Cannabis withdrawal mimicked eating disorders in three adolescents | Research

The takeaway

Three adolescents referred to an eating disorders program for food avoidance and weight loss actually had cannabis withdrawal syndrome, highlighting the importance of screening for cannabis use in teens with gastrointestinal symptoms.

Read this if you are a teenager or parent dealing with unexplained appetite loss or weight loss alongside cannabis use changes.

Three teens misdiagnosed with eating problems actually had cannabis withdrawal

What the researchers found

Three adolescents presented to an eating disorders program with gastrointestinal symptoms, food avoidance, and weight loss. None met criteria for an actual eating disorder. Instead, all three fulfilled DSM-5 criteria for cannabis withdrawal syndrome.

The cases demonstrated that cannabis withdrawal can produce symptoms that closely mimic eating disorders, particularly appetite loss, nausea, and associated weight loss. The authors emphasized that CWS is an important and under-recognized consideration when adolescents present with disordered eating patterns.

Why it matters

Misdiagnosis of cannabis withdrawal as an eating disorder can lead to unnecessary and potentially harmful treatments. As cannabis use among adolescents is common, clinicians evaluating teens with appetite loss and weight loss need to screen for recent changes in cannabis use.

The numbers in context

Three adolescents. All met DSM-5 criteria for cannabis withdrawal syndrome. None met criteria for an eating disorder.

How the study worked

Case series of three adolescents presenting to an eating disorders program. Clinical assessment revealed heavy cannabis use history and symptoms consistent with DSM-5 cannabis withdrawal syndrome rather than eating disorders.

What this study cannot tell us

Three cases from a single program. The overlap between CWS and eating disorder symptoms may not always be this clear-cut. Some patients may have both conditions. The cases highlight a diagnostic consideration rather than establishing prevalence.

How to read the evidence

Case series highlighting an important diagnostic consideration, though limited to three patients at one program.

When this study was published

Published in 2014, shortly after DSM-5 added cannabis withdrawal as a diagnosis.

The bigger picture

Cannabis withdrawal was not included in the DSM until DSM-5 (2013), so clinician awareness remains limited. These cases illustrate how withdrawal symptoms can masquerade as other conditions, particularly in adolescents who may not disclose drug use voluntarily.

Questions still open

How often are adolescents with cannabis withdrawal misdiagnosed with eating disorders? Would routine cannabis screening in eating disorder programs identify additional CWS cases? Do the appetite effects of cannabis withdrawal vary by age or sex?

Common questions

Can cannabis withdrawal cause weight loss?

Yes. These three cases showed that cannabis withdrawal can cause food avoidance, gastrointestinal symptoms, and significant weight loss that mimics eating disorders. Symptoms resolved when the withdrawal was properly recognized and managed.

How is cannabis withdrawal different from an eating disorder?

Cannabis withdrawal can produce similar symptoms (appetite loss, nausea, weight loss) but has a clear temporal relationship to stopping or reducing heavy cannabis use. Proper history-taking about substance use is key to distinguishing the two.

Read the original research

Cannabis withdrawal syndrome: An important diagnostic consideration in adolescents presenting with disordered eating.

The International journal of eating disorders, 47(2), 219-23

View on PubMed ↗Publisher’s paper ↗

Citation

Chesney, Tyler; Matsos, Laura; Couturier, Jennifer; Johnson, Natasha. (2014). Cannabis withdrawal syndrome: An important diagnostic consideration in adolescents presenting with disordered eating.. The International journal of eating disorders, 47(2), 219-23. https://doi.org/10.1002/eat.22229