Explore published research on appetite, including study methods and limitations.
A 1997 Annals of Internal Medicine review supported pharmaceutical THC for nausea and appetite but concluded evidence did not support reclassifying crude marijuana as prescribable medicine.
Cannabis cachexia affects two-thirds of advanced cancer patients. Whole cannabis may be better tolerated than THC alone because CBD reduces psychoactive effects without blocking appetite stimulation.
Comprehensive review mapping how cannabinoids affect different brain regions: memory in the hippocampus, movement and reward in the basal ganglia, appetite in the hypothalamus, with neuroprotective properties.
Stopping heavy cannabis use was linked to withdrawal that began within 1–3 days, peaked in Days 2–6, and typically resolved by two weeks.
The hypothesis that migraine, fibromyalgia, and IBS share underlying endocannabinoid deficiency. Now supported by CSF studies (reduced anandamide, p < 0.0001), platelet data, neuroimaging, and genetics — but still awaiting definitive clinical trials.
Comprehensive review of 15 years of cannabinoid research catalogs receptor distribution across the body and identifies therapeutic potential for pain, neurological disorders, obesity, and addiction.
Review shows endocannabinoids stimulate appetite by making food more attractive and more pleasurable, acting through CB1 receptors in the nucleus accumbens and hypothalamus.
Review shows endocannabinoids promote obesity through dual mechanisms: stimulating brain appetite circuits and directly promoting fat storage in adipose tissue, with CB1 blockers showing promise for both.
Review confirmed CB1 receptors drive appetite and fat storage. The CB1 blocker rimonabant showed significant weight loss and metabolic improvement in early Phase III obesity trials.
Four large trials of CB1 blocker rimonabant showed significant weight loss, improved lipids and blood sugar, and increased smoking quit rates. Later withdrawn due to psychiatric side effects.
Major endocrinology review describes the endocannabinoid system as a regulator of hormonal axes, stress response, reproduction, and energy balance through both brain and peripheral tissue mechanisms.
Review of nicotine-cannabis interactions found co-use may enhance reinforcing and anxiolytic effects while having opposite effects on appetite and cognition, with adolescent co-use being a major concern.
Review described how the endocannabinoid system drives reward-seeking in both addiction and obesity, making targeted CB1 modulators promising but challenging drug candidates.
Brief review explained how the endocannabinoid system drives both food craving and fat storage, making CB1 receptor blockers potential anti-obesity drugs.
Review found limited evidence that cannabis use may worsen metabolic health in psychosis patients already at elevated cardiovascular risk, though long-term effects remain unclear.
Mice on high-fat diet showed tissue-specific endocannabinoid changes: increased levels in the pancreas (enzyme redistribution) and decreased levels in subcutaneous fat.
Review found CB1 receptor antagonists show metabolic benefits for obesity but psychiatric side effects limit use, proposing "neutral antagonists" as a safer next-generation approach.
Critical review found CB1 antagonists for obesity achieved weight loss no better than existing drugs while carrying serious psychiatric side effects, questioning the approach's clinical value.
A cell culture study found that a cannabis extract containing THC increased glucose uptake, reduced fat cell formation, and restored insulin sensitivity in insulin-resistant cells.
After rimonabant was pulled from the market due to psychiatric side effects, this commentary argued for continuing endocannabinoid research with better safety measures rather than abandoning the therapeutic potential of the system.
A review explored why cannabinoids paradoxically cause vomiting in chronic users despite being established anti-nausea drugs, proposing mechanisms including receptor desensitization, metabolite accumulation, and differential brain vs gut effects.
First documented cases of cannabinoid hyperemesis syndrome (severe cyclic vomiting) in two teenagers with chronic marijuana use.
Eight US patients with cannabinoid hyperemesis averaged 19 years of cannabis use before symptoms, 7 ER visits each, and recovered when they stopped using.
A 21-year-old with 7 years of cannabis use developed cannabinoid hyperemesis that resolved with abstinence but relapsed repeatedly with resumed use.
Review characterized CHS as a three-phase paradoxical vomiting syndrome from chronic cannabis use, with compulsive hot bathing as a hallmark and frequent misdiagnosis.
About half of IBD patients reported lifetime cannabis use, with 33-50% of users specifically using it for symptom relief, especially those with prior surgery and chronic pain.
First reported case of cannabinoid hyperemesis syndrome in pregnancy, highlighting the need to screen for cannabis use in treatment-resistant vomiting.
Four patients with chronic cannabis use developed recurring severe vomiting and compulsive hot bathing, all resolving when they stopped using cannabis.
