Orthorexia is on the rise and, while it isn’t an ‘official’ eating disorder, it can be a serious threat to a person’s health. In short terms, orthorexia is the obsession with healthy eating, to the point of an individual damaging their wellbeing. For example, compulsively checking nutritional labels and/ or engaging with damaging diets, such as the raw food diet (which has, since its conception, been proven to be extremely low in calories and nutritional value), obsessing over nutrition and health and, in general, spending excessive portions of the day talking about ‘healthy foods’, what they will eat for their next meal, and feeling nervous or anxious if what is ‘healthy’ isn’t included on the menu. Orthorexia has been shown in close connection with obsessive-compulsive disorder and can accompany the development of anorexia or bulimia.
Some symptoms include (but not limited to): fainting, weight loss, dizziness, quick to fall ill (low immunity), meal-skipping, over or under-sleeping/sleep problems, difficulty concentrating, brittle hair and nails, dental problems, skin discolouration irregular periods, swelling or bloating or sudden appearance of fine hairs on the body.
Despite the three most common eating disorders being more heard of in popular culture, there are actually 5 subsections.
Avoidant/ Restrictive Food Intake Disorder (ARFID)
Those who have BED report that binges are far from fun: they tend to be extremely difficult and distressing, causing discomfort. Since a binge session will accompany sluggishness due to intake of excessive amounts of fat, sugar, carbohydrates and salts, a binge cycle can leave the individual feeling a lot worse than before. Emotionally, a binge cycle will accompany feelings of shame, failure or misery – which makes it similar to the eating disorders above. These are emotions which can lead an individual with BED to suffer feelings of anxiety and depression, or feel that they’ve lost out in some way. Since society has conditioned many of us to believe that BED isn’t a ‘real’ eating disorder because it doesn’t cause visible weight loss, it can be extremely hard for an individual with BED to get the help that they deserve. Since body ideals and fat shaming exists on a much larger basis (both in popular culture and media) and so BED might go undetected.
The diagnostic criteria for those who might have bulimia:
Characterised by bingeing and vomiting meals, bulimia is another common eating disorder. This type of eating disorder primarily circulates around overeating and, subsequently, vomiting up a meal- a person who has bulimia might also have a period of anorexia which follows (so, following an excessively harsh diet, low calorie intake, drastically losing weight). What distinguishes bulimia is the purging cycle which occurs after eating a meal. However, bulimia is built around compensating for meals- which means that taking laxatives or excessively exercising to ‘make up’ for eating is another way that those suffering from bulimia tend to ‘purge’. Bulimia can overlap with symptoms of anorexia- for the most part, though, someone who is bulimic tends to follow the rules of diet, binge, purge and repeat . You can have more than one eating disorder- but experts advise that it is incredibly important to find the ‘primary driving behaviour’ behind your eating disorder. If you display symptoms of anorexia, but spend the majority of time in a binge-purge-repeat cycle, then it is most likely you should be treated for bulimia, with the correct level of treatment accorded to a bulimic patient. This, according to a wealth of research and on the advice of health professionals, will allow for a quicker, more beneficial course of treatment.
Common signs to notice in an individual with BED:
How do we deal with this dilemma? We begin with a very extensive physical and psychological diagnostic assessment for the history of the eating disorder and substances use/abuse. We need to determine whether the patient can participate in our program, and whether they are using edibles, tinctures, or smoking. Are they using Indica or Sativa? Can we wean them off the higher levels of THC with a mix of CBD and a much lower percentage of THC? And finally, what withdrawal effects such as irritability, insomnia and changes in appetite need to be treated while still focusing upon their compromised emotional and medical state due to their eating disorder?
Another challenge is that individuals with anorexia are empowered by resisting the temptation of eating. Therefore, the appetite-stimulating properties of cannabis can’t necessarily overcome the neurobiological issues that are also intimately involved with their eating disorder.
Eating disorders are complex psychopathologies, which present clinical challenges for many reasons. A major one is that eating disorders often co-occur with a Substance Use Disorder (SUD). This includes cannabis abuse, which can begin before, concurrently with, or after the onset of an eating disorder. Given this, EDCare uses an integrative model in treating the SUD, along with other eating disorders symptoms such as anxiety, OCD, and depression.
Eating Disorders and Co-Occurring Addiction
One EDCare patient reported that medical cannabis helped slow down her mind, allowing her to observe her irrational thoughts surrounding food. Food began to taste better making her mealtimes an enjoyable experience.
That being said, medical cannabis might be a helpful tool for some people in conjunction with therapies such as Cognitive Behavioral Therapy (CBT). There are three primary strains of cannabis: sativa, indica, and hybrids.
Addiction of course, is a big concern. In Denver, between 7 and 9% of our eating disorder patients who use cannabis show signs of addiction. With 364 legal dispensaries in Denver and 1,021 in Colorado, we can clearly expect that up 50% of our eating disorder patients are using. Moreover, testing an individual’s level of intoxication has proven to be a challenge due to the length of time THC takes to clear the body.
There are many unanswered questions concerning medical cannabis usage in eating disorders. We have learned to practice “beginner’s mind” with an attitude of openness, curiosity, and lack of preconceptions or judgment when learning the adaptive function of both the eating disorder and the cannabis use.
Cannabidiol (CBD) is the chemical that we find in the cannabis sativa plant. That’s right; cannabis can help you stop binge eating. This chemical isn’t like the famous THC that gets you high and gives you the munchies, though that chemical has plenty of health benefits we can’t rule out. CBD interacts with your endocannabinoid system differently, preventing it from giving you intoxicating effects like THC.
Endocannabinoids don’t go from sending cell to receiving cell like most chemicals in the brain. Instead, they travel from the receiving cell to the sending cell to give information. When your brain needs information passed between neurons, it will send neurotransmitters through the synapse from presynaptic cell to postsynaptic cell. If too much or too little information is being sent over, the endocannabinoids come across with their own transmission telling the presynaptic cell to either pump the breaks or pump up the volume.
Did you know that binge-eating is the most common eating disorder? Though many think of it as something to chastise, it’s a serious condition that affects about 2.8 million Americans. This disorder is even more common than breast cancer and HIV. It is the breeding ground for diabetes, heart disease, bone disease, and mental health disorders. If you are someone who suffers from binge-eating disorder, CBD might be the help you need to get into a healthy lifestyle.
When studying eating disorders on rats, scientists noticed a change in dopamine, acetylcholine, and opioid systems in areas of the brain that are related to the reward system. This evidence suggests that the reward system plays a pivotal role in binge-eating, which is excellent news for those using CBD to help treat their disorder.
Those who suffer from depression are incredibly vulnerable to over activating their reward system because most of them feel so terrible all of the time. This could be drug use, extremely sexual lifestyle, and binge eating.
There are healthy foods that you can try to eat that also give you this dopamine release like protein and raw vegetables, but it can be challenging to fight the cravings when your brain is telling you what it wants. You don’t have to have depression to fall victim to binge eating; you can have a chemical imbalance or a brain injury that can cause you to crave that intense pleasure that the reward system brings. Fighting off a biochemical craving is hard, just ask the people trying to get off of opiates. Many people are turning to CBD because it helps that craving go away so they can retrain themselves to be healthier.
Cannabinoids come from cannabis, and endocannabinoids come from our brains. The names are so similar because the chemicals share many similarities. THC is so close to the endocannabinoid anandamide that it can actually bind to the CB1 cannabinoid receptor which is partly how it gets you high. Endocannabinoids don’t make you feel that extreme euphoria, but they do some other really cool stuff like reduce your sensitivity to pain and calm your immune system down.