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Can Cannabis Help Treat Obesity?

by Emily Earlenbaugh, PhD

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How cannabis affects weight

Can cannabis help with weight-loss in obesity? Research on this is complex but suggests that cannabis can help. 

Cannabis impacts weight and appetite primarily because of its interaction with a natural system in the human body known as the endocannabinoid system.

Made up of natural chemicals called endocannabinoids, endocannabinoid receptors that interact with those chemicals, and enzymes which clear the endocannabinoids from our body, this important system is responsible for homeostasis in some of our bodies most crucial functions. For example, it is a vital element in functions such as:

  • Hunger
  • Energy
  • Inflammation
  • Stress response
  • Memory building 
  • Sleep
  • Mood
  • Muscle control
  • Pain 

Normally endocannabinoids are able bind to their endocannabinoid receptors stimulating this system and thus regulating and balancing these key functions. But interestingly, these molecules are very similar to cannabinoids, some of the active chemicals in cannabis. Cannabinoids can also stimulate these receptors to modulate multiple effects. 

When it comes to weight, the endocannabinoid system definitely plays a role. Endocannabinoids are important to the regulation of feeding behavior, energy metabolism, and body weight, so cannabinoids are also likely to affect these. In fact, scientists were inspired to look into the endocannabinoid-obesity connection because they noticed that THC — one of cannabis’ active cannabinoids — has a tendency to produce an increased appetite. This cannabinoid is known for stimulating CB1, an endocannabinoid receptor that is primarily concentrated in the central nervous system. Stimulating CB1 leads to increased food cravings and enjoyment of food, as well as promotion of fat storage. So researchers decided to investigate whether blocking CB1 might reduce appetite for those struggling with weight loss.    

In rodent models, scientists found more evidence for this theory. Blocking CB1 led to reduced feeding behavior, less food intake and less weight gain. 

This might have to do with how endocannabinoid receptor activity affects fat cells. Fat cells come in three basic types: White fat cells are involved in storing fat and secreting hormones, brown fat cells work to expend calories and produce heat, and beige fat cells are transitional, turning from white to brown in response to various stimuli. These beige fat cells can protect against obesity by enhancing energy expenditure, so some researchers believe that a medical intervention that converts white fat cells to beige could be a helpful way to treat obesity. Interestingly, cannabinoid receptors regulate this function — transforming white fat cells into beige ones. 

Given this information, there are two basic routes that scientists believe can help with weight loss. The first is blocking CB1 activation to reduce feeding behavior and cause less weight gain. In some rodent-based experiments, blocking CB1 also led to an improved metabolic profile and other markers of improved weight-related health. These changes occurred before the actual weight loss, which suggests a causal relationship between blocking CB1 and achieving weight loss. 

In other animal models, scientists have also observed a long lasting overstimulation of the endocannabinoid system in genetically induced obesity. This seems to result in permanent over-activation of CB1, adding more reason to believe that blocking CB1 could help with weight loss. Still, weight loss in human studies doesn’t seem to cause a change in endocannabinoid system activation — suggesting that there is some underlying factor yet to be discovered. 

CB1 modulation is also a tricky route to take because CB1 is located primarily in the central nervous system and thus comes with an array of psychoactive effects. In clinical trials, a weight-loss drug called Rimonabant was successful at achieving weight loss by blocking CB1, but was pulled from the market due to severe psychological side effects. Those taking the drug reported anxiety and depression — sometimes to the point of suicidal ideation. This could be a factor that limits our ability to use CB1 activation for weight loss. More research is ongoing.

The other potential route is stimulating CB2. Research suggests that blocking CB2 inhibits weight loss. On the other hand, stimulating it reduces appetite and can indeed lead to weight loss. It’s hypothesized this may also increase fat cell transformation from white to beige. Again, beige fat cells fight obesity by increasing energy expenditure.  Since CB2 is not primarily located in the central nervous system (like CB1), stimulating this receptor doesn’t lead to psychoactive effects.

Medical studies on obesity and cannabis

The endocannabinoid system has a big impact on weight. Based on the research to date, scientists have good reason to believe that blocking CB1 or stimulating CB2 will lead to weight loss. Of course, things get a little bit more complicated when we look at the research on human subjects. 

For a long time, we assumed that cannabis always induces increased appetite and weight gain. And it makes sense. Many have experienced cannabis’ appetite stimulating effects. One minute you’re smoking or vaping, then suddenly you have an insatiable craving for snacks. This is known colloquially as the “munchies.” More than one cannabis user has regretted their enthusiastic snacking after the fact. 

