Millions of people suffer from an eating disorder, but a new report indicates that the most effective treatment may not be what is most commonly prescribed.
According to a survey published in JAMA Network, cannabis and psychedelics were rated the highest for improving eating disorder symptoms. The study was funded by the Lambert Initiative for Cannabinoid Therapeutics, which is a philanthropically funded research program at the University of Sydney.
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The survey assessed responses from 7,648 participants from 83 different countries, representing all major eating disorders, such as anorexia nervosa, bulimia nervosa, and avoidant/restrictive food intake disorder. Eligibility to be a participant included either being clinically diagnosed with an eating disorder or reporting disordered eating that causes distress.
Overall, the best-rated drug for eating disorder symptoms was cannabis, with 56.1 percent of respondents rating it the highest. Along with cannabis, the survey results also indicated that psychedelics, specifically psilocybin (magic mushrooms) and lysergic acid diethylamide (LSD), were also rated highly for alleviating eating disorder symptoms. Ratings for cannabis and psychedelics were much higher than psychotropics, like lisdexamfetamine or fluoxetine, which are commonly prescribed for eating disorders.
Further findings
Cannabis was rated much higher by those with restrictive eating disorders, like anorexia, in comparison to its rating by those with nonrestrictive eating disorders like bulimia or binge-eating. The authors hypothesize that cannabis may benefit those with restrictive eating disorders by “increasing the hedonic value of food,” according to the report. In contrast, it may be lower-rated by those with bulimia or binge-eating, as the appetite-enhancing effects of cannabis may increase binge-and-purge episodes, exacerbating the disorder.
For bulimia and binge-eating, the highest rated medications were fluoxetine and lisdexamfetamine, respectively, both of which are U.S. Food and Drug Administration-approved and are specifically indicated for those disorders.
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The report also found that 49.3 percent of respondents believed that they had a problem with using at least one substance. Despite the high ratings for cannabis, many daily cannabis users reported problematic use. In contrast to cannabis and psychedelics, the survey found that alcohol, nicotine, and tobacco were rated as the most harmful drugs.
One of the major limitations of this survey was that it relied primarily on self-diagnosis, indicating that the results may be affected by recall bias.
“As such, our results should be interpreted as exploratory rather than definitive,” the study authors wrote.
However, the findings do suggest that future clinical research should be conducted to confirm which avenue is most effective in treating eating disorders.