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Obesity and Medical Cannabis Treatment

by Sarah Walker

March 11, 2020 02:13 pm ET Estimated Read Time: 10 Minutes

Medically reviewed by Dr. Abraham Benavides Fact checked by Kymberly Drapcho

Key Takeaways: Medical Cannabis and Obesity

The use of medical cannabis as a potential intervention for obesity has gained attention due to its complex interactions with the endocannabinoid system, which plays a crucial role in regulating appetite, metabolism, and energy balance. Cannabinoids, the active compounds in cannabis, have been found to influence the body’s response to food intake and energy expenditure. Some studies suggest that certain cannabinoids, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), may have an impact on appetite regulation by modulating the release of appetite-stimulating and -suppressing hormones. Additionally, cannabinoids may have anti-inflammatory properties, potentially addressing obesity-related inflammation and metabolic dysfunction.

While preliminary research indicates a potential role for medical cannabis in managing obesity, it is essential to approach this avenue with caution and further investigate its long-term effects and potential risks. The complex nature of obesity involves multifaceted factors such as lifestyle, diet, and genetics, and a comprehensive approach to weight management is crucial. As medical cannabis research progresses, it is important for healthcare professionals to consider individual patient characteristics and closely monitor the potential side effects and interactions with other medications, ensuring a personalized and evidence-based approach to addressing obesity through cannabis therapy.

The Science Behind Medical Cannabis for Obesity

1. Obesity Treatment: Can Cannabinoids Provide Relief?
2. The Role of the Endocannabinoid System in Treating Obesity
3. What Preparations of Cannabis are Best for Obesity?
4. Obesity: Signs, Symptoms, and Types
5. Obesity Causes and Complications
6. Talking to Your Doctor About Obesity Diagnosis and Treatments
7. Complementary Treatments Worth Discussing with Your Doctor

Weight management is essential for maintaining good overall health. Unfortunately, being overweight is very common in the United States, with all 50 U.S. states recording an obesity rate higher than 20% as of 2022 (1). Persons with obesity face a higher risk of developing other health issues, particularly if they battle obesity for a long period of time. 

Obesity is characterized by an increase in the amount and size of fat cells in the body. It is determined by body mass index (BMI), but someone with a high BMI will not necessarily be diagnosed “clinically obese.” An estimated 42% of American adults are obese, whereas approximately 30.7% are overweight. On a countrywide scale, more than two-thirds of U.S. adults are overweight or obese (2). Additionally, 1 in 5 children and adolescents are affected by childhood obesity, leading to a public health crisis.

 Presently, 22 states in the USA have an obesity rate exceeding 35%, with the South having the highest prevalence of obesity at 35.6%. The South is followed by the Midwest (35.8%), the Northeast (30.5%), and the West (29.5%).

According to the Centers for Disease Control and Prevention (CDC), adults aged 40-59 are at the highest risk of developing obesity, with racial factors stratifying risk. As many as 44% of adults in this age group are obese, whereas 39.8% of adults aged 20-39 and 41.5% of adults above 60 are obese (3). 

Obesity Treatment: Can Cannabinoids Provide Relief?

Preliminary evidence exists to support the efficacy and tolerability of cannabis-derived cannabinoids as treatments for obesity. In particular, compounds that antagonize CB1 receptors are recommended, such as THCV and CBD. 

THCV, a natural and nonintoxicating form of THC, is the most promising cannabinoid (4) in the world of weight management. It may regulate blood sugar levels, suppress caloric intake and appetite, promote weight loss, and could be a potential future treatment option for diabetes. 

A 2016 clinical trial (5) of THCV and CBD in 62 type 2 diabetes patients shows THCV potential in lowering blood glucose levels and improving pancreatic β-cell function. CBD had lesser metabolic benefits than THCV.  

In mice, THCV was also able to improve lipid metabolism, which is relevant to fatty liver disease (NAFLD), a significant complication of obesity. However, the same benefit has not been evaluated clinically.

Note that hunger-inducing cannabinoids like tetrahydrocannabinol (THC) should be avoided since this psychoactive compound is renowned for causing consumers to increase food intake or binge eat (also known as “the munchies”). 

In 1992, Dronabinol (a synthetic form of THC) gained FDA approval in 1985 for treating HIV/AIDS-induced anorexia and chemotherapy-induced nausea (6). Marijuana use has been linked to increased appetite, but new research discovered that cannabis users tend to weigh less and face a lower risk of obesity than nonusers (6). 

Published in the International Journal of Epidemiology, the study was conducted by Michigan State University (MSU) researchers. It involved participants (aged 18+) completing computer-assisted personal interviews on the subjects of cannabis consumption, body weight, and height (7). 

Conversely, cannabinoids like cannabidiol (CBD) may stimulate the metabolism. CBD is described as a “potentially promising therapeutic agent for the prevention of obesity” in this study published in the Journal of Molecular and Cellular Biochemistry (8). In mice studies, CBD’s multiple anti-inflammatory and antioxidant effects show promise (9) for improving liver triglycerides, metabolic markers, and responses to cardiovascular stress.

The faster your metabolism, the faster your body is able to burn calories and fat, as well as convert food into essential energy. The emotional and mental signs of obesity may also be treated using cannabinoids that harbor anxiolytic effects, such as cannabigerol (CBG).

The Role of the Endocannabinoid System in Treating Obesity

Weight management and CB1 receptors maintain a strong connection. Cannabinoid receptors are found in the body’s endocannabinoid system (ECS), which is in charge of achieving homeostasis – the steady state of maintaining essential bodily functions, including memory, mood, thinking, hunger, sleep, and libido (10). 

