The first placebo-controlled trial of cannabidiol in anorexia is promising — if preliminary
STUDY: Sahota N et al, International Journal of Eating Disorders 2026;0:1–12
STUDY TYPE: Randomized, double-blind, placebo-controlled pilot trial
EVIDENCE GRADE: Moderate (6/10)
FUNDING: Center for Medicinal Cannabis Research, University of California, San Diego
Background
We’ve searched for effective medications for anorexia since 1960, and so far nothing has worked (except possibly zinc). This study tested cannabidiol (also known as CBD oil), the safer ingredient in cannabis that is FDA approved as Epidiolex for rare forms of epilepsy. The theory: The endocannabinoid system regulates appetite, energy, and fear-based learning — all of which are disrupted in anorexia.
The Study
Thirty-two women with anorexia or atypical anorexia completed this 21-day trial. Participants were randomized to CBD or placebo, with CBD titrated weekly from 1.25 mg/kg twice daily to a maximum of 6.25 mg/kg twice daily (similar to dose range of 300-600 mg used in anxiety trials). Primary outcomes included safety and tolerability; secondary outcomes included BMI and eating disorder symptoms.
CBD was well tolerated — one participant reported mild abdominal discomfort. Weight (BMI) increased in the CBD group compared to placebo, though barely reaching statistical significane (partial η²=0.252, p=0.046). Effect sizes also favored CBD for body shape concern (Eating Disorders scale (EDE-Q)) and perceived lack of control over eating (Food Craving Questionnaire (FCQ-S)), though these didn’t reach statistical significance. Anxiety (STAI) and depression (BDI) improved in both groups, with no significant between-group difference.
Limitations: Tiny sample (n=32), short duration, and marginal significance.
Practice Implications
- CBD has a theoretical rationale in anorexia, but this trial it too small to encourage clinical use
- CBD can help people get off cannabis, and may reduce anxiety, but is therapeutic doses are expensive – whether in the over-the-counter or prescription form
- Vaping CBD is risky for the lungs, but safer than smoking cannabis, which can worsen anxiety and paranoia
— Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
What’s Your Take? Share in Comments
- Have you seen appetite change on CBD? Have you seen results in anroexia?
