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Obesity is a medical condition involving excessive body fat that increases the risk of serious health conditions like heart disease and diabetes. Studies have shown marijuana is associated with a lower prevalence of obesity and may stimulate changes in the body’s metabolic process.
Overview of Obesity
Obesity is a disorder caused by having an excessive amount of body fat. One is considered obese when their body mass index (BMI) is 30 or higher. Body mass index is calculated by dividing body weight (in pounds) by height (in inches squared), then multiplying that value by 703.
Obesity is caused by taking in more calories than are burned through daily activities and exercise. Any excess calories consumed are stored as fat. Inactivity and unhealthy eating habits contribute to the creation of a calorie surplus and thus obesity. Genetics also play a role in how efficiently the body converts energy and burns calories. In addition, with age come hormonal changes and typically a less active lifestyle that contributes to obesity.
Obesity significantly increases the risk of heart disease, diabetes and high blood pressure. In addition, being obese increases the risk of developing cancer, arthritis, fatty liver disease and stroke. It can also lead to depression, disability, sexual problems, shame and guilt.
In many cases, obesity can be treated with an increase in physical activity and dietary changes. However, in some cases, medications or weight-loss surgery is required.
Findings: Effects of Cannabis on Obesity
Cannabis is well known as an effective appetite stimulant, so one would assume that its use would contribute to weight gain. However, the opposite effect has been shown true. Cannabis use has found to be associated with a lower BMI, lower body fat percentage, lower fasting insulin and lower insulin resistance (Ngueta, Belanger, Laouan-Sidi & Lucas, 2015). Another study also found that marijuana use was associated with lower levels of fasting insulin and resting insulin, and smaller waist circumferences (Penner, Buettner & Mittleman, 2013). Multiple surveys also found the prevalence of obesity to be lower in cannabis users than in nonusers (Le Strat & Le Foll, 2011). Animal studies found that cannabis protected rats against obesity (Levendal, Schumann, Donath & Frost, 2012). In addition, CBD has shown to significantly reduce food intake (Farrimond, Whalley & Williams, 2012).
Researchers discovering that the prevalence of obesity is paradoxically much lower in cannabis users compared to non-users have subsequently hypothesized that it’s the THC or a combination of THC and CBD that causes weight loss (Le Foll, Trigo, Sharkey & Le Strat, 2013).
The relationship between THC and CBD and the body’s metabolic processes, however, remains unknown. The endocannabinoid system controls metabolic function and it’s THC’s agonist effect on the CB1 receptor of that system that stimulates appetite. Therefore, the fact that THC also provides weight loss effects is unexpected. A hypothesis is that the cannabinoids found in cannabis help to regulate an endocannabinoid system that has become dysregulated. An unbalanced energy intake has been found to cause the endocannabinoid system to become dysregulated and overactive, which in turn likely contributes to fat accumulation and obesity (Di Marzo, 2008). Researchers have suggested that cannabis may have a broad-spectrum regulatory effect; it increases weight in those who are underweight and reduces weight in those who are overweight (Sansone & Sansone, 2014) (Matias & Di Marzo, 2007).
States That Have Approved Medical Marijuana for Obesity
No states have approved medical marijuana specifically for the treatment of obesity. However, in Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment. In addition, a number of other states will consider allowing medical marijuana to be used for the treatment of obesity with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
Recent Studies on Cannabis’ Effect on Obesity
Di Marzo, V. (2008, August). The endocannabinoid system in obesity and type 2 diabetes. Diabetologia, 51(8), 1356-67. Retrieved from http://link.springer.com/article/10.1007%2Fs00125-008-1048-2.
Di Marzo, V., and Matias, I. (2005, May). Endocannabinoid control of food intake and energy balance. Nature Neuroscience, 8(5), 585-589. Retrieved from http://www.nature.com/neuro/journal/v8/n5/full/nn1457.html.
Farrimond, J.A., Whalley, B.J., and Williams, C.M. (2012, September). Cannabinol and cannabidiol exert opposing effects on rat feeding patterns. Psychopharmacology, 223(1), 117-29. Retrieved from http://link.springer.com/article/10.1007%2Fs00213-012-2697-x.
