jrapdx3 3 hours ago

After reading the article and the comments on this page, I also think it's unclear what exclusion criteria were used to select the cannabis using and control cohorts. Controlling for likely and unlikely confounding variables is essential in this kind of study. Obesity is a notoriously heterogenous condition with a great number of inheritable and environmental contributors which makes the task especially difficult.

However, a connection of particular interest concerns ADHD, a disorder identified as having a strong link to obesity, including common genetic predisposition [0]. Furthermore, individuals with ADHD are also more likely than non-ADHD peers to develop drug dependence, including cannabis-use disorder [1,2]. If ADHD was not among direct or indirect exclusion criteria, the results of the recent study could be misleading or at least incompletely characterized.

    [0] https://pmc.ncbi.nlm.nih.gov/articles/PMC6097237/ 
    [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC5568505/  
    [2] https://pmc.ncbi.nlm.nih.gov/articles/PMC8025199/
  • bb88 3 hours ago

    I think the issue I have is simpler. My understanding is those that were obese and have lost weight still have a higher chance of getting type 2 diabetes than those that were slim throughout their lives. If your chance of getting diabetes is 70% while obese, and 2.2% (or 15% or whatever it actually is) after losing weight, how is that not a win?

bb88 6 hours ago

> The researchers found that new cases of diabetes were significantly higher in the cannabis group (1,937; 2.2%) compared to the healthy group (518; 0.6%).

We know there's a path from obesity to diabetes. I think it would be interesting to see if there's a path from cannabis to obesity.

  • klipt 6 hours ago

    > a path from cannabis to obesity

    I believe the technical term is "the munchies"

    • bb88 6 hours ago

      You would think that's the mechanism, but there seems to be evidence that points to lower BMI with cannabis use.

      Mouse study: https://medschool.uci.edu/news/new-research-may-explain-why-...

      Human study: https://www.liebertpub.com/doi/10.1089/can.2024.0069

      Many people might have removed alcohol intake with cannabis use, to reduce overall caloric intake.

      • gleenn an hour ago

        Very interesting conclusion directly from the human study you linked: "Marijuana use is correlated with lower BMI. As legalization and prevalence of the drug in the U.S. increases, the prevalence of obesity may decline. However, clinicians should view this outcome along with the known health risks associated with marijuana use."

      • Sparkle-san 6 hours ago

        I wonder if this is skewed by the states where marijuana was legal/more accessible during that time window. Colorado was the first state to legalize it and is also the state with the lowest BMI.

        • zoklet-enjoyer 5 hours ago

          Washington was the first state to legalize because of the time difference

          • MegaButts 5 hours ago

            Wouldn't it be the opposite? 9 AM in Colorado is 8 AM in Washington.

            • Sparkle-san 4 hours ago

              Depending on the level of pedantry you want you could argue for either. Washington's measure went into effect first, on Dec 1st, 2013 while Colorado's went into effect on Jan 1st, 2014. Colorado opened retail shops that same day though while the first shops didn't open until July 2014 in Washington and they had a lot of initial issues around licensing leading to slower expansion.

              • MegaButts 4 hours ago

                Sure, but in reference to the comment "because of the time difference" it seems pretty obvious he was referring to time zones, not the dates the laws took effect.

                Anyway, it doesn't actually matter. Cheers.

      • tapoxi 6 hours ago

        Speaking from personal experience I went from a BMI of 24 (healthy) to a BMI of 31 (obese) because of daily cannabis use that gave me insane munchies.

        This may be genetic, I had friends that didn't get them nearly as badly as I did.

        (I have since quit weed and lost the weight.)

      • blackjack_ 6 hours ago

        I don't know why this isn't talked about that often, but a lot of people who smoke weed end up needing to smoke weed to be able to eat. Which probably is part of the thing that leads to reduced BMI.

        • DontchaKnowit 5 hours ago

          Yeah in my experience real heavy users of weed don't get munchies anymore and actually just smoke instead of eat pretty frequently. Eating kinda kills your high.

