Understanding How Cannabis Affects Appetite and Gut Health

The relationship between cannabis use, the endocannabinoid system (ECS), and digestive health is complex, with both potential benefits and important cautions. Ethos Medical Professional, Dr. Margaret Marsh, goes into detail explaining what current science and clinical evidence reveal.

Understanding the Endocannabinoid System (ECS)

The endocannabinoid system (ECS) is a highly complex network found in all animals, from fish to humans. It regulates functions such as memory, digestion, motor function, immune response and inflammation, appetite, pain, blood pressure, bone growth, and the protection of neural (nerve) tissues, among others. The ECS is made up of three main components: receptors (CB1 and CB2), endocannabinoids that interact with these receptors, and enzymes that form or break down these compounds. These receptors are distributed throughout the body, including the brain, digestive tract, reproductive system, spleen, endocrine organs, heart, and circulatory system. Notably, the ECS is tightly linked to gut function and regulates almost all digestive processes.

How does cannabis influence appetite?

One of cannabis’s most well-known potential effects is stimulating appetite, commonly called “the munchies.” The main culprit is tetrahydrocannabinol (THC), which binds to the CB1 receptor in the brain’s hypothalamus, the region that manages appetite. Normally, neurons here signal when you’re full, but THC mimics the body’s appetite-stimulating hormone (ghrelin), tricking the brain into feeling hungry even when you’re not.

The science behind the “munchies”

The binding of THC to the CB1 cannabinoid receptor and its activation causes the “munchies.” CB1 acts differently depending on the body tissue. In the brain’s grey matter, it enhances appetite. In the forebrain, it may enhance the palatability (taste) and pleasure of food. In the stomach and small intestines, it regulates ghrelin—a hormone that speeds up digestion—and the parts of the brain that regulate food intake. These actions together may cause the “munchies”: an increased appetite.

Can cannabis also suppress appetite?

Not all cannabis strains or compounds produce the same effect; an increase in appetite may depend on the cannabinoid profile. Strains with high levels of THC are most likely to stimulate a strong hunger response. However, other cannabinoids may counteract this. For example, some research in obesity suggests that tetrahydrocannabivarin THCV may suppress appetite and reduce THC’s hunger-inducing effects. Cannabidiol (CBD), especially in high levels, has been shown not to stimulate appetite like THC does and may help moderate some effects of THC.

How does cannabis interact with GLP-1 agonists?

GLP-1 agonists (like Ozempic, Wegovy, or Mounjaro) are medications used to suppress appetite and manage weight. If you’re considering using cannabis alongside GLP-1 agonists, caution is warranted; research on their interaction is limited. Potential interactions may include:

• Opposing effects on appetite: GLP-1 agonists are designed to suppress appetite and promote a feeling of fullness. THC is known to stimulate appetite. These opposing effects could diminish the effectiveness of GLP-1 agonists for weight management.
• Reduced GLP-1 blood levels with cannabis use as a potential concern (the significance of which is not fully understood).
• Increased risk of gastrointestinal side effects (nausea, vomiting, diarrhea) when combining both.
• Delayed digestion caused by GLP-1 agonists can further delay the effects of edibles’ psychoactive effects.
• People with Type 2 diabetes taking GLP-1 agonists should be aware that consuming cannabis can affect blood sugar control, and its mind-altering effects could mask symptoms of hypoglycemia or hyperglycemia (low or high blood sugar).

Could long-term cannabis use impact the gut microbiome or digestion?

There is emerging evidence from animal and some human data that suggests that chronic cannabis use can affect the gut microbiota, leading to changes in the abundance of specific bacteria. Some studies suggest that CBD may have a prebiotic or anti-inflammatory effect, promoting a healthier gut at low doses. Other studies suggest that high doses of CBD or chronic use of THC can lead to dysbiosis or imbalance, which may increase gut inflammation. It’s also been shown in animal studies that high-dose CBD can lead to “leaky gut” syndrome, a condition that allows bacteria and toxins to pass from the gut to the bloodstream, which could possibly lead to more serious health problems.

What conditions related to gut health have shown promise in being treated or managed with cannabis?

Clinical research suggests that cannabis and its compounds (THC, CBD, CBG, CBC) show some promise in managing several gut-related conditions, primarily addressing symptoms such as pain, nausea, and inflammation. For example:

• Inflammatory Bowel Disease (IBD): Observational studies and patient reports suggest cannabis can help with pain, cramping, diarrhea, and poor appetite.
• Gastritis: Some animal studies indicate cannabis may help with stomach pain, nausea, and inflammation.
• Crohn’s Disease: Small studies report that some patients experience pain relief, improved appetite, and even remission.

Does cannabis have anti-inflammatory effects in the gut?

Cannabis may have anti-inflammatory effects in the gut due to the endocannabinoid system and the CB1 and CB2 receptors located in the gut, which help regulate digestive processes and immune function. Cannabis compounds such as THC and CBD interact with the CB1 and CB2 receptors to influence gut inflammation. The CB1 receptors located on nerve cells affect gut motility and sensation, while the CB2 receptors suppress the inflammatory response and promote gut health.

Advice for those considering cannabis for gut health

Anyone considering cannabis for gut health should consider a cautious and informed approach, consulting a knowledgeable healthcare professional. While cannabis may help with abdominal pain and nausea, evidence for reducing actual inflammation is mixed. If you’re new to cannabis, start with a low dose and increase slowly. The method of consumption (smoking, edibles, etc.) also affects how your body responds.

Cannabis interacts with the body’s endocannabinoid system in ways that both support and challenge appetite and gut health. While some people find relief from gut-related symptoms, others may experience side effects or complications, especially when combining cannabis and other medications. As research evolves, a cautious, well-informed approach is the best way to explore cannabis for digestive health.