But does cannabis intake (and the resulting snacking) actually lead to weight gain? The research is somewhat conflicted. 

In patients with low weight, such as HIV or cancer patients, we do see weight gain associated with cannabis use. One study on HIV patients found smoked or oral cannabinoids were effective at increasing food intake. Another found that it led to increased weight gain over the placebo. But other studies found that repeated dosing could result in a tolerance to these effects. 

So contrary to the mythos surrounding the “munchies” effect, there are cases where cannabis increases caloric intake, and cases were it does not. But this evidence still suggests cannabis use could lead to weight gain. Still, things get even more interesting when we look at larger studies on the topic. 

Large longitudinal studies have also been undertaken to look at the connection between cannabis use and obesity. Consistent with the studies above, more extensive cannabis use was associated with increased caloric intake. But mysteriously, it was not associated with increased weight. Multiple longitudinal studies have come back with similar results. While cannabis users report more caloric intake, they have lower levels of obesity

So despite theory and research suggesting that stimulating CB1 with cannabis’ most plentiful chemical, THC, will lead to weight gain — the majority of cannabis users seem to be benefiting from the opposite effect. Cannabis seems to be protecting from obesity — even while encouraging increased snacking behaviour. 

One clue that might help us solve this mystery is a recent study looking at the gut microbiota of obese mice, treated with THC. The study found that chronic THC treatment prevented diet-induced increases in body weight. While the untreated mice gained weight from a high-fat diet — those who were given THC did not. In addition, treatment with THC shifted the gut microbiata of obese mice to look more like the microbiota of healthy mice. Researchers on this study concluded that changes in the gut might actually be contributing to the THC-induced protection from obesity. 

Other researchers suggest there may be differences in short term and chronic cannabis use for obesity. Short-term use may cause weight gain, while chronic use protects from it. Researchers also consider the possibility that cannabis has a regulating effect on weight — increasing it only for those who are underweight. Others suggest it may even lead to weight loss for those who are overweight

There are some limitations to these studies that could be causing conflicting results. For one thing, study design and bias can come into play — and in these studies — it’s worth noting that in some cases the research was looking at cannabis as a potential treatment for obesity, while in others they were looking at it as a potential cause. 

Another important factor is the chemical composition of the cannabis being used, which varied amongst the studies, when it was tracked at all. In some studies, THC levels were as low as 1.84% — a very low level when compared to a majority of cannabis products on the market. Other studies looked at cannabis use in general, with no regard for the actual chemical composition of the plants being used. 

While looking specifically at THC and CBD is important, the overall chemical composition of the cannabis plant is incredibly varied, and the effects of any individual compound in the plant can shift, depending on the other chemicals present. This is called the entourage effect. Due to this variability, it’s hard to get clear results from studying cannabis in general — rather than studying specific compound or blends of compounds found within cannabis. So it’s not yet clear whether the protective effect cannabis seems to have on obesity might be due to compounds other than THC and CBD.  

Another factor is the size of the group being studied. In some cases we saw large studies with thousands of participants. But in other cases the groups were so small (less than a dozen), any data found has to be taken with a grain of salt. With small groups like this, individual differences and other factors can cloud the data. 

The one thing everyone can agree on is that more research is needed to fully understand these implications. 

Side effects

If you are considering using cannabis for obesity, keep in mind that cannabis has been shown to cause weight gain in with short-term use, with data showing a higher likelihood of weight gain. Still, statistically, you are more likely to be protected from weight gain than to gain weight from using cannabis in the long term.

Potential side effects of cannabis

Disclaimer

The Cannigma content is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with an experienced medical professional with a background in cannabis before beginning treatment.

About Obesity

Overview

Many people think of obesity as another way of talking about being overweight, but it’s not the same as feeling that your clothes are tight or that you want to lose some weight. Obesity is a serious medical condition that affects every aspect of your health, including your heart, your brain, your breathing, your joints, and your digestive system. 

Generally, doctors use your body mass index, or BMI, to measure whether or not you’re obese. If you have a BMI of 30 or above, you’re usually considered obese. 

Obesity has tripled worldwide since 1975, with over 650 million adults considered obese in 2016. It’s particularly prevalent in high-income countries, like the US and western Europe. In the US, 39.8% of the population was considered obese in 2015-16. Fifteen percent of European adults were considered obese in 2014, although obesity rates vary greatly between countries; in Turkey, the obesity rate was 28%, in contrast to 10% in Italy.  

