Obesity has become a significant public health challenge, characterized by an excessive accumulation of fat that can be harmful. The prevalence of obesity has tripled since 1975, with updated data from the World Health Organization (WHO) revealing a rapid increase in obesity rates across all age groups. This condition is not only an inflammatory disease but also a trigger for other comorbidities, highlighting the need for specific treatments beyond the standard lifestyle changes involving diet and exercise. As such, researchers are exploring new therapeutic alternatives, including herbal medicines like Cannabis sativa, for potential use in obesity management.
Both cannabis use and obesity have been on the rise, prompting investigations into their relationship with eating behaviors, physical activity, and weight. While it's often assumed that cannabis use leads to weight gain due to increased appetite (commonly known as "the munchies"), research findings have been conflicting. This article aims to summarize the current understanding of the connection between cannabis and weight loss, considering various factors and research perspectives.
Cannabis Overview
Cannabis products are derived from plants like Cannabis sativa, Cannabis indica, and Cannabis ruderalis. The two primary compounds are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is mainly responsible for psychoactive effects, including euphoria, increased appetite, cognitive impairment, and acute intoxication. CBD, on the other hand, is non-psychoactive and known for its therapeutic effects, such as reduced pain and inflammation.
THC activates endocannabinoid receptors CB1, leading to increased appetite and heightened sensitivity to palatable foods. CB2 activation results in an anti-inflammatory response. CBD acts as a CB1 antagonist, inhibiting hedonic effects and potentially reducing appetite, particularly in individuals with higher body mass index (BMI).
The ratio of THC to CBD in cannabis products varies, which influences the mixed research findings regarding cannabis, eating behaviors, and weight. The subjective experience of cannabis also depends on the route of administration, such as inhalation (smoking or vaping) or ingestion (edibles, drinks, pills, etc.). Inhaled THC tends to lead to a rapid onset but shorter duration of increased appetite, while ingested THC results in delayed and stronger increases in appetite that may last for hours.
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Other factors influencing the impact of cannabis on appetite and weight include frequency and duration of use. Long-term, frequent cannabis users may develop a tolerance to the appetite-stimulating effects of THC due to the downregulation and desensitization of CB1 receptors.
Cannabis and Eating Behaviors
THC use is commonly associated with increased appetite, overconsumption, and heightened appreciation of food, known as "the munchies." Studies on the role of cannabis in appetite and eating behaviors have been limited, with much of the research based on animal models.
A study by Roberts and colleagues found that cannabis use was associated with enhancing both motivational factors (increased hunger, salience of food, perceived capacity for food) and hedonic factors (enhanced smell, taste, and appreciation of food) influencing eating behaviors. However, there was no correlation between BMI and scores on a questionnaire measuring these factors.
Another study by Weltens and colleagues provided evidence for the role of THC in "the munchies." They found that THC was associated with increased "liking" and "wanting" high-calorie foods, and oral THC increased milkshake consumption. This suggests that orosensory stimulation is an important factor in increasing food intake among those who have been administered THC.
Consistent with these findings, another study found correlations between cannabis use and various dietary patterns. Participants who more frequently used edible cannabis reported more frequent consumption of higher-fat food and greater calorie intake. Cannabis users also had higher intakes of salty snacks and fast food compared to non-users, although this difference was small. Despite these differences in eating behaviors, BMI was not significantly different between users and non-users, potentially due to both groups being physically active.
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Cannabis and Eating Disorders
Multiple studies have examined cannabis use among individuals with eating disorders (EDs), particularly binge eating disorder (BED). BED is characterized by episodes of consuming unusually large amounts of food in a short period with a feeling of loss of control (LOC) over food intake.
One study found that cannabis use frequency did not predict eating disorder symptoms in adults with at least weekly binge eating. However, problematic cannabis use (i.e., negative consequences) was associated with eating pathology via LOC eating.
Another study of college students found that those who screened positive for an ED reported significantly greater frequency of cannabis use and greater CUD symptom severity compared to those who did not screen positive for EDs. There was also a high overlap between EDs and CUD in men.