          Source: was a burnout in college for 4 years

          • bb88 4 hours ago

            My personal hypothesis, is that cravings (drug, sugar, food, sex, alcohol, socializing, etc) fill a need for stimulation. Most people get that through maybe watching sports, reading books, or if you can, mental stimulation (math, science, programming, 3d printing, juggling, etc). Or maybe some combination of all of them. If you didn't have very many friends growing up, it felt agonizing with a deep desire to fit in -- that was the "social" craving kicking in early in life.

            Some of those cravings exist to extend life and to help the species multiply. Some of them were artificial (drugs, alcohol, gambling, computer gaming).

            GLP-1 agonists (wegovy, zepbound) are prescribed for certain addictions other than obesity. This shows that we don't understand addiction at all.

        • aurareturn an hour ago

            but a lot of people who smoke weed end up needing to smoke weed to be able to eat.
          
          A negative side effect of weed abuse is that you get so dependent on it, you have no appetite to eat unless you're high.
        • mock-possum an hour ago

          > I don't know why this isn't talked about that often, but a lot of people who smoke weed end up needing to smoke weed to be able to eat.

          As someone with a pretty drug-friendly friend group… I’m surprised to hear that happens ‘a lot’ because I have never heard of that, or experienced it myself.

          In my experience, you eat food because it tastes good - and while being stoned might make some foods more satisfying texturally (ice cream when you have cotton mouth is rad) or lower your inhibition to try weird stuff, or to alter your perception in a way that exposes you to new avenues to appreciating familiar foods - I really can’t imagine that not transferring to being sober. Peanut butter and pickles still taste good sober, even if you develop an appreciation for them while stoned.

          Are you saying a lot of people just stop experiencing hunger? Like does their stomach not growl and feel empty unless they’re high? Really having trouble thinking of what you could be describing, and squaring jt with what I know.

          • bb88 30 minutes ago

            It's a pretty common mechanism in humans to replace one craving with another. AA (e.g.) doesn't necessarily care if you have a two pack a day smoking addiction -- that's not what they're "optimizing" for.

            > Are you saying a lot of people just stop experiencing hunger? Like does their stomach not growl and feel empty unless they’re high?

            I think maybe a better way is to understand what the best solutions are. Right now it seems to be replacing one craving with another. People who stop cigarette smoking often gain weight -- that's been well documented for decades now. Knowing that, is type 2 diabetes better or worse than smoking and risking lung cancer?

            People who run get a lot of endorphins from the exercise. People who haven't run and start running get a lot of pain from it at first. Maybe after a few months they get endorphins.

            GLP-1 agonists (wegovy, zepbound) do reduce food cravings, but they also are being studied for alcoholism. I've heard it could affect gambling addiction as well. The real question is, why would a GLP-1 agonist affect a gambling addiction at all?

          • hattmall 22 minutes ago

            Are they drug friendly, or are they stoners? In my experience it's not so much needing to be high to eat as it is the craving to get high outweighs that for food, then when you get high you forget to eat. Then when it begins to wear off all the hunger hits you and you eat a whole pizza and a bag of Doritos right before falling asleep.

            When the first thing on your mind when you wake up is smoking weed and that's your primary activity throughout the day, food just becomes secondary, so the idea of eating without smoking first is just not realistic.

    • caboteria 6 hours ago

      Also "couch lock", i.e., reduced physical activity.

      • keeda 3 hours ago

        I actually would like to see a study about this. I am starting to think that the stereotype of lethargic potheads chilling on a couch comes mostly from portrayals in movies. Anecdotally, I encounter many people casually using cannabis while engaged in varying levels of physical activity, ranging from just hanging out in the city, to going on hikes, to outright partying or dancing late into the night. I even heard a couple folks use it as a "pre-workout" for long runs or lifting.

        I'm sure it depends on the dosage, but the relationship between usage and physical activity seems to be more nuanced than is generally understood.

        • hattmall 17 minutes ago

          It's shockingly accurate. Sure people get high and do other stuff but the amount of people just sitting on couches passing weed around for hours is huge.

    • dyauspitr 6 hours ago

      There’s also something to cannabis potentially messing with your metabolism because anecdotally potheads usually aren’t particularly fat.

  • thekevan 3 hours ago

    I always wonder about connection and correlation in these studies. Does the cannabis do something to the body to cause diabetes or is the type of person who would indulge in cannabis also the type of person that would indulge in some cake?

