Cannabis Use and Binge Eating in Emerging Adults: High Prevalence and High Burden Across Ten Years of the Healthy Minds Study

Background: Existing evidence on co-occurring binge eating and cannabis use is preliminary, and it is unclear how common the combination is or how much burden it carries. We examined both questions among college students, who are high risk for both behaviors.Method: We pooled ten annual cohorts (2015–16 to 2024–25) of the Healthy Minds Study (577,962 students, 807 campus-year clusters). Eating pathology was measured with the SCOFF loss-of-control item. A subsample of 17,114 students also completed the Eating Disorder Examination Questionnaire (EDE-Q). Estimates were weighted for non-response and clustered by campus.Results: Across cohorts, loss of control over eating was reported by 39.0% of past-30-day cannabis users and 30.7% of non-users (adjusted OR = 1.43, p < .001). Severe SCOFF screening (score of 4 or higher) rose from 3.5% in non-users to 7.1% in near-daily users (adjusted OR per step = 1.22, p < .001). Weekly binge eating (EDE-Q) was more common among users (23.4% vs. 15.3%; adjusted OR = 1.68, p < .001). Overall, 8.3% of all students reported both behaviors. Students reporting both had higher odds of 10 out of 11 correlates. Relative excess risk due to the interaction between cannabis use and loss of control over eating was positive for depression, self-injury, suicidal ideation, and academic harm (odds ratio based; p < .001).Conclusions: Binge eating is common among students who use cannabis and is more severe at higher frequencies of cannabis use. Importantly, co-occurrence carried higher odds of depression, suicidality, self-injury, and academic harm. Thus, these cross-sectional findings underscore the need for dedicated longitudinal research.