Chronic cannabis smokers had 50% more visceral belly fat, lower HDL, and fat cell insulin resistance, but normal blood sugar, liver fat, and pancreatic function.
NHANES analysis of 4,657 adults found current marijuana users had 16% lower fasting insulin, 17% lower insulin resistance, and smaller waist circumferences.
A review described cannabinoid hyperemesis syndrome, a condition in long-term cannabis users featuring severe cyclical vomiting and compulsive hot bathing that is often underdiagnosed.
A man with 16 years of severe vomiting and compulsive hot showering from CHS remained completely symptom-free for nine years after quitting marijuana.
Three adolescents referred for eating disorders actually had cannabis withdrawal syndrome, demonstrating how CWS symptoms can mimic disordered eating.
A patient with chronic vomiting previously diagnosed as cyclic vomiting syndrome was found to have cannabinoid hyperemesis syndrome, highlighting the importance of cannabis screening.
A 20-year-old woman with protracted nausea and vomiting from cannabis withdrawal was successfully treated with the synthetic cannabinoid nabilone.
A dual enzyme inhibitor that boosts natural endocannabinoids suppressed anticipatory nausea in rats through CB1 receptor activation, with enhanced effects when combined with anandamide.
Hawaii population survey found women with severe pregnancy nausea were 63% more likely to report marijuana use during pregnancy, though the direction of this relationship is unclear.
First human study of THCV found it increased brain responses to both food reward and aversion, suggesting potential for obesity treatment without the depressive effects of rimonabant.
Survey of 514 CVS patients found 81% used marijuana, reporting symptom improvement. Hot showers were used by 67%, more commonly among marijuana users but not exclusively.
Review of cannabis in cancer care covers established uses (chemotherapy nausea, wasting) and emerging potential for cancer pain (possibly synergistic with opioids) and preclinical antitumor effects.
NADA (an endocannabinoid) inhibited fat cell formation in human stem cells via CB1 receptors, while anandamide promoted it via PPARg, revealing opposing metabolic roles.
Case report and literature review outlining cannabinoid hyperemesis syndrome: severe cyclic vomiting in chronic cannabis users, relieved by hot bathing, resolved by cessation.
Case of a woman with CHS whose chronic vomiting caused dangerous electrolyte imbalances that had to be corrected before she could undergo jaw surgery.
Review showed CB1 receptors produce different effects depending on whether they are on glutamate neurons, GABA neurons, astrocytes, or mitochondria, with implications for targeted therapy.
Chronic THC prevented weight gain and fat accumulation in obese mice and reversed obesity-related gut microbiota changes, without affecting lean mice or causing sedation.
A 17-year-old had 5 ER visits for vomiting and weight loss before CHS was diagnosed, illustrating how underrecognized the condition is in adolescents.
A 13-year-old with cyclic vomiting had a false-positive cannabis urine screen caused by pantoprazole, highlighting a drug interaction that could lead to misdiagnosis of CHS.
A 29-year-old presented with the classic CHS triad of cyclic vomiting, chronic cannabis use, and compulsive bathing, reinforcing the need to consider this diagnosis in chronic users.
Nursing guide to CHS emphasizes that standard antiemetics fail, narcotics may worsen pain, and abstinence from marijuana is the most effective treatment for this underrecognized condition.
New CB1 receptor blocker ENP11 reduced food intake and blocked endocannabinoid-driven overeating in rats without affecting pain or motor function.
THCV, a cannabis-derived CB1 neutral antagonist, altered brain connectivity in ways relevant to obesity without subjective effects, suggesting potential as a safer alternative to rimonabant.
79 RCTs: strong signal for chemo nausea, but pain relief averaged under 0.5 points on a 0-10 scale.
Study of 238 adolescent cannabis users found more lifetime use was linked to higher BMI and greater obesity risk, regardless of decision-making ability.
Review finds cannabis users consistently have equal or lower diabetes and obesity rates despite cannabis activating the same system that controls fat storage and appetite.
Human pancreatic islets exposed to cannabinoid receptor agonists for up to 5 days showed gene expression changes but no impairment of insulin secretion or cell survival.
Serotonin 5-HT1B and 5-HT2C receptors are required for the appetite-suppressing effect of combining leptin with a CB1 blocker, revealing a three-way neuroendocrine interaction in feeding behavior.
Researchers designed CB1 receptor blockers that cannot enter the brain, aiming to treat obesity through the cannabinoid system without causing psychiatric side effects.
