Anorexia Nervosa

One high-quality RCT showed a weight gain of 1 kg over placebo in 4 weeks, another RCT with a higher THC dose showed no effect.

Systematic review on cannabinoids in anorexia nervosa; k=2 original RCTs identified (after exclusion of duplicates from an initial pool of 1288 studies). One methodologically sound, adequately powered RCT showed weight gain of +1 kg over 4 weeks vs. placebo under dronabinol. The other RCT (Delta9-THC at high dose) found no effect, possibly counteracted by side effects. Level of evidence: low; more research on psychopathological effects required.

Pilot RCT on cannabidiol (CBD) in anorexia nervosa (n=32, CBD n=16 vs. placebo n=16), 21 days of treatment with up-titration to 6,25 mg/kg 2×/day. CBD well tolerated with expected pharmacokinetics and limited, non-serious side effects. Significant group×time interaction for BMI increase in favor of CBD (F=3,039, p<0,05, partial η²=0,252). Large effect sizes (partial η²>0,14) for improvements in body image concerns and loss of control over eating in favor of CBD, but not significant. Study limited by small sample size and short duration.

n=24 adult women with chronic AN (≥5 years disease duration), prospective double-blind cross-over RCT of dronabinol vs. placebo. Total duration of physical activity unchanged, but average intensity +20% (p=0.01) under dronabinol, resulting in +68.2 kcal/day energy expenditure (p=0.01) over placebo. Strong correlation between leptin levels and physical activity in chronically undernourished patients.