A systematic review and meta-analysis found that CUD was one of the most common co-morbid diagnoses in individuals meeting criteria for an ED. Those with binging and purging behaviors were more likely to evidence substance use disorders, including CUD, potentially due to greater difficulty with emotion regulation and impulse control.
Cannabis and Physical Activity
Another factor to consider when examining the role of cannabis in weight is its potential influence on physical activity. Anecdotal reports suggest that cannabis may decrease motivation for physical activity, particularly when strains with a more calming effect are used.
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A systematic review found that cannabis use was negatively associated with physical activity and positively associated with sedentary behavior among adolescents. A population-based study of adults found that current and past cannabis users had a lower prevalence of self-reported moderate or vigorous physical activity compared to non-users. Additionally, as frequency of cannabis use increased, time spent engaging in physical activity decreased. However, another smaller study found no difference in exercise behavior between cannabis users and non-users.
Another 2024 study found that young to midlife adults were neither more sedentary nor more intensely active after consuming cannabis. Another study, published in 2023, linked marijuana use to an enhanced “runner’s high” and lower pain during exercise. Participants experienced “less negative affect, greater feelings of positive affect, tranquility, enjoyment, and dissociation, and more runner’s high symptoms during their cannabis (vs.
Given these conflicting findings, additional research is needed to understand the role of cannabis use in physical activity.
Cannabis and Weight
Research suggests a link between cannabis use and a lower body weight, but the exact connection isn’t clear.Building upon older cross-sectional research which found a lower prevalence of obesity in cannabis users compared to non-users, Alshaarawy and Anthony conducted a large prospective study dawn from the National Epidemiologic Survey on Alcohol and Related Conditions. In this study, there were two waves of data collection three years apart. At both timepoints, cannabis use and BMI were collected. Cannabis use was categorized as: 1) lifetime never use, 2) discontinuation/quitting (used at the first time point but not in the 12 months preceding the second timepoint), 3) initiation (no use at the first time point, but did use in the 12 months preceding the second timepoint), and 4) persistent use (used at both timepoints). Consistent with previous epidemiological stud…
Despite the research suggesting a relationship between cannabis use, eating behaviors, eating disorders, and physical activity, recent studies have not supported the notion that cannabis use is associated with weight gain and obesity. Several studies have found a lower prevalence of obesity in cannabis users compared to non-users.
One large prospective study found that cannabis users had significantly lower BMIs and obesity rates but an increased calorie intake. This suggests that there may be other factors at play that contribute to the relationship between cannabis use and weight.
Potential Mechanisms Behind the Cannabis-Weight Connection
Experts have a few theories on why cannabis use is linked to reduced BMI and lower chance of obesity.
- Increased Mobility: Cannabis may relieve symptoms of pain and stiffness, allowing people with mobility issues to be more active.
- Reduced Alcohol Consumption: Younger people who use cannabis may consume less alcohol, reducing their calorie intake from alcoholic drinks.
- Stress Reduction: Cannabis can ease anxiety and help calm people when they’re feeling stressed, which might replace stress eating for some.
- Improved Sleep: Cannabis may improve insomnia and help reduce stress and pain, two factors that contribute to poor sleep and potential weight gain.
- Boosted Metabolism: Cannabis may interact with cannabinoid receptor 1, which plays a role in metabolism and food intake. High amounts of cannabis appear to increase metabolism and reduce energy storage, resulting in a lower BMI.
- The Endocannabinoid System (ECS): The primary function of the ECS is to maintain bodily homeostasis-biological harmony in response to environmental changes.
- Omega Fatty Acids: Maintaining proper endocannabinoid system tone for optimal metabolic functioning requires a nice balance of omega-6 (linoleum acid, LA) and omega-3 (α-linolenic acid, ALA) fatty acids. To keep our body burning and storing calories the way it should, we need a good omega-6/omega-3 ratio.
