The relationship of cannabis with appetite and metabolism extends far beyond the well-known “munchies.” This article features insights from leading clinicians and researchers, exploring cannabinoids like THC, THCV, and CBD, their impact on hormones and the microbiome.
“Tell me what you eat, and I will tell you what you are.”
— Jean Anthelme Brillat-Savarin
“He hath eaten me out of house and home.”
— William Shakespeare, Henry IV, Part 2, Act II, Scene 1
Could the Cannabis plant hold the key to both healthy weight loss and weight gain? Cannabis has long been associated with appetite stimulation, commonly referred to as “the munchies.” While this phenomenon is widely recognized in popular culture, scientific investigations reveal a far more complex relationship between cannabis, appetite, and metabolism. A pivotal study by Farokhnia et al. (2020) provides valuable insights into cannabis’s acute effects on metabolic hormones. The research has resonated with the public, many cannabis consumers might be wondering, can we smoke our way to a healthier weight?
In this article we will explore concepts related to the munchies, diet weed, weight management, and hormonal regulation. Accompanying us on this exploration are a few guides, sharing their the expertise of Dr. Patricia Frye, Dr. Ruth Fisher, Dr. Ethan Russo, Dr. Codi Peterson and others healthcare professionals shed light on the broader implications, complexities, their observations, and future directions for cannabis in the areas of appetite and metabolism.
Why is appetite stimulation with cannabis important?
“Poor or disordered appetite is a common reason for using cannabis. In our research, 96% of medical cannabis use was tied to disorders of pain, mood, sleep, and appetite,” said Jean Talleyrand, MD, Chief Science Officer, MyTepi, Inc.
Dr. Talleyrand emphasizes that cannabis’s psychological, neuromodulatory, and anti-inflammatory properties make it effective for treating appetite-related conditions, such as anorexia nervosa, chronic pain, and inflammatory bowel disease. However, he stresses that standardized cannabinoid profiling, including THC:CBD ratios, is critical for ensuring effective and safe use. He offers this key point, “Regulated cannabis products should adopt chemotype classifications to standardize cannabis research and product development, addressing both safety and efficacy.”
The Farokhnia Study: Key Findings and Implications
The Farokhnia study is a landmark investigation into cannabis’s acute effects on appetite and metabolic hormones. Conducted as a randomized, double-blind, placebo-controlled trial, the study examined cannabis administration through oral, smoked, and vaporized methods, providing a controlled framework to analyze hormone changes in response to THC exposure.
Key Findings:
- Insulin: Cannabis blunted the expected post-meal insulin spike. Insulin is essential for glucose regulation, and this finding suggests cannabis may influence how the body processes sugar.
- GLP-1: Glucagon-like peptide-1 (GLP-1), a hormone that promotes insulin secretion and regulates appetite, was significantly lower during cannabis sessions compared to placebo.
- Ghrelin: Known as the “hunger hormone,” ghrelin levels were elevated during oral cannabis administration, emphasizing the importance of delivery methods in modulating appetite effects.
Dr. Ethan Russo, a clinical neurologist and the world’s leading cannabis expert, emphasizes the importance of this research:
“The work of Farokhnia now demonstrates significant acute effects of cannabis on appetitive, metabolic hormones, but the gestalt of the issue of cannabis and food intake is far more complicated because short-term changes in hormones related to cannabis usage are frequently quite distinct from those in chronic usage.”
Historical and Cultural Perspectives on Cannabis and Appetite
Dr. Russo shared that the relationship with appetite has been documented for centuries. According to Dr. Russo’s research, the first European account dates back to Garcia da Orta in 1563, who noted that Indian cannabis produced a “craving for food.” This aligns with modern scientific findings on cannabis’s orexigenic (appetite-stimulating) effects, particularly in patients with cancer and HIV/AIDS, where it is used to counteract wasting syndrome.