Although anyone can become obese, obesity is more common among some ethnic and socio-economic groups. In the US, women are more likely than men to become obese, and obesity rates are higher among hispanic and black Americans than among white Americans, while Asians have extremely low obesity rates. 

This is an interesting curve ball for humanity.  For much of history, being poor meant being skinny and malnourished. Today, poor populations with less resources are actually suffering from excess weight, or obesity, which is significantly impacting their health.

Symptoms

The main symptom of obesity is too much body fat. Obesity also has an effect on your general health, so you’ll find that you are often short of breath, experience joint pain, and have difficulty sleeping.

When to see a doctor

If you have any concerns about your health or your weight, you should consult with your doctor. A doctor can take accurate measurements of your weight, assess your health, and give you advice about lifestyle changes, possible therapies, and other treatment to treat obesity.

Diagnosis

The most common way to diagnose obesity is by using the body mass index, or BMI. Your BMI takes your height in centimeters and your weight in kilograms, and calculates kg/m². A BMI over 30 is considered obese. If your BMI is over 40, that’s considered morbidly obese. The BMI score does correlate with more serious disease, meaning the higher it is, the higher your risk for developing chronic and life threatening conditions. 

But your BMI isn’t a good enough test to diagnose obesity. For example, it doesn’t distinguish between weight from fat and weight from muscle or bone. So your doctor will do a few more tests. This can include measurement of the circumference of your waist, because extra fat around your abdomen is a greater health risk than fat stored elsewhere. A waist circumference of over 35” for women, or 40” for men, is considered detrimental to your health.

You can also expect your doctor to check your blood pressure and heart rate, take a full medical history, order blood tests to check for other conditions associated with obesity, and ask you about your overall health. This is to find out how much your weight is impacting your health in general. 

Doctors often use something called the Edmonton Obesity Scale, to see how serious your obesity is. The scale has 5 stages:

  • Stage 0: Your weight isn’t causing any health problems.
  • Stage 1: You have mild weight-related health issues, like borderline high blood pressure and/or occasional joint pain.
  • Stage 2: You have a chronic disease that is directly related to obesity, like type 2 diabetes, sleep apnea, high blood pressure, or osteoarthritis, and you find it a little difficult to carry out your daily activities.
  • Stage 3: You have or have had one or more serious weight-related problems, like a stroke, heart attack, heart failure, or similar condition.
  • Stage 4: Your weight is causing severe, life-threatening chronic health conditions.

Causes

Although the fundamental cause of obesity is consuming more calories than you burn, the causes of obesity are complex. Research has shown that the etiology of obesity is actually multifactorial, meaning it is a combination of genetic and environmental factors. Some of the known causes include:

  • Eating foods that are high in fat and sugar, especially fast foods and processed foods
  • Drinking high-calorie drinks
  • Living a sedentary life in which you don’t move much or get much exercise

There are also risk factors that raise your risk of becoming obese, including:

    • Genetics. Obesity runs in families, so if your relatives are obese, you have a higher chance of developing obesity. 
    • Age. Although anyone can become obese at any age, the older you are, the more likely you are to become obese, because you tend to become less active and lose muscle mass.
    • Stress. Many people gain weight during times of stress. This can be due to stress hormones that increase appetite and lead to other changes, which lead to obesity.  Stress itself can also increase appetite.
    • Hypothyroid – When someone has hypothyroidism, not enough thyroid hormone is produced, leading to a host of symptoms. One of the most common is unexplained weight gain. 
    • Depression and Anxiety. Like stress, depression can also lead to changes in weight.
    • Sleep problems. Not getting enough sleep, or sleeping too much, can affect the production of hormones that control your appetite, leading you to eat too much.
    • Pregnancy. Many women gain extra weight during pregnancy, and find it hard to lose weight after the baby is born. This can contribute to becoming obese.
    • Gut bacteria. The bacteria that live in your gut play a role in helping you to gain or lose weight, although that role still isn’t completely clear.
    • Quitting smoking. It’s very common to quickly gain weight after quitting smoking, and sometimes that weight gain is enough to lead to obesity. 
    • Yo-yo dieting. Losing weight, then gaining it back, then losing it again is called yo-yo dieting. When this happens frequently, it can upset your metabolism and cause it to slow down, making it harder to lose weight and keep it off in the long term. 
    • Medications. Many medications, including birth control for women, can lead to weight changes, often weight gain. 