Specific Cannabis Compounds and Weight Loss
- THCV (Δ9-tetrahydrocannabivarin): THCV primarily works by antagonizing the CB1 receptor; this compound can, therefore, have anorectic effects, inhibiting appetite, controlling food, and consequently decreasing body weight. However, at high dosages, THCV can demonstrate CB1 agonism and partial CB2 agonism. THCV is known to act as a CB1 antagonist and a CB2 partial agonist. As an antagonist, THCV blocks the action of cannabinoids at the CB1 receptor, especially in the central nervous system. This action is crucial because CB1 receptors are widely implicated in appetite regulation and feeding behavior. Moreover, in lower doses, THCV appears to act as a CB1 antagonist, but in higher doses, it may start to activate CB1 receptors, albeit less intensely than THC. Research suggests that THCV may also influence metabolism. By interacting with the ECS, particularly through the CB2 receptors, THCV might help in regulating blood sugar levels and reducing insulin resistance.
- CBD (cannabidiol): CBD, in contrast, acts as a weak antagonist (inhibits the effects) of CB1 and CB2 receptors, and an important inverse agonist (decreases the effect, but does not inhibit) of CB2 receptors. CBD also showed an affinity for peroxisome proliferation-activated receptors (PPARs), which are a family of transcription factors inducible by ligands belonging to the nuclear hormone receptor superfamily. CBD enhances expression of a core set of brown fat-specific marker genes (Ucp1, Cited1, Tmem26, Prdm16, Cidea, Tbx1, Fgf21, and Pgc-1a). The anti-inflammatory effect of CBD is also mediated by the adenosine A 2A (A 2A) receptor, whose activation attenuates the immune system, causing a decrease in antigen presentation, immune cell trafficking, immune cell propagation, proinflammatory cytokine production, and cytotoxicity. In addition to CB receptors, it has been suggested that CBD is also associated with other pharmacological substrates. CBD appears to activate the transcriptional activity of PPARγ, which plays an essential role in controlling adipocyte formation, insulin sensitivity, and activation of the inflammatory response. Thus, CBD activates PPARγ receptors causing less expression of proinflammatory genes.
- CBG (cannabigerol): CBG “has been shown to reduce appetite and induce weight loss by blocking CB1 receptors” and “to increase the activity of brown adipose tissue (BAT), which is responsible for burning calories and generating heat.
- Oral Strips Containing THCV and CBD: A study analyzed outcomes among 44 people who were administered either oral strips containing a mixture of the two cannabinoids or a placebo. “Use of the THCV/CBD strip was associated with statistically significant weight loss, decreases in abdominal girth, systolic blood pressure, and total and LDL cholesterol,” says the report, authored by Dr. Participants-31 of whom were female and 13 of whom were male, with a combined average age of about 52 years-were given either a placebo or one of two different mucoadhesive oral strips. A lower-dose version contained 8 milligrams of THCV and 10 mg CBD, while a higher-dose version had 16 mg THCV and 20 mg CBD. Of 24 people who received the lower-potency oral strips, 16 (66.7 percent) demonstrated weight loss over the course of the 90-day period-on average losing 2.6 kilograms (5.7 pounds).
The "Marijuana Paradox for Obesity"
Small, short-term studies have shown that marijuana is associated with an initial increase in weight, but long-term studies indicate weight loss with chronic use.
One explanation for this paradox is that THC may correct an imbalance in our endocannabinoid system caused by the standard American diet, resulting in weight loss. While consuming marijuana may cause a short-term increase in appetite, it may influence our body to switch gears and start burning and storing calories more efficiently.
Risks and Considerations
While there’s some evidence that smoking weed may affect weight, a lot more research is needed. Plus, smoking still does more harm than good, even if it’s just cannabis. Cannabis smoke contains many of the same irritants, toxins, and cancer-causing agents as tobacco smoke, according to the American Lung Association. And because weed-smokers inhale more deeply and hold the smoke in longer, they’re exposed to more tar per breath than cigarette smokers.
Over time, smoking weed damages your lungs and airways, reducing respiratory function and increasing your risk for airway inflammation and chronic bronchitis.
Then there’s the issue of misuse and dependence. Up to 30 percent of users may have some degree of cannabis use disorder, according to a report from 2013. Younger people are especially at risk, particularly people who use cannabis before the age of 18.