly, this depiction could be fuelled by weight stigma and fatphobia. It is worthwhile to distinguish between overeating secondary to the use of a recreational drug and binge eating disorders in hopes of developing a more compassionate view of the dynamics at play.

Binge eating tends to be caused by an interplay of factors. These include genetics, dieting behaviours, food insecurity, history of trauma or mental health struggles.

As a result, those who struggle with binge eating involuntarily slip into this behaviour repeatedly.

On the other hand, marijuana consumption tends to be a voluntary behaviour, while users are aware of eliciting the “munchies” when under the influence. Evidently, overcoming either BED and/or dependence on marijuana requires tremendous determination and often extensive professional support.

 

Marijuana and Recovery from Disordered Eating

Continuing to rely on marijuana can certainly offer challenges for clients seeking relief from the munchies. People feeling stuck in diet mentality often go through cycles of restricting, followed by episodes of overeating. This vicious cycle is inherently challenging to break, particularly for cannabis users.

The situation is similar for those diagnosed with BED who demonstrate marijuana dependence. Being intoxicated certainly reduces one’s determination and opportunity to ride out the urge to binge.

Whereas sober people find overcoming binge eating particularly challenging, those relying on marijuana have an even harder time.

Analogy: The impact of marijuana on eating disorders (binge eating)

An analogy that may illustrate the complexity of the situation is as follows: Having binge eating and relying on marijuana on a regular basis is like asking the driver to steer a vehicle on the highway, while having them sit in the passenger’s seat.

Having a secondary superimposed urge to binge created by the munchies for clients who already struggle with binge eating creates unfair circumstances to give recovery work a full chance.

In summary, both reliance on excessive amounts of food and/or marijuana routinely represent maladaptive coping mechanisms. Often affected individuals struggle with low mood, chronic stress, or life circumstances beyond their control.

Whereas initially relying on food and/or marijuana appears to offer symptom relief, with time most people realize that these behaviours are not serving them well.

Where to find help

Reaching out to a dietitian specializing in eating disorders is an excellent start to regain eating competence and confidence. This is an excellent place to start. It’s also a place you can potentially learn a great deal about nutrition, behaviour, and even the connection between marijuana and disordered eating and eating disorders. 

Connecting with a counsellor or psychotherapist specializing in addictions, trauma and mood disorders can offer further leverage for clients wanting to expand their repertoire of adaptive coping strategies.

What if I do not want to give up marijuana completely?

Many people are ready to reduce reliance on marijuana yet cannot fathom the idea of completely parting ways from it. They often mention how this is a social activity, where they can connect with others, and they experience a reduced sense of social anxiety.

Health care professionals need to validate the benefits their clients attribute to substance use, and they simultaneously must encourage self-monitoring and self-discovery for clients to take stock of drawbacks as well.

Compassionate enquiry about the interplay of concurrent cannabis use and food struggles need to be offered to each client who finds themselves in this predicament. Once clients observe and admit to the slippery slope marijuana consumption presents to their eating challenges, discussions about harm reduction strategies can be initiated. 

 

Strategies to Consider When Overcoming the Munchies or Binge Eating

No marijuana and eating disorders discussion would be complete without some tips and strategies for overcoming the munchies and binge eating.

1. Commit to regular meals

Ensure to eat well-balanced meals for your main meals and include snacks as necessary.

Aim for a variety of foods, without rigidity around options. If you label certain foods as “forbidden” you can set yourself up for overindulging in them, when under the influence of marijuana.

Eradicate dieting mentality can be of further help. Ask a dietitian specializing in Intuitive Eating or eating disorders to help you with this goal.

2. Have distraction strategies in place when the urge to munch or binge arises

Think about the urge as a wave that you want to ride out. An urge is an impulse, however not an invitation to act upon and give in to the unwanted behaviour. Notice how the intensity of the urge escalates and how it can decrease in intensity with time.

Distraction strategies can buy you time to ride out the wave successfully. Training your mind to pivot from relying on food for comfort to another activity takes practice and perseverance.

Remember, this is not an all-or-nothing approach. Success may mean not eating at all or having something to eat without feeling uncomfortably full or overly guilty in the aftermath of the episode.

Distractions can include calling a friend, going for a walk, doing some visualization, or breathing exercises, or listening to a podcast. Do literally what appeals personally to you; just be sure to have some choices lined up before the urge hits.

3. Consider brushing your teeth or using a mint flavoured mouthwash to neutralize your palate

Chances are food will not taste as good afterwards, thereby you can dull your otherwise hedonistic food exposures. Chewing gum is another strategy, yet often less effective.