Ignatowska-Jankowska, B., Jankowski, M.M., and Swiergiel, A.H. (2011, February 18). Cannabidiol decreases body weight gain in rats: involvement of CB2 receptors. Neuroscience Letters, 490(1), 82-4. Retrieved from http://www.sciencedirect.com/science/article/pii/S0304394010015776.
Kobyliak, N., Virchenko, O., and Falalyeyeva, T. (2015). Pathophysiological role of host microbiota in the development of obesity. Nutrition Journal, 15, 43. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4841968/.
Kunos, G., Osei-Hyiaman, D., Liu, J., Godlewski, and Batkai, S. (2008). Endocannabinoids and the control of energy homeostasis. The Journal of Biological Chemistry, 283, 33021-33025. Retrieved from http://www.jbc.org/content/283/48/33021.full.
Le Foll, B., Trigo, J.M., Sharkey, K.A., and Le Strat, Y. (2013, May). Cannabis and Δ9-tetrahydrocannabinol (THC) for weight loss? Medical Hypotheses, 80(5), 564-7. Retrieved from http://www.medical-hypotheses.com/article/S0306-9877(13)00042-X/fulltext.
Le Strat, Y., and Le Foll, B. (2011). Obesity and Cannabis Use: Results From 2 Representative National Surveys. American Journal of Epidemiology, doi: 10.1093/aje/kwr200. Retrieved from https://academic.oup.com/aje/article/174/8/929/155851/Obesity-and-Cannabis-Use-Results-From-2.
Levandal, R.A., Schumann, D., Donath, M., and Frost, C.L. (2012, May 15). Cannabis exposure associated with weight reduction and β-cell protection in an obese rat model. Phytomedicine, 19(7), 575-82. Retrieved from http://www.sciencedirect.com/science/article/pii/S0944711312000402.
Matias, I., and Di Marzo, V. (2007, January-February). Endocannabinoids and the control of energy balance. Trends in Endocrinology and Metabolism: TEM, 18(1), 27-37. Retrieved from http://www.cell.com/trends/endocrinology-metabolism/fulltext/S1043-2760(06)00243-8.
Ngueta, G., Belanger, R.E., Laouan-Sidi, E.A., and Lucas, M. (2015, February). Cannabis use in relation to obesity and insulin resistance in the inuit population. Obesity, 23(2), 290-295. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/oby.20973/full.
Obesity. (2015, June 10). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/obesity/basics/definition/con-20014834.
Penner, E.A., Buettner, H., and Mittleman, M.M. (2013, July). The impact of marijuana use on glucose, insulin, and insulin resistance among US adults. The American Journal of Medicine, 126(7), 583-589. Retrieved from http://www.amjmed.com/article/S0002-9343(13)00200-3/fulltext.
Rossi, F., Bellini, G., Luongo, L., Manzo, I., Tolone, S., Tortora, C., Bernardo, M.E., Grandone, A., Conforti, A., Docimo, L., Nobili, B., Perrone, L., Locatelli, F., Maione, S., and Del Giudice, E.M. (2016, September). Cannabinoid receptor 2 as anti-obesity target: inflammation, fat storage and browning modulation. The Journal of Clinical Endocrinology & Metabolism, 101(9), 3469-78. Retrieved from https://academic.oup.com/jcem/article-abstract/101/9/3469/2806822/Cannabinoid-Receptor-2-as-Antiobesity-Target?redirectedFrom=fulltext.
Sansone, R.A., and Sansone, L.A. (2014). Marijuana and Body Weight. Innovations in Clinical Neuroscience, 11(7-8), 50–54. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204468/.
Simopoulos, A.P. (2016). An Increase in the Omega-6/Omega-3 Fatty Acid Ratio Increases the Risk for Obesity. Nutrients, 8(3), 128. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808858/.
Wargent, E.T., Zaibi, M.S., Silvestri, C., Hislop, D.C., Stocker, C.J., Stott, C.G., Guy, G.W., Duncan, M., Di Marzo, V., and Cawthorne, M. A. (2013). The cannabinoid Δ9-tetrahydrocannabivarin (THCV) ameliorates insulin sensitivity in two mouse models of obesity. Nutrition & Diabetes, 3(5), e68–. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671751/.
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