More specifically, chronic overactivation of the ECS (9) is identified in both obesity and type 2 diabetes, which often run together. Historically, synthetic antagonists to CB1, such as rimonabant, are not well-tolerated. Thankfully, THCV is a well-tolerated and natural CB1 antagonist with small, clinically supportive evidence.

What Preparations of Cannabis are Best for Obesity?

When choosing cannabinoids for obesity, THCV and CBD are the best options. The easiest way to take these is through tinctures or oral sprays, which are favorable because they are naturally sugar-free, low-calorie tinctures that are based on healthy oils like olive, coconut, and avocado.

Edibles also offer a non-smokable approach for medical marijuana patients, and the plant’s therapeutic effects can be felt for up to 8 hours. However, most edibles are candies or baked goods that are high in sugar and caffeine and thus should be avoided by patients concerned by obesity or diabetes.

Some other cannabis preparations available for people with obesity include:

• Pills, capsules, and tablets
• Powdered Cannabis 

Obesity: Signs, Symptoms, and Types

Doctors usually diagnose three main types of obesity: Class I, Class II, and Class III (11). Approximately 9% of adults in the United States were diagnosed with class III obesity from 2017 to 2018 (12). Someone who is 100 pounds over the optimum body weight range for their sex and height will be considered “morbidly obese.” 

Body mass index (BMI) is usually used to diagnose people with obesity. For most people, a general overview of body fat can be gleaned using BMI data, but it should be noted that BMI doesn’t offer a direct measure of body fat. The formula is “BMI = kg/m2” where “kg” refers to their weight in kilograms and “m2” is their height recorded in meters squared. 

Let’s take a look at the typical BMI levels for each class of obesity:

• Class I obesity: 30 to 34.9
• Class II obesity: 35 to 39.9
• Class III obesity: Over 40

The signs of obesity are not just visible from a higher or lower BMI or body shape. Certain emotional, mental, and physical health issues can also indicate a weight problem. If you or someone you know is experiencing any of the following symptoms, consult with a healthcare professional for further advice and guidance:

• Chronic pain and physical functioning problems due to excess weight
• Breathing problems caused by excess fat 
• Lack of physical activity
• Feeling depressed unless eating
• Regular binge eating
• Anxiety, clinical depression, and other mental disorders

Obesity Causes and Complications

Obesity is caused by a very complex set of socioeconomic factors, generally correlated with educational attainment, age, and race more than anything else. It is much more complicated than calories in versus calories out. Like any other condition, patients should not be blamed or shamed for their disease.

Environmental factors can have a profound impact on a person’s weight and lifestyle habits as a whole. According to the American Heart Association (AHA), spending time in nature reduces obesity levels (13). There is clearly some level of truth to this claim, considering the fact that Hawaii and Colorado – two destinations with plenty of physical activities to enjoy in the great outdoors – were last on the list of the U.S. states with high obesity rates.

People who are overweight or obese, as opposed to people with a healthy weight, are more likely to develop a long list of health conditions and diseases. According to the CDC (14), obesity may cause side effects including:

• Coronary heart disease
• Gallbladder disease
• High blood pressure (hypertension)
• High LDL cholesterol
• Low HDL cholesterol
• High levels of triglycerides (dyslipidemia)
• Reduced quality of life 
• Stroke
• Sleep apnea 
• Type 2 diabetes
• Osteoarthritis 
• Mortality
• Various types of cancer (15)
• Transdermal Patches 
• Vapes 
• Tinctures

Talking to Your Doctor About Obesity Diagnosis and Treatments

Using Body Mass Index (BMI) is currently the most common way to determine if a person is affected by overweight or obesity. BMI is an estimate of body fat that compares a person’s weight to their height, but this measurement is imperfect. Healthcare providers use BMI, along with information about additional risk factors, to determine a person’s chances of developing weight-related diseases. Usually, the higher a person’s BMI, the higher the risk of disease.

Many doctors also measure a person’s waist circumference to help guide treatment decisions. Weight-related health problems are more common in males with a waist circumference over 40 inches (102 centimeters) and in females with a waist measurement exceeding 35 inches (89 centimeters) (16). 

After an obesity diagnosis, you can begin discussing lifestyle or dietary modifications and the medical uses of cannabis-based treatment options with a doctor. However, it’s important to note that cannabis should never be used as a substitute for other types of doctor-prescribed medications and treatments.

Complementary Treatments Worth Discussing with Your Doctor 

Some alternative therapies can benefit people with obesity by treating the conditions related to the disease, such as sleep disturbances or mood swings. Complementary medicine should be adopted alongside traditional Western medicine that has been prescribed by your doctor.

Examples of complementary medicine that could help tackle the mental problems associated with obesity, such as depression and isolation, include guided imagery, music therapy, and meditation. Doctors may also recommend getting a massage or exercising in nature for improved mood and weight loss.

You might also consider trying CBD oil to ease the symptoms of various forms of anxiety. Currently, there is no proof that cannabis or cannabis oil (CBD oil) can stop, reverse or prevent obesity. However, some studies suggest cannabis use, particularly with THCV, could help to manage symptoms and biomarkers of weight gain.

While the effects of cannabis can provide a host of health benefits, it’s important that you continue using any medication(s) that are prescribed by your doctor. Since certain cannabinoids may have a synergistic effect when consumed with other medicines, it’s vital that you inform your healthcare practitioner before introducing medical cannabis into your treatment of obesity.

Note: The content on this page is for informational purposes only and is not intended to be professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided. Always consult a physician before making any decision on the treatment of a medical condition.