Tumisu (CC0), Pixabay

Teenage tales of “the munchies” are the most commonplace conversations on the topic of cannabis and weight management. If anything, the consensus s that if cannabis is at all going to be used for weight management, it should be used to gain weight because of the appetite-stimulating effects of THC. But not all cannabinoids were created equally, and alas, we aren’t talking about THC, but its non-psychoactive cousin, CBD.

While THC may be a good candidate for those whose doctors call for gaining weight, there is some interesting scientific evidence to suggest that CBD might be a good candidate for obesity treatment. Until now, there is very little consensus among physicians about how to adequately treat obesity. While some doctors prescribe weight-loss drugs, other doctors believe it can be managed by lifestyle adjustments such as exercise and diet.

This disagreement on how to treat obesity is probably due to the fact that there is barely even a consensus about what causes this condition, which affects approximately 39% of Americans. Many of the things hypothesized to cause obesity are largely out of the public’s control, such as advertising, environmental factors (such as a lack of outdoor leisure locations in a suburb or city), food additives and even genetics. In certain circumstances, obesity is caused by other health conditions or medications being used to treat those health conditions.

In any case, and whatever the cause, there is a call for obesity management in the USA. Obesity has been considered an epidemic, both in the USA and globally. Cannabinoids — especially hemp-derived CBD — pose a potential target for the medical treatment of obesity.

The endocannabinoid system and weight regulation

The endocannabinoid system — the human body’s very own system of endogenous cannabinoids and cannabinoid receptors – is known to regulate many aspects of metabolism, food intake, appetite, and energy expenditure. When CBD enters the human body, it alters the behavior of the body’s cannabinoid receptors, inducing a cascade of events that affect multiple facets of physiology, including how the body metabolizes food. In fact, by some researchers, the endocannabinoid system has been coined the “pivotal orchestrator of  obesity.”

The CB2 receptor is hypothesized to play an essential role in feeding. In particular, CB2 receptor agonists may reduce caloric intake. The literature also suggests that in the absence of CB2 receptors, or in organisms where CB2 expression is lacking, there is a much higher chance of fat tissue development.

The CB1 receptor is also implicated in weight management; in one study, in particular, mice lacking CB1 receptors had less fat and were better protected against obesity compared to wild-type mice. The authors of this study, therefore, hypothesized that CB1 blockade may pose a potential treatment target for obesity.

The science behind CBD therapy for obesity

In the last decade, plenty of scientific attention has been paid to cannabis pharmacology, especially in the treatment of various diseases. While attention has been paid to the application of CBD and THC for many conditions, obesity is, unfortunately, an understudied aspect of cannabis treatment.

In one study published in the journal, Molecular and Cellular Biochemistry, authors explained CBD’s mechanism of action for reducing the likelihood of obesity. While white adipocytes (fat cells) store fat as a source of energy, brown adipocytes play an integral role in energy production and heat distribution. In general, brown adipocytes are considered a healthier kind of fat tissue because they are involved in energy dissipation rather than energy storage.

Therefore, the browning of white adipocytes is a beneficial process for those with obesity. The authors of this study suggest that CBD contributes to the browning of adipocytes, as well as encouraging lipolysis, reducing lipogenesis (creation of fat stores), and improving thermogenesis.

This is the only scientifically proposed mechanism of action by which CBD may be able to treat obesity. Essentially, the mouse research presented earlier suggests that overexpression of CB1 receptors may have a causal relationship with obesity. A treatment which can inactivate these CB1 receptors may be a potential treatment option. CBD is one such treatment, as it is an antagonist to the CB1 receptor, and therefore limits its activity.

CBD vs. pharmaceuticals for the treatment of obesity

As mentioned earlier, the most common treatments for obesity are pharmaceutical medications. These include:

  • Orlistat (Xenical)

  • Lorcaserin (Belviq)

  • Phentermine and topiramate (Qsymia)

  • Bupropion and naltrexone (Contrave)

  • Liraglutide (Saxenda)

These medications are, in many cases, effective at reducing body weight. However, there are often risks associated with weight loss medication. For example, orlistate is an inhibitor of certain pancreatic and gastric enzymes. It has been associated with an increased risk of acute liver injury. Lorcaserin, on the other hand, may cause gastrointestinal upset as well as neuropsychiatric symptoms such as dizziness, fatigue, headache and euphoria.

One of the reasons CBD might be preferred as a treatment method if in fact, it is effective, is that it has virtually no known side effects. High doses may lead to gastrointestinal upset such as sore stomach, but a reduction in dose can immediately mitigate this. There are no known long-term side effects of CBD treatment.

Above all else, management of obesity should be undertaken with a combination of medical treatment and lifestyle alteration. This is especially true for the maintenance of long-term weight loss. Diet and exercise are factors in obesity management and medical treatment should be used as a complementary tool rather than a complete line of treatment.