Having lived in Holland for many years, I am always amazed at the number of morbidly obese people I see when visiting family in the USA. I do not mean just overweight, I mean extremely heavy. So large in fact, that you can understand many have, or will have, health problems from bad knees, to diabetes, to heart attacks, to cancer, and more. There are also many middle-aged people walking around with potbellies, high blood sugar, hypertension, and other cardiovascular issues, known as Metabolic Syndrome. What is going on? What can these people do about this? Are you part of this group? What can you do?

Well, guess what: regularly having “the munchies” seems to help people lose weight and get healthier. Huh? This sounds like a paradox: eat more and lose weight. Well, yes and no.
A recent literature review article by Thomas Clark, et al., Theoretical Explanation for Reduced Body Mass Index and Obesity Rates in Users, published in the journal Cannabis and Cannabinoid Research tries to explain what may be going on.
According to the authors, scientific research shows that diets with increased ratios of omega-6 to omega-3 fatty acids contribute to obesity rates by increasing levels of the endocannabinoid signals AEA (anandamide) and 2-AG (2-arachidonoylglycerol),
overstimulating CB1 receptors and leading to increased caloric intake, reduced metabolic rates, and weight gain. And where do you find diets where the omega-6/omega-3 ratio is high? Welcome to the good ol’ USA! Supersize me, McDonald’s, KFC, Taco Bell, and all the wonderful processed foods we can buy at our local supermarket. Easy and yummy!
This dietary dysregulation of the Endocannabinoid (eCB) system appears to be a primary cause of the problem by elevating CB1 receptor activity which directly causes excess intake, storage, and conservation of energy leading to disruption of body mass and fat tissue homeostasis. Add to this the high glycemic load in the modern Western diet and you not only get fat, but also risk bad blood lipids, insulin resistance, inflammation in liver and kidneys, and increased cardiovascular problems.
Now it seems that cannabis (THC in particular) downregulates CB1 receptors which leads to reduced sensitivity to AEA and 2-AG. This downregulation continues 3-4 weeks after cessation of cannabis use. This means acute exposure leads to “the munchies,” increasing appetite and energy consumption along with hypothermia as metabolic rates decline. However, this rapid downregulation leads to long-term effects that easily offset the short-term increase in energy stores. In other words, moderate cannabis use (weekly or biweekly) along with dietary changes (relatively more omega-3) can lead to weight loss and reduced BMI.
So if you are concerned about being overweight and dying young as a result, you could consider improving your diet and becoming a cannabis aficionado.
As the old saying goes, “Eat, drink, vape, and be merry.”
Dr. B.