Novel peripherally restricted CB1 blocker TXX-522 produced weight loss and improved insulin sensitivity in obese mice without affecting food intake or entering the brain.
A potent CB1 blocker raised liver glucose production through sympathetic nerve activation, warning that strong CB1 inverse agonism in weight-loss drugs could worsen blood sugar control.
Ultra-potent DAGL inhibitors that block endocannabinoid production reduced feeding in fasting mice, but off-target effects of the chemical scaffold complicate interpretation.
A natural brain peptide that modulates CB1 cannabinoid receptors reduced food intake in rats but did not produce weight loss, possibly due to compensatory reduction in energy expenditure.
CB1 blockade in the stomach triggered release of the satiety hormone nesfatin-1 through the mTOR pathway, revealing a peripheral mechanism for cannabinoid-regulated appetite.
Rat study showing CB1 receptor antagonists reversed olanzapine-induced weight gain, metabolic disruption, and liver changes without reducing the antipsychotic's behavioral effectiveness.
Rat study showing CB1 inverse agonists produce impulsivity only when serotonin is disrupted, explaining why rimonabant caused suicidal behavior in a vulnerable subpopulation and suggesting neutral antagonists are safer.
Review of nabilone, a synthetic cannabinoid antiemetic that offers a unique mechanism for treating chemotherapy-induced nausea, particularly the delayed form that other drugs fail to control.
Case report of cannabinoid hyperemesis syndrome, a condition in heavy daily cannabis users featuring cyclical vomiting relieved only by hot showers or stopping cannabis.
Hypothesis paper proposing that CHS results from chronic cannabis disruption of the HPA stress axis and sympathetic nervous system, causing endocannabinoid dysfunction and loss of autonomic balance.
Systematic review of 63 studies (205 patients) found benzodiazepines, haloperidol, and capsaicin most frequently effective for acute CHS, with hot showers universally helpful.
Review revealing that the endocannabinoid system regulates metabolism throughout the body via peripheral CB1 receptors, opening new treatment avenues after rimonabant's psychiatric side effects ended its use.
Systematic review of 183 studies establishing 14 diagnostic features of CHS, confirming cannabis cessation as the only cure and hot bathing relief in 92.3% of cases.
First reported case of exercise-relieved CHS: a patient ran for 15 continuous hours, developing rhabdomyolysis, supporting the theory that blood flow redistribution explains symptom relief.
Review finding the strongest evidence for cannabis in cancer care is for nausea and pain, with emerging evidence for appetite, sleep, and anxiety, plus preclinical anti-cancer effects.
Head-to-head comparison found all classical CB1 blockers reduced weight but caused anxiety, while next-generation alternatives either caused convulsions or had no activity.
Four CHS patients who failed standard ER antiemetics improved significantly with haloperidol, suggesting dopamine-cannabinoid receptor interactions explain the treatment's effectiveness.
Review of dronabinol (synthetic THC) for appetite loss: FDA-approved for HIV/AIDS since 1985, new oral solution since 2016, but no cancer indication despite clinical need.
Mice lacking CB1 cannabinoid receptors showed reduced fat taste preference, with impaired calcium signaling in taste bud cells and lower GLP-1 hormone levels.
Comprehensive review cataloged six approved cannabinoid medications and evidence across pain, epilepsy, cancer, neurodegeneration, PTSD, anxiety, and addiction, spanning the full endocannabinoid system.
First-episode schizophrenia patients who used cannabis gained significantly less weight during 12 months of antipsychotic treatment, with less metabolic deterioration than non-users.
Hair analysis found cannabis hyperemesis patients had similar THC levels as recreational users without symptoms, suggesting the condition is idiosyncratic rather than purely dose-dependent.
Cancer patients in Minnesota's medical cannabis program reported significant improvement across all 8 tracked symptoms, with 27-50% achieving lasting clinically meaningful reductions and only 10.5% reporting side effects.
A survey of nearly 6,000 adults found 2.2% had functional vomiting disorders, with all cannabinoid hyperemesis cases in the US and hot water bathing for symptom relief augmented by cannabis use.
Cyclic vomiting hospitalizations in Colorado rose 46% from 2010-2014 alongside rising cannabis use after legalization, with CVS patients 8-10x more likely to use cannabis than other patients.
A heavy cannabis user developed Wernicke's encephalopathy (brain damage from thiamine deficiency) after severe vomiting from cannabis hyperemesis, a complication usually associated with alcoholism.
Cannabis-related pediatric ER visits are rising, ranging from accidental ingestion (hyperkinesis, coma in young children) to chronic hyperemesis and psychosis in adolescents.
