A large study that was presented at SAGES Virtual 2020 Annual Meeting explored patients who underwent bariatric surgery and self-reported as cannabis users. It found that cannabis use had no impact on the efficacy of the bariatric surgery and that patients actually did slightly better in terms of weight loss and metabolic comorbidity remission than those who do not consume cannabis. Additionally, the information from the study suggested that the cannabis consumers who had bariatric surgery would benefit from psychological intervention as a result of cannabis use but what they failed to recognize is that cannabis is not a stand-alone reason for psychological intervention and that it is actually beneficial to psychological treatments of mental conditions associated with obesity.
Bariatric surgery is the collective term for gastric bypass and other weight-loss surgery. These types of surgeries are done when exercise and diet did not work for losing weight as well as when one’s health is in danger as a result of being overweight. All bariatric surgeries are considered to be beneficial with risks and side effects too. Bariatric surgery is done when there are life-threatening risks which include heart disease and stroke, high blood pressure, nonalcoholic fatty liver disease or nonalcoholic steatohepatitis, sleep apnea, and type 2 diabetes.
The study was published was conducted by Nicole Shockcor, Sakib Adnan. Ariel Siegel and Eric Wise and found that cannabis did not have any adverse impact on the outcome of the surgery. John Hammond from the medical department at the University of Michigan told MedPage Today that it “doesn’t mean bariatric surgery patients should start using cannabis”. It should be noted that John Hammond is still a medical student.
Mr. Hammond went on to explain that cannabis consumers are substantially more likely to present with mental disorders and tobacco- and alcohol use when compared to non-users. He also stated that “patients who use marijuana are likely to potentially benefit from psychological intervention and behavioral consult”. However, Mr. Hammond and his acquaintances, who also conducted a study on cannabis use and weight-loss surgery, were careful not to mention any benefits of cannabis for weight loss. Mr. Hammond’s research concluded with the following statement “marijuana use does not appear to negatively impact weight loss or comorbidity remission following bariatric surgery”.
While Shockcor and her team concluded their study by stating that “marijuana use has no impact” on “complications or weight loss following bariatric surgery, and should not be a contraindication to bariatric surgery”. A contraindication is a specific drug, procedure, or surgery which should not be used because it is harmful to a person, which means that cannabis should not be considered as a contraindication in relation to weight loss and bariatric surgery, according to Shockcor and team.
Both studies conducted by Hammond, Shockcor, and their respective teams, came to the same conclusion but one implies that cannabis necessitates psychiatric, or psychological, intervention, while the other deems cannabis use irrelevant to bariatric surgery. The difference is that Mr. Hammond implies that there is a correlation between cannabis use and mental conditions. In light of that, let’s assess the relationship between obesity and mental health as well as how cannabis can help maintain mental health and encourage weight loss.
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Another study that was conducted on the psychosocial burden of obesity by Dr. David Sarwer and Heather Polonsky stated that,
“Numerous studies have demonstrated a positive association between obesity and various mental health issues, including depression, eating disorders, anxiety, and substance abuse”.
Obesity can impact an individual’s quality of life which includes dealing with stigmatized and discriminatory behavior from others. This impacts one’s psychosocial state and motivates the setting of unrealistic weight-loss goals, taking extreme measures for weight-loss while also knocking down the self-esteem and state of happiness. Psychiatric Advisor explains that “the link between obesity and psychiatric problems are unsurprising: poor self-image, physical inactivity, the biological disruptions caused by obesity and the social stigma being related to being overweight all contribute to a predisposition to mental illness”. They also note that depression and low self-esteem are significantly present in obese individuals across the world.
Cannabis can assist with many of the mental health issues associated with obesity by treating the symptoms of- and alleviating- depression, assisting those who suffer from eating disorders, curbing anxiety, assisting with combating substance abuse and addiction as well as promoting weight loss. Psychiatric intervention could be beneficial to bariatric surgery patients who consume cannabis, but it would also appear to be beneficial to bariatric surgery patients who do not consume cannabis. This is due to the fact that the mental health risks are associated with obesity, not cannabis use. The science is still out on the relationship between cannabis and mental health, so making statements as Mr. Hammonds, is just singling out a group of patients. As always, it is important that patients be open and upfront with their physicians so that they may consider it when developing and implementing the treatment plan.
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