However, long-term epidemiological studies reveal a surprising paradox: chronic cannabis use is associated with leaner body composition and a healthier gut microbiome aka the skinny hippy theory. This suggests that cannabis’s effects extend beyond appetite stimulation, influencing systemic processes like metabolism and energy regulation.
Cannabinoids and Appetite Regulation
While much of the focus on cannabis and appetite centers around THC, other cannabinoids like THCV and CBD play distinct roles in appetite and metabolic regulation. Dr. Ethan Russo explains:
“Both cannabidiol (CBD) as a negative allosteric modulator, and tetrahydrocannabivarin (THCV) as a neutral antagonist of the CB1 receptor, allay hunger and counteract laboratory derangements in the metabolic syndrome.”
Cannabis for Appetite Stimulation in Medical Contexts
“Cannabis uniquely combines antiemetic (anti-nausea) properties with appetite stimulation, making it invaluable for patients undergoing chemotherapy or dealing with AIDS-related wasting syndrome,” said Rhea Jacobson, DPT, MS.
Jacobson highlights that cannabis enhances the flavor of food while alleviating nausea, helping patients maintain essential nutritional intake. She notes that inhaled cannabis flower is her preferred method for appetite stimulation, citing its rapid onset and effectiveness compared to edibles.
THCV and Appetite Regulation
Dr. Patti Ormiston, CPNP, MS, Graduate Faculty, University of Maryland School of Pharmacy, shared her interest in the unique properties of tetrahydrocannabivarin (THCV).
“THCV, as a CB1 receptor antagonist, holds potential for weight loss. However, it must be approached cautiously given historical challenges with similar drugs like rimonabant, which was linked to increased suicidality.”
Dr. Ormiston underscored the importance of regulated formulations and cannabinoid-specific research. She is quick to highlight that inhalation delivers faster effects, while edibles can maintain satiety with microdosed, time-released formulations.
THCV: The “Diet Weed” Debate
Dr. Codi Peterson, a pediatric pharmacist, provides a balanced perspective on the potential of THCV, often marketed as “diet weed”:
“While we are hopeful THCV could be of value, existing data is quite weak. Dose-dependent effects and the presence of other cannabinoids in products are major factors to consider. Could THC appetite stimulation outweigh the benefits of THCV suppression? Is it better as an isolate or alongside CBD or other cannabinoids? The jury is still out, and most research so far is not terribly compelling…even if the marketers would have you believe it is.”
This highlights the need for rigorous studies to better understand THCV’s potential, particularly in complex formulations containing multiple cannabinoids.
Bioactive Lipids: Beyond Cannabinoids – Get the skinny on important fats
Dr. Peterson also points to emerging research on bioactive lipids within the endocannabinoidome (eCBome), a broader system related to, but distinct from, the traditional endocannabinoid system (ECS):
“There is growing interest in leveraging bioactive lipids within the endocannabinoidome—molecules like oleoylethanolamide (OEA) and palmitoylethanolamide (PEA). These compounds act on pathways distinct from the traditional CB1 and CB2 receptors we think of within the ECS and represent promising avenues for targeting appetite regulation, inflammation, and metabolic health.”
These bioactive lipids may offer alternatives for metabolic regulation without the psychoactive effects of cannabinoids like THC. Their ability to influence inflammation and energy balance opens new possibilities for treating obesity and related conditions.
Dr. Frye: Metabolic Mechanisms and Insights
Dr. Patricia Frye, author of The Medical Marijuana Guide: Cannabis and Your Health, adds critical insights into the Farokhnia study’s findings, particularly on cannabis’s effects on insulin and related hormones. She notes that cannabis may enhance insulin sensitivity, potentially reducing the weight-promoting effects of elevated insulin levels:
“Since insulin is weight-promoting, it makes sense that if they found lower insulin levels, users would not gain weight at the rate of someone with higher levels. Perhaps there is increased insulin sensitivity, such that not as much insulin or GLP-1 is required to maintain homeostatic glucose levels—much like what is seen with berberine, chromium, and apple cider vinegar.”
