Eating disorders and cannabis use share genetic risk factors | Research

The takeaway

A massive genome-wide analysis found significant positive genetic correlations between anorexia nervosa and both cannabis initiation and cannabis use disorder, suggesting shared biological pathways.

Genetics researchers, eating disorder specialists, addiction researchers, and anyone interested in shared biological vulnerability across disorders.

Anorexia nervosa genetically correlated with cannabis initiation (rg = 0.23)

What the researchers found

Significant positive genetic correlations emerged between anorexia nervosa and cannabis initiation (rg = 0.23), and between anorexia nervosa with binge eating and cannabis use disorder (rg = 0.27). Conversely, anorexia without binge eating showed negative genetic correlations with smoking phenotypes. The genetic correlation between alcohol use disorder and anorexia was no longer significant after controlling for depression genetics.

Why it matters

The genetic overlap between eating disorders and cannabis use challenges the view that these are entirely separate conditions. Shared biological vulnerability could explain co-occurrence patterns and inform treatment approaches that address both conditions simultaneously.

The numbers in context

Sample sizes ~2,400 to ~537,000; AN-cannabis initiation rg = 0.23; AN with binge eating-CUD rg = 0.27; AN without binge eating showed negative correlations with smoking phenotypes

How the study worked

Linkage disequilibrium score regression calculated genetic correlations between four eating disorder phenotypes and eight substance-use-related phenotypes (including cannabis initiation and cannabis use disorder) using GWAS data from eight studies. Sample sizes ranged from ~2,400 to ~537,000 individuals.

What this study cannot tell us

GWAS correlations identify shared genetic architecture but not specific causal mechanisms. European ancestry-predominant samples limit generalizability. Cannot distinguish direct from indirect genetic effects.

How to read the evidence

Massive GWAS dataset with rigorous statistical methods, though observational genetic correlations cannot establish causation.

When this study was published

Published in 2021.

The bigger picture

The substance-specific pattern of genetic correlations is striking: eating disorders share genetic risk with cannabis and alcohol but show the opposite pattern with smoking. This suggests complex and substance-specific biological relationships rather than a simple shared addiction vulnerability.

Questions still open

What specific biological pathways are shared between eating disorders and cannabis use? Does the shared genetic risk involve reward, appetite, or stress-response systems? Could treatments targeting shared mechanisms help both conditions?

Common questions

Are eating disorders and cannabis use genetically linked?

Yes. This study found significant shared genetic risk between anorexia nervosa and cannabis use. The correlation was stronger when binge eating was present alongside anorexia.

Does this mean the same genes cause both?

Not exactly. Genetic correlations identify shared genetic architecture but do not pinpoint specific genes or prove that the same genetic variants directly cause both conditions.

Read the original research

Shared genetic risk between eating disorder- and substance-use-related phenotypes: Evidence from genome-wide association studies.

