Cannabis Mouth Spray Did Not Increase Calorie Intake in Older Adults With Poor Appetite
In a triple-blind crossover trial of 17 older patients with poor appetite, an oromucosal spray containing THC and CBD did not increase caloric intake compared to placebo, though it was generally well tolerated.
Quick Facts
What This Study Found
No statistically significant difference in mean caloric intake was observed between cannabis-based medicine and placebo (10 kcal difference, CI -55 to 75 kcal, favoring CBM). Of 16 possibly-related adverse events, 5 occurred during placebo conditions. All adverse events were mild and transient with no serious related adverse events.
Key Numbers
n=17 patients aged 65+; 8.1 mg THC + 7.5 mg CBD per dose, two doses per trial day; mean difference of 10 kcal (CI -55 to 75); 36 unrelated adverse events; 16 possibly-related adverse events (5 during placebo); all adverse events mild and transient.
How They Did This
Investigator-initiated, single-center, triple-blinded, randomized, placebo-controlled, superiority, crossover trial with 17 patients aged 65+ with poor appetite. Two doses of oromucosal spray (8.1 mg THC + 7.5 mg CBD per dose) or placebo on two separate trial days with two-week washout. Caloric intake measured via controlled feeding study with standardized meals.
Why This Research Matters
Anorexia of aging is a significant problem with limited effective treatments. While cannabis has long been associated with appetite stimulation ("the munchies"), this RCT found no meaningful effect in older adults with poor appetite at the tested dose and formulation.
The Bigger Picture
This negative result is important for clinical practice. Despite widespread belief in cannabis as an appetite stimulant, this trial suggests that a single-day buccal spray at this dose does not meaningfully increase food intake in older adults. However, the very small sample size and single-day dosing protocol leave room for different results with different approaches.
What This Study Doesn't Tell Us
Very small sample (n=17). Single-day dosing may not capture effects of repeated use. Buccal spray delivery may not be optimal for appetite stimulation. Fixed dose may have been too low for some patients. Controlled meal setting may not reflect real-world eating behavior.
Questions This Raises
- ?Would multiple days of dosing produce different results?
- ?Is a higher THC dose needed for appetite effects in older adults?
- ?Would a different delivery method (oral capsule, edible) be more effective?
- ?Do certain subgroups of older adults respond better than others?
Trust & Context
- Key Stat:
- THC/CBD spray produced only a 10 kcal difference from placebo in older adults with poor appetite
- Evidence Grade:
- Preliminary: Well-designed triple-blind crossover RCT, but very small sample (n=17) and single-day dosing protocol substantially limit conclusions.
- Study Age:
- Published in 2025.
- Original Title:
- The appetite stimulating effect and safety of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in older patients with poor appetite: A triple-blinded, randomized, placebo-controlled, cross-over trial.
- Published In:
- Clinical nutrition (Edinburgh, Scotland), 47, 248-257 (2025)
- Authors:
- Nielsen, Rikke Lundsgaard(2), Bornæs, Olivia(2), Christensen, Louise Westberg Strejby(2), Juul-Larsen, Helle Gybel, Storgaard, Ida Klitzing, Kallemose, Thomas, Jørgensen, Lillian Mørch, Jawad, Baker Nawfal, Altintas, Izzet, Lund, Trine Meldgaard, Rasmussen, Henrik Højgaard, Munk, Tina, Andersen, Ove, Houlind, Morten Baltzer, Andersen, Aino Leegaard
- Database ID:
- RTHC-07258
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
Doesn't cannabis increase appetite?
While cannabis is commonly associated with increased appetite, the evidence is more nuanced than popular belief suggests. This trial found no meaningful appetite increase in older adults from a THC/CBD mouth spray, suggesting that dose, formulation, delivery method, and patient population all affect whether appetite stimulation occurs.
Was the cannabis treatment safe for older adults?
In this small trial, the THC/CBD spray was generally well tolerated. All possibly-related adverse events were mild and transient, and no serious related adverse events occurred. However, the small sample size means rare adverse effects may have been missed.
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Cite This Study
https://rethinkthc.com/research/RTHC-07258APA
Nielsen, Rikke Lundsgaard; Bornæs, Olivia; Christensen, Louise Westberg Strejby; Juul-Larsen, Helle Gybel; Storgaard, Ida Klitzing; Kallemose, Thomas; Jørgensen, Lillian Mørch; Jawad, Baker Nawfal; Altintas, Izzet; Lund, Trine Meldgaard; Rasmussen, Henrik Højgaard; Munk, Tina; Andersen, Ove; Houlind, Morten Baltzer; Andersen, Aino Leegaard. (2025). The appetite stimulating effect and safety of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in older patients with poor appetite: A triple-blinded, randomized, placebo-controlled, cross-over trial.. Clinical nutrition (Edinburgh, Scotland), 47, 248-257. https://doi.org/10.1016/j.clnu.2025.02.024
MLA
Nielsen, Rikke Lundsgaard, et al. "The appetite stimulating effect and safety of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in older patients with poor appetite: A triple-blinded, randomized, placebo-controlled, cross-over trial.." Clinical nutrition (Edinburgh, 2025. https://doi.org/10.1016/j.clnu.2025.02.024
RethinkTHC
RethinkTHC Research Database. "The appetite stimulating effect and safety of delta-9-tetrah..." RTHC-07258. Retrieved from https://rethinkthc.com/research/nielsen-2025-the-appetite-stimulating-effect
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.