Dr. Frye also highlights cannabis’s dual effects on hunger hormones:
“Perhaps there is an increased insulin sensitivity such that not as much insulin or GLP-1 is required to maintain homeostatic glucose levels, much like what is seen with berberine, chromium, and apple cider vinegar. And while there was an increase in ghrelin to stimulate appetite ,needed for survival, there was also an increase in leptin which tells you’ve had enough so there is not the overeating associated with hedonic eating and obesity.”
Ghrelin, the hunger hormone, stimulates appetite and is elevated after cannabis use. Leptin, the satiety hormone, counterbalances ghrelin and signals fullness, preventing overeating. This balance may explain why chronic cannabis users, despite experiencing short-term appetite stimulation, tend to maintain leaner body mass.
However, she also notes a critical gap in the Farokhnia study:
“I wish they had included pre- and post-prandial glucose levels. I would have liked to see whether there was a difference in peak glucose elevation after eating the brownie.”
Dr. Fisher: The Challenge of Weight Management
Dr. Ruth Fisher, Co-Founder of CannDynamics, frames the Farokhnia findings within the broader context of weight management. She emphasizes the difficulty of achieving long-term success in this area:
“Weight management is a lifelong struggle, and the only way to successfully manage weight is to adopt healthy eating habits. Yet, one of the most difficult things to accomplish is getting people to change their lifestyles.”
Dr. Fisher contrasts cannabis with pharmacological approaches like GLP-1 agonists, which have gained popularity but come with limitations:
“To my knowledge, we don’t yet know the long-term implications of chronic GLP-1 agonist use, but I would bet they’re going to find some serious problems. And while the costs of obesity are higher, the costs of chronic GLP-1 agonist use are not cheap.”
She sees cannabis, particularly low-THC and THCV formulations, as a promising alternative:
“The beauty of whole-plant cannabis is that if we can figure out how to use it effectively, it offers a viable, relatively safe, relatively cheap, long-term solution to weight management.”
Cannabis and the Gut Microbiome
The relationship between cannabis and the gut microbiome is another area of growing interest. A diverse microbiome supports healthy digestion, immune function, and energy balance. Dr. Russo notes:
“Epidemiology demonstrates that regular exposure to THC-dominant cannabis is associated with the promotion of a more diverse and healthier microbiome in the gut.”
Research could help identify which products, varieties or strains could alter microbial diversity—a critical factor in combating obesity and inflammation. This suggests that cannabis could influence weight management not only through appetite regulation but also by modulating gut health. The gut microbiome plays a central role in energy metabolism and inflammation, making it a critical target for future research.
Future Directions
The intersection of cannabis, appetite, and metabolism is a rapidly evolving field. Several key areas require further investigation:
- Cannabinoid-Specific Effects: Studies on cannabinoids like THCV, CBD, and THCA are essential to understand their unique roles in appetite and metabolic regulation.
- Bioactive Lipids: Molecules within the endocannabinoidome, such as OEA and PEA, hold promise for targeting appetite and inflammation without engaging traditional CB1 and CB2 receptors.
- Long-Term Studies: Chronic cannabis use and its impact on weight, metabolic health, and the microbiome need to be explored in greater detail.
- Formulation Development: Understanding how combinations of cannabinoids and bioactive compounds interact will be critical for creating effective therapies.
Conclusion
The relationship between cannabis and appetite is far more intricate than the cultural trope of “the munchies.” The Farokhnia study provides crucial insights into cannabis’s acute effects on hormones like insulin, GLP-1, and ghrelin. However, as health professionals interviewed for this article highlight, the long-term implications of these findings extend into areas like gut health, chronic metabolism, and weight management.
Emerging research on cannabinoids like THCV and CBD, as well as bioactive lipids within the endocannabinoidome, hold immense potential for addressing obesity and metabolic disorders. As cannabis research expands, it may unlock innovative solutions for appetite regulation and metabolic health—bridging ancient wisdom with cutting-edge science.
Healthcare professionals discuss cannabis and appetite at their monthly Cerium Journal Club.