Addiction biology, 26(1), e12880

View on PubMed ↗Publisher’s paper ↗

Citation

Munn-Chernoff, Melissa A; Johnson, Emma C; Chou, Yi-Ling; Coleman, Jonathan R I; Thornton, Laura M; Walters, Raymond K; Yilmaz, Zeynep; Baker, Jessica H; Hübel, Christopher; Gordon, Scott; Medland, Sarah E; Watson, Hunna J; Gaspar, Héléna A; Bryois, Julien; Hinney, Anke; Leppä, Virpi M; Mattheisen, Manuel; Ripke, Stephan; Yao, Shuyang; Giusti-Rodríguez, Paola; Hanscombe, Ken B; Adan, Roger A H; Alfredsson, Lars; Ando, Tetsuya; Andreassen, Ole A; Berrettini, Wade H; Boehm, Ilka; Boni, Claudette; Boraska Perica, Vesna; Buehren, Katharina; Burghardt, Roland; Cassina, Matteo; Cichon, Sven; Clementi, Maurizio; Cone, Roger D; Courtet, Philippe; Crow, Scott; Crowley, James J; Danner, Unna N; Davis, Oliver S P; de Zwaan, Martina; Dedoussis, George; Degortes, Daniela; DeSocio, Janiece E; Dick, Danielle M; Dikeos, Dimitris; Dina, Christian; Dmitrzak-Weglarz, Monika; Docampo, Elisa; Duncan, Laramie E; Egberts, Karin; Ehrlich, Stefan; Escaramís, Geòrgia; Esko, Tõnu; Estivill, Xavier; Farmer, Anne; Favaro, Angela; Fernández-Aranda, Fernando; Fichter, Manfred M; Fischer, Krista; Föcker, Manuel; Foretova, Lenka; Forstner, Andreas J; Forzan, Monica; Franklin, Christopher S; Gallinger, Steven; Giegling, Ina; Giuranna, Johanna; Gonidakis, Fragiskos; Gorwood, Philip; Gratacos Mayora, Monica; Guillaume, Sébastien; Guo, Yiran; Hakonarson, Hakon; Hatzikotoulas, Konstantinos; Hauser, Joanna; Hebebrand, Johannes; Helder, Sietske G; Herms, Stefan; Herpertz-Dahlmann, Beate; Herzog, Wolfgang; Huckins, Laura M; Hudson, James I; Imgart, Hartmut; Inoko, Hidetoshi; Janout, Vladimir; Jiménez-Murcia, Susana; Julià, Antonio; Kalsi, Gursharan; Kaminská, Deborah; Karhunen, Leila; Karwautz, Andreas; Kas, Martien J H; Kennedy, James L; Keski-Rahkonen, Anna; Kiezebrink, Kirsty; Kim, Youl-Ri; Klump, Kelly L; Knudsen, Gun Peggy S; La Via, Maria C; Le Hellard, Stephanie; Levitan, Robert D; Li, Dong; Lilenfeld, Lisa; Lin, Bochao Danae; Lissowska, Jolanta; Luykx, Jurjen; Magistretti, Pierre J; Maj, Mario; Mannik, Katrin; 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van Elburg, Annemarie A; van Furth, Eric F; Wagner, Gudrun; Walton, Esther; Widen, Elisabeth; Zeggini, Eleftheria; Zerwas, Stephanie; Zipfel, Stephan; Bergen, Andrew W; Boden, Joseph M; Brandt, Harry; Crawford, Steven; Halmi, Katherine A; Horwood, L John; Johnson, Craig; Kaplan, Allan S; Kaye, Walter H; Mitchell, James; Olsen, Catherine M; Pearson, John F; Pedersen, Nancy L; Strober, Michael; Werge, Thomas; Whiteman, David C; Woodside, D Blake; Grove, Jakob; Henders, Anjali K; Larsen, Janne T; Parker, Richard; Petersen, Liselotte V; Jordan, Jennifer; Kennedy, Martin A; Birgegård, Andreas; Lichtenstein, Paul; Norring, Claes; Landén, Mikael; Mortensen, Preben Bo; Polimanti, Renato; McClintick, Jeanette N; Adkins, Amy E; Aliev, Fazil; Bacanu, Silviu-Alin; Batzler, Anthony; Bertelsen, Sarah; Biernacka, Joanna M; Bigdeli, Tim B; Chen, Li-Shiun; Clarke, Toni-Kim; Degenhardt, Franziska; Docherty, Anna R; Edwards, Alexis C; Foo, Jerome C; Fox, Louis; Frank, Josef; Hack, Laura M; Hartmann, Annette M; Hartz, Sarah M; Heilmann-Heimbach, Stefanie; Hodgkinson, Colin; Hoffmann, Per; Hottenga, Jouke-Jan; Konte, Bettina; Lahti, Jari; Lahti-Pulkkinen, Marius; Lai, Dongbing; Ligthart, Lannie; Loukola, Anu; Maher, Brion S; Mbarek, Hamdi; McIntosh, Andrew M; McQueen, Matthew B; Meyers, Jacquelyn L; Milaneschi, Yuri; Palviainen, Teemu; Peterson, Roseann E; Ryu, Euijung; Saccone, Nancy L; Salvatore, Jessica E; Sanchez-Roige, Sandra; Schwandt, Melanie; Sherva, Richard; Streit, Fabian; Strohmaier, Jana; Thomas, Nathaniel; Wang, Jen-Chyong; Webb, Bradley T; Wedow, Robbee; Wetherill, Leah; Wills, Amanda G; Zhou, Hang; Boardman, Jason D; Chen, Danfeng; Choi, Doo-Sup; Copeland, William E; Culverhouse, Robert C; Dahmen, Norbert; Degenhardt, Louisa; Domingue, Benjamin W; Frye, Mark A; Gäebel, Wolfgang; Hayward, Caroline; Ising, Marcus; Keyes, Margaret; Kiefer, Falk; Koller, Gabriele; Kramer, John; Kuperman, Samuel; Lucae, Susanne; Lynskey, Michael T; Maier, Wolfgang; Mann, Karl; Männistö, Satu; Müller-Myhsok, Bertram; 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(2021). Shared genetic risk between eating disorder- and substance-use-related phenotypes: Evidence from genome-wide association studies.. Addiction biology, 26(1), e12880. https://doi.org/10.1111/adb.12880