Self-Medication & Emerging Therapies: A New Look at Substance Use in Eating Disorders
For decades,the treatment of eating disorders (EDs) has been hampered by limited pharmacological options and often disappointing outcomes. A groundbreaking new study, published recently and funded by the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney, sheds light on a hidden reality: individuals with eating disorders are frequently self-medicating with a range of substances, both prescription and non-prescription, and often perceive these substances as beneficial for managing their symptoms. This research, built on the lived experiences of over 2,500 individuals, is prompting a critical re-evaluation of treatment approaches and paving the way for rigorously controlled clinical trials exploring the therapeutic potential of previously stigmatized substances.
Understanding the Landscape: Who Participated in the Study?
This wasn’t a study conducted on patients, but with them. The research team meticulously gathered data through a thorough survey, ensuring representation across the major ED categories. The participant breakdown was as follows:
Anorexia nervosa: 40%
Bulimia Nervosa: 19%
Binge-Eating Disorder (BED): 11%
Avoidant/Restrictive Food Intake Disorder (ARFID): 9%
Self-Reported ED (causing distress, but undiagnosed): Approximately 33%
Importantly, the study also acknowledged the high rates of co-occurring mental health conditions common in this population, including depression (65%), generalized anxiety disorder (55%), ADHD (33%), and substance dependence (drug: 15%, alcohol: 9%). The majority of respondents (94%) identified as female, and hailed primarily from English-speaking countries: Australia (30%), the UK (21.3%), and the US (18%). This demographic profile reflects the known prevalence of eating disorders, but the global reach of the survey highlights the universality of the challenges faced.
Key Findings: A Complex Relationship with Substances
The study revealed a striking pattern of substance use, with significant differences in perceptions based on the type of eating disorder. Here’s a breakdown of the key findings:
Cannabis: A Potential Aid for Restrictive Disorders: Respondents with anorexia nervosa and ARFID reported high rates of cannabis use and overwhelmingly positive effects, specifically noting an enhanced “rewarding value of food.” This suggests cannabis may address a core issue in these disorders – the difficulty experiencing pleasure from eating.
Stimulants: A Double-Edged Sword: Prescription stimulants like lisdexamfetamine,sometimes prescribed for BED due to their appetite-suppressing effects,were viewed positively by those with BED. Though, individuals with restrictive disorders reported negative experiences.This highlights the importance of tailored treatment approaches.
Psychedelics: Hope for Long-Term Benefit: While used less frequently (typically once or twice a year), psychedelics were associated with “remarkable long-lasting benefits,” aligning with emerging research demonstrating their potential in treating depression and anxiety. This finding is particularly exciting given the often-chronic and treatment-resistant nature of eating disorders.
Customary Medications: Falling Short? Commonly prescribed antidepressants, while acknowledged to help with overall mental health, were generally perceived as ineffective in directly reducing eating disorder symptoms.
Harmful Substances: Alcohol, nicotine, and cocaine were consistently linked to negative outcomes for both ED symptoms and general mental health.
The Urgent Need for Rigorous Research
“These findings highlight an important pattern: with traditional medications often falling short in treating eating disorders directly, while many individuals are self-medicating with substances they perceive as helpful,” explains Ms. Rodan, a key researcher on the project. “This underlines the urgent need to better investigate these substances in rigorously controlled clinical trials.”
Pioneering Clinical Trials: A New Era of Treatment?
The insights from this study are already translating into concrete research initiatives. The Lambert Initiative,in collaboration with the Inside Out Institute at the University of Sydney,is actively preparing for:
A Clinical Trial of Psilocybin for anorexia Nervosa: This trial represents a significant step towards exploring the therapeutic potential of psychedelics in a controlled setting.
A Pilot Study of CBD for Severe Anorexia in Young People: this study will investigate the potential benefits of cannabidiol (CBD), a non-intoxicating component of cannabis, for individuals struggling with severe anorexia.Professor iain McGregor, Senior Author and Academic Director of the Lambert Initiative, emphasizes the significance of this work: ”This research suggests that cannabis and psychedelics hold significant promise for improving quality of life in individuals suffering eating disorders. This is particularly salient since current pharmacological options for these patients are severely limited and current treatment outcomes so disappointing.”
Moving Forward: Giving Voice to Lived Experience
This study is more than just data;