 

 

Sometimes, people become obese due to specific medical conditions, like Cushing Syndrome or Prader-Willi Syndrome, which make it difficult to limit the amount you eat. Some chronic health issues, like arthritis, can also lead to obesity because they make it more difficult for you to stay active and get the exercise you need.

Complications

While obesity itself is highly treatable, it frequently leads to serious health complications, some of which are life-threatening. Complications of obesity include:

  • Type 2 diabetes, which can in turn lead to kidney failure, blindness, and sometimes require amputation of the limbs
  • Heart disease, high blood pressure, and high cholesterol, which increase the risk of heart attacks and strokes
  • Digestive issues like heartburn, liver disease, and gallbladder disease
  • Osteoarthritis, which causes joint pain and inflammation within the body
  • Gynaecological and sexual problems, including infertility, erectile dysfunction in men, and irregular periods in women
  • Sleep apnea, which is when you repeatedly stop breathing and then start breathing again during sleep
  • Increased risk of developing certain cancers, like cervical cancer, colon cancer, pancreatic cancer, ovarian cancer, and breast cancer

Treatment

The good news is that for most people, obesity is highly treatable. Very often, just losing a few pounds can be enough to make a significant difference to your overall health. The goal is not only to lose weight, but also to maintain a healthy lifestyle that will keep those extra pounds off. 

Here are some of the ways to help treat obesity. 

Dietary changes

The main approach is to change what you eat, so that you eat more lean protein, whole grains, and fresh fruits and vegetables, and avoid processed foods and foods that are high in fat and sugar. Different diet plans and approaches work for different people, so it’s best to consult with your doctor and/or a nutritionist to see what is the best option for you.  

It’s important to aim to lose weight gradually, rather than trying out crash diets that are not sustainable which make you lose weight fast, but then tend to leave you gaining it all back, often plus a little more. 

Simple and universal dietary recommendations include:

  • Eat less. Less is more 
  • More vegetables. 
  • Less saturated fats
  • Try not to eat big meals at night 
  • Try to avoid eating excess carbohydrates
  • Avoid high calorie processed foods and high calorie beverages

Exercise 

Becoming more active is a key element in treating obesity. Recent research has shown that cardiovascular workouts, or aerobic exercise, is better for overall health and reducing weight.  Furthermore, working out in the morning time may even offer added benefits. Nonetheless, any type of exercise is great, safely performed, is great. It’s recommended that adults get 150 minutes of exercise per week. Exercise brings many health benefits alongside treating obesity.

Treating Contributing Conditions

If there is a specific condition that is leading to obesity, treatment can also lead to weight loss and control of obesity. For instance, treating hypothyroidism and Cushing Syndrome will invariably lead to weight loss. This is also the case for mood conditions such as depression and anxiety.  

Medication

If you’re finding it hard to lose weight, your doctor might prescribe a specific medication for weight-loss. It’s not a magic pill and does not replace the need for lifestyle changes! You’re still meant to take the medication while getting more exercise and eating a more healthy diet.  Nonetheless, certain medications have been known to reduce appetite and lead to weight loss.  

Surgical procedures and operations

In extreme cases, your doctor might recommend surgery as a way to help you to lose weight and stop being obese. With the growth of obesity, these interventional procedures have been rising in popularity.  

Endoscopic procedures don’t involve any actual surgery — they are carried out by inserting a flexible tube down your throat and into your stomach. These procedures include:

  • Inserting stitches into your stomach to make it smaller, so that you can eat less food
  • Placing a small balloon that is filled with water into your stomach, leaving less space for food so that you feel full more quickly

Endoscopic procedures are only approved if your BMI is over 30, and diet and exercise haven’t helped you to lose weight.

Bariatric surgery, or weight-loss surgery, involves actual surgery. There are a few different types of bariatric surgery, including gastric bypass surgery, but they all involve making your stomach smaller so that you eat less. This type of surgery is only recommended if you have a BMI of over 40, or your BMI is 35-40, but you also have a serious weight-related disease, like diabetes.

Alternative therapies

Many people find that talk therapy, counseling, or CBT is a vital part of treating obesity. It helps to address the underlying issues that might be leading you to eat too much and/or move too little, which is causing obesity. Changing the way that you react to stress or emotional trauma, for example, can change the way that you relate to food and boost healthy weight loss. 

For some people, complementary therapies like acupuncture and guided meditation can help treat obesity. 

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