Anna Demarco was 21 the first time she smoked weed. She was having an anxiety attack in the car with her friend Patrick, who had a habit of burning while cruising, and he passed her the bowl to try to help calm her down. Anna didn’t know what else to do, so she took a hit.
Anxiety was a regular thing for Anna, who had been anorexic for as long as she could remember. She weighed less than 100 pounds until her junior year of high school; by the time she turned 20, she was fluctuating between 115 pounds and a dangerously-low 85 pounds. The anxiety seemed to feed her eating disorder, and sometimes manifested itself in throttling attacks like the one she felt that day.
In the car with Patrick, she coughed a few times, the unfamiliar smoke curling in her lungs. Then she sat back and realized she felt… calm. Her breathing steadied, and her anxiety began to melt away. She was relaxed. She was free.
She was hungry.
Five minutes later, Anna called her mom and said she was trying to decide where to eat. Her mom started to cry. When Anna and Patrick went to a buffet for lunch, Anna ignored all of her usual rules about eating food—the kind of compulsive, compartmentalizing rules that mark an anorexic—and made it all the way to the end of the buffet, where they kept the soft serve.
For the first time in her entire life, she felt normal. She loaded up her plate with a slice of pie and a scoop of soft serve and sat down to eat.
By the estimates of the National Eating Disorder Association, there are 30 million people in the United States living with an eating disorder. Finding adequate treatment can be difficult, since the illness is both psychological and physical, it often occurs in conjunction with other disorders, and the relapse rate is high (about one-third of anorexic patients remain chronically ill, some of whom eventually die). Treatment often involves some combination of cognitive-
behavioral therapy and medication, but since the source and symptoms of an eating disorder are highly individualized, treatment options are not one-size-fits-all.
Of the 23 states with medical marijuana programs, only five of them include anorexia nervosa on the list of conditions eligible for medical marijuana cards (none of them include bulimia or unspecified eating disorders). Neither the Academy for Eating Disorders, an organization responsible for developing research and best practices for eating disorders, nor the National Eating Disorders Association acknowledge cannabis as a viable treatment option (both also declined to comment on this story).
The American Psychiatric Association offers a 128-page document outlining guidelines for treating patients with eating disorders, which rattles off an extensive list of psychiatric medications that might aid in recovery—benzodiazepines, SSRIs, anti-psychotics, topiramate, lithium. Marijuana is not on the list. Of the medications listed, the guide acknowledges a litany of possible problems: Malnourished patients tend to have worsened side-effects from antidepressants and anti-psychotic medications, both of which are commonly prescribed. Patients taking anti-psychotic medication need to be monitored for akathisia, a type of corollary distress from the meds. Certain antidepressant (like bupropion) come with a black-box warning because in underweight people, there is an increased risk of seizure. Benzodiazepines can become highly addictive. Other medications can cause “insulin resistance, abnormal lipid metabolism, and prolongation of the QTc interval,” which can lead to heart problems.
Dr. Beth Braun, a psychologist in Los Angeles who works specifically with eating disordered patients, says she’s seen greater success with her clients who smoke weed than those who take psychotropic drugs. Dr. Braun doesn’t recommend pot to her patients, since she can’t legally prescribe drugs (she’s a psychologist, not a psychiatrist) but she says if it works for her patients—if they feel better and it helps them start eating—then she supports it.
There’s always a risk that marijuana can negatively affect younger patients, whose brains and bodies are still developing, but Dr. Braun points out that practitioners already “give kids benzodiazepines, Valium, and Xanax.” Those drugs can have lasting effects on kids, too, and the side-effects are way more dangerous than weed.
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By Arielle Pardes
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If you are suffering from an eating disorder, please visit the National Eating Disorder Association.