Animal study showing THC and synthetic cannabinoids suppress substance P-induced vomiting through CB1 receptor activation, helping explain why cannabinoids work against nausea resistant to standard treatments.
Literature review describing cannabinoid hyperemesis syndrome, an under-diagnosed condition causing cyclic vomiting in chronic cannabis users, with complete cessation as the only known cure.
Mouse study reveals a peripheral CB1 blocker reduces alcohol drinking by suppressing active ghrelin production in the stomach, working through gut-to-brain vagal nerve signaling without entering the brain.
Review of cyclic vomiting syndrome highlights its overlap with cannabinoid hyperemesis syndrome and connections to migraine and mitochondrial disorders, proposing a multicenter registry for future research.
Case of cannabis hyperemesis in a patient with terminal ALS shows atypical presentation without hot bath behavior, and suggests dose reduction rather than cessation may manage symptoms in palliative care.
Mouse study finds cannabinoids reduce a brain appetite signal (nesfatin-1) through both CB1 and CB2 receptors, with CB2 activation separately linked to increased insulin resistance.
Case series of four CHS patients who failed standard antiemetics but responded to benzodiazepines.
Review finds reasonable evidence for cannabis in cancer-related nausea, appetite loss, and pain, with promising data for neuropathy and sleep issues.
Retrospective study found droperidol halved ER stay duration for CHS patients (6.7 vs. 13.9 hours) and reduced overall antiemetic use.
Nationwide analysis found cannabis-related intractable vomiting hospitalizations increased significantly from 2010-2014, with rising anxiety and high tobacco co-use.
Systematic review of capsaicin for CHS finds positive case reports but no significant benefit in retrospective cohort studies, highlighting low evidence quality.
Novel peripherally restricted CB1 antagonist TM38837 was 10x less fear-promoting than rimonabant in mice while maintaining anti-obesity efficacy in previous studies.
Review of cannabinoids for chemotherapy nausea highlights CBD's non-psychoactive antiemetic potential through serotonin inhibition, alongside THC's established efficacy.
Review maps how CB1 receptor activation drives hepatic insulin resistance and obesity, highlighting peripheral-only CB1 blockade as a promising therapeutic approach.
The first cannabis receptor blocker worked for obesity and quitting smoking but caused depression and suicidal thoughts. Researchers are now developing safer alternatives.
The cannabinoid agonist HU-210 paradoxically reduced sucrose intake in rats by impairing licking motor mechanics via CB1 receptors, while rimonabant reduced intake through what may be reward devaluation.
Review found CB1 receptor remains a promising obesity target despite rimonabant failure, with peripheral-only blockers and neutral antagonists as safer alternatives.
Review describes cannabis hyperemesis syndrome as a gut-brain disorder caused by CB1 receptor changes in chronic users, with hot bathing, capsaicin, and haloperidol as management options.
Among 140 CVS patients, 41% used cannabis with most reporting symptom relief. Only 1 of 57 cannabis users met formal criteria for cannabinoid hyperemesis syndrome.
GPR55 knockout mice had impaired glucose tolerance on any diet, and the weight-reducing effects of rimonabant and THCV were partly dependent on this receptor.
Mouse study found a brain-sparing CB1 receptor blocker reduced weight gain, improved glucose metabolism, and reversed fatty liver without the psychiatric risks that ended rimonabant.
A stabilized CBDA derivative reduced weight and improved metabolic markers in both diet-induced and genetically obese mouse models.
First reported case of a 17-year-old developing superior mesenteric artery syndrome (bowel obstruction) from rapid weight loss caused by cannabinoid hyperemesis syndrome.
Cannabis users who had bariatric surgery lost equivalent weight to non-users at all time points through 2 years — the 'munchies' didn't undermine surgical outcomes.
Low-dose oral cannabis reversed insulin resistance in diabetic rats, with different fat depots responding through distinct mechanisms.
Systematic review of 13 animal studies found CB2 cannabinoid receptors in brain reward areas are necessary for modulating food intake and energy balance.
Two drugs that simultaneously target cannabinoid CB1 and PPAR receptors reduced binge eating in rats and corrected disrupted appetite-regulating brain pathways, offering a potentially safer dual-target approach than CB1 blockers alone.
A review examines the endocannabinoid system's role in regulating nausea, vomiting, and stress, explaining how chronic cannabis use may dysregulate these processes and contribute to the paradoxical vomiting seen in CHS and CVS.
A high-fat/high-sugar diet impaired mouse memory by overactivating the hippocampal endocannabinoid system and mTOR pathway, with CB1 receptor blockade or mTOR inhibition rescuing the memory deficits.