4. Decide on a level of food accessibility that serves you best

As meal and grocery delivery applications have become commonplace in our post-pandemic world, affected clients need to carefully evaluate how such conveniences are serving them. This is important to underscore with the significant impact of marijuana on eating.

The dynamics of being under the influence make it more challenging to stay in charge of eating behaviours. Disabling phone apps for meal delivery and limiting the amount and type of foods kept at home can serve as supportive strategies, particularly for clients demonstrating a fraught relationship with food.

5. Considering having an accountability partner can also be beneficial

A family member or a friend can help the affected person set intentions and provide support going forward. A healthcare professional can also offer tips to monitor behaviour and provide with additional guidance to assist with progress.

For the support to be impactful, loved ones and clinicians need to ensure that they offer support that is non-judgmental and non-coercive.

6. Consider seeking help for your mental health struggles

Both eating disorders and substance use tend to co-occur with mental health challenges, including depression and anxiety disorders.

As much as manipulating one’s food intake or relying on marijuana to escape the realities of daily living can offer momentary relief, for most people psychotherapy offers superior solutions. As the stigma of mental health issues decreases, more people turn to therapy. Self-blame is a maladaptive coping strategy, whereas acceptance of one’s vulnerabilities and seeking help is an act our courage and strength that clients often forget to acknowledge. 

7. Look for ways to avoid self-isolating

As more people live alone today than ever before and as more employers are offering remote work arrangements, the reality of feeling isolated affects a large segment of the population. Taking intentional steps to nurture and deepen relationships can safeguard clients when hoping to overcome disordered eating behaviours and substance use. 

8. Body image struggles commonly overlap with marijuana use and eating struggles

Improving body image takes extensive work, yet some tips can be shared here.

a) Shift your focus from appearances to the functionality of your body. In other words, appreciate all your body can do.

b) Keep a top-ten list of things you like about yourself.

c) Avoid the impulse to compare your appearances. When you compare, you despair.

d) Become a critical viewer of social media.

e) Consider surrounding yourself with people who have achieved body acceptance, parted ways with dieting mentality and treat they body with respect and dignity.

f) Lastly, wear clothes that are comfortable and that make you feel at peace with your body. 

9. Be gentle with yourself in the event you have slipped

It is overwhelming enough to feel that you have overeaten or binged, and it is understandable to feel physically and emotionally drained.

Exposing yourself to self-criticism and downward spiralling emotions such as guilt and shame is unfair. Showing yourself the same amount of kindness and self-compassion that you would routinely and unquestionably demonstrate towards your loved ones under similar circumstances will be of essence in finding your way out of this vicious cycle.

Remember, you are more than your eating challenges and that you deserve grace!

 

Conclusion

In summary, the impact of marijuana on eating patterns is evident. Appetite and feeding behaviours are carefully orchestrated by the brain, peripheral organs and multiple pathways that connect them. The endogenous or our internal endocannabinoid system has a vital role in alerting us to rewarding experiences, such as those derived from food characteristics and the process of eating.

What about marijuana and disordered eating and eating disorders? Evidence suggests that in clients with eating disorders, the internal endocannabinoid system becomes impaired. The assumption of relying on exogenous cannabis to stimulate the system in hopes of supporting clients with eating disorders is a relatively new and evolving field of research. 

Furthermore, one needs to keep in mind that eating disorders often co-occur with co-morbid conditions like anxiety, depression, obsessive-compulsive and substance-use disorders. More research is needed to elucidate the mechanism of action when assisting clients with eating challenges who rely on marijuana, since this substance impacts feeding behaviours and mood concurrently.

 

Should you require personalized nutritional care with dietitian Kinga Balogh, or another practitioner, book a free consultation or contact us for an appointment.

 

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Kinga Balogh is a registered dietitian specializing in disordered eating. She is a weight-neutral HAES™ dietitian and health and nutrition coach, combining dietetics and coaching strategies to enable clients achieve fulfilling lives. She also works with clients to help them make peace with food and their bodies. In addition, she works towards achieving self-liberation from unrealistic body ideals and develop body acceptance. Kinga has appeared in a number of publications including The Toronto Star, Bored Panda, Canadian Living and more.

Watch: Dietitian Kinga Balogh discusses her nutritional counselling approach.

 

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JM Nutrition is a nutritional counselling service by registered dietitians and nutritionists in Canada. Main area of service: dietitians in Ontario, main office: Toronto. Nearby: Mississauga, Vaughan, Markham, Scarborough.