Cell studies showed THC enhanced fat cell development and changed how fat cells handled fatty acids over time, which influenced how much fat accumulated in liver cells.
Among 1,568 young adults, cannabis use was linked to nearly double the binge eating rate in women (24% vs 13%) but showed no such association in men, independent of depression.
First analysis of cyclic vomiting and cannabis hyperemesis syndrome in Mexican patients found CHS patients had higher tobacco and alcohol use than CVS patients.
A teen's nausea and vomiting were blamed on cannabis use and eating disorder — but her seizures the next day revealed acute intermittent porphyria, a rare treatable condition nearly missed due to diagnostic anchoring.
Anorexia nervosa involves coordinated epigenetic suppression of the endocannabinoid system: reduced cannabinoid receptors and increased endocannabinoid degradation simultaneously impair appetite signaling.
Two pregnant women with severe cyclic vomiting were diagnosed with cannabinoid hyperemesis syndrome after the hot bathing relief pattern was identified; symptoms resolved with cannabis cessation.
Comprehensive review found CHS is increasingly common with rising cannabis potency, characterized by daily use for 2+ years, and challenging to treat due to patient skepticism.
Pilot study of 18 CHS patients found high pain severity, elevated anxiety, extensive prior imaging workups, and a 17% 30-day ER return rate.
PNAS study found cannabis vapor increased food intake in humans and rats by boosting eating motivation and overriding food reward signals, without altering hunger hormones.
A woman developed brain damage from thiamine deficiency after 8 weeks of uncontrolled vomiting caused by cannabinoid hyperemesis syndrome—but recovered rapidly with treatment.
Rat study found cannabis-induced overeating works by triggering more frequent meals through the brain's orexin system, and blocking this pathway eliminated the munchies effect.
Advanced cancer patients vaporizing cannabis for appetite reported eating benefits and tolerated psychoactive effects well—some even enjoyed them.
Pilot RCT of nabilone for obesity was stopped early due to poor tolerability at 6 mg/day, but low-dose (2 mg/day) showed preliminary weight loss and gut microbiome changes in just 4 completers.
Review finds THCV, a non-psychoactive cannabinoid, shows promise for appetite suppression and blood sugar regulation in preclinical and early human studies.
Study of 128 mother-child pairs finds prenatal THC exposure linked to less body fat at birth followed by rapid postnatal growth, with shorter breastfeeding amplifying the pattern.
CB1 receptor blocker caused 27% weight loss in obese mice and improved airway function, identifying the endocannabinoid system as a link between obesity and asthma.
A triple-blind crossover trial of 17 older adults with poor appetite found that a THC/CBD mouth spray did not increase caloric intake compared to placebo, though it was well tolerated.
Study of 406 gastroparesis patients found cannabis use independently associated with more ER visits and hospitalizations.
Review finds cannabinoid hyperemesis syndrome, causing severe vomiting in chronic cannabis users, is increasingly diagnosed in emergency departments and frequently misidentified.
Review finds CHS is increasingly diagnosed in teenagers, with diagnostic delays and ineffective standard treatments highlighting the need for greater pediatric awareness.
Small RCT found cannabis oil significantly improved hunger scores in systemic sclerosis patients with wasting, with trends toward better appetite, weight, and quality of life, though most results did not reach statistical significance.
Six unique challenges of running cannabis trials in palliative care—from legislation to product variability to compassionate access—drawn from real trial experience.
Survey of 6,600+ people with eating disorders found cannabis and psychedelics rated highest for symptom relief, while most prescription antidepressants were rated ineffective for ED symptoms.
Mouse study found that combining a CB2 cannabinoid receptor activator with a dopamine D4 blocker reduced binge eating more effectively than the dopamine blocker alone.
Preclinical study showing cannabinoids drive appetite by activating AgRP hunger neurons in the brain, with neuron ablation eliminating the munchies effect.
Latent profile analysis of 435 cannabis users found all subgroups reported more binge eating while high, with coping-motivated users showing the worst sober eating disorder symptoms and emotion regulation difficulties.
Survey of 612 bariatric surgery patients found cannabis use jumped 52% post-operatively, with hazardous drinkers most likely to pick it up.
Matched study of 152 burn patients found cannabis intoxication at admission had no significant impact on nutritional markers like prealbumin and albumin.
Pilot RCT of 32 pancreatic cancer patients found medical cannabis feasible through state program partnership, with promising but non-significant improvements in pain, appetite, and insomnia.