    • ivape 2 hours ago

      You can easily eat entire cakes every single day if you are high all the time.

  • faangguyindia 4 hours ago

    Doesn't it boost appetite? It's traditionally fed to underweight kids in india.

  • yieldcrv 2 hours ago

    Or a path from cannabis to diabetes such as declined insulin production

  • sonicggg 5 hours ago

    Part of research work is removing extraneous variables.

KingOfCoders an hour ago

"While the authors note that more research is needed to fully explain the association between cannabis and diabetes, it may come down to insulin resistance and unhealthy dietary behaviors." Too much chocolate I'd guess.

khelavastr 4 hours ago

This doesn't make sense as causation. Cannabis stimulates insulin-sensitizing hormone.

It makes sense for the same reason that prediabetic people feel better with cannabis

duffpkg 3 hours ago

This is a sketchy article about a study which is not even named because it has not yet been presented. It will be presented in the next week. I would take this entire thing with a grain of salt.

  • yellowapple 3 hours ago

    The website also has a bunch of other sketchy articles playing up the alleged “dangers” of cannabis, usually by the classic approach of conflating correlation with causation.

    I'll refrain from suggesting this to be deliberate on the authors' part, but there's obviously some bias at play here.

lvl155 5 hours ago

Anything in excess is bad for you. Even water.

homeonthemtn 7 hours ago

Wonder if cannabis triggers blood sugar level changes which causes the munchies.

I have funky blood sugar issues, and I can certainly see the overlap in how the cravings feel but never made the connection until now. Very interesting.

  • AngryData 6 hours ago

    There does seem to be an effect on blood sugar levels, but apparently not in a simple way because studies struggle to get consistent results. It seems like it lowers it a little bit, atleast at first, but many people spend far more time with excess sugar levels, possibly due to eating in response.

    Anecdotally it always seemed to me that it didn't make you that hungry straight out, but it did depress the feeling of satiation after eating so it is much easier to binge on food once you start eating something.

  • Fade_Dance 6 hours ago

    Seems to me that that would have been known/measured by now if it was the case. Fairly easy to measure.

lr4444lr 5 hours ago

I occasionally use CBN for sleep, never THC, so maybe it's different, but I quickly develop a tolerance, like within a week of daily use and have to cease for many days or a few weeks to get any further benefit at all.

As I read, the endocannabinoid system in the brain is pretty homeostasic.

Does something similar happen with cannabis munchies subsiding to people who ingest THC or whole leaf products daily?

  • heavyset_go 4 hours ago

    Yes, but it remains a good anti-emetic.

  • morkalork 4 hours ago

    I've been taking CBD daily in the evening for sleep (can't find a quality source if CBN where I live - I am interned tho, the research is compelling for sleep) and I find it can act almost like an appetite suppressant.

  • giraffe_lady 5 hours ago

    Anecdotally yes. I'm a very occasional user now and get insane munchies but when I was using it differently I felt that tolerance built quickly and I stopped having munchies once it did. Not even quite daily use either like 3-4/week. Another comment elsewhere in here describes the same experience.

  • jaco6 5 hours ago

    Once you become a heavy user it no longer reliably triggers appetite, maybe because you get better at recognizing the hunger is fake and focus on other aspects of the high.

Havoc 5 hours ago

Everything fun is always bad :(

  • gyomu 2 hours ago

    Plenty of bad things that are no fun (microplastics, air pollution, pesticides in food, ...) that are near impossible to escape, so don't deprive yourself of the fun stuff (with moderation).

pama 5 hours ago

Is there a link somewhere to the actual scientific contribution? (Or at leadt an abstract?)

onemoresoop 5 hours ago

I wonder if this is connected to the appetite the cannabis consumption brings about. I personally experienced appetite from consuming it but learned that not acting on it is equally pleasant. Maybe I have more self control or something...

afw333 4 hours ago

From my experience regular stoners eat less and less. Yes at first the munchies might cause issues but quickly with the developed tolerance it gets so intense that these people will barely eat without having consumed which usually causes them to loose weight.

Also someone at age 18 already being a regular stoner to age 25 being a regular stoner is vastly different.

  • apwell23 4 hours ago

    occasional use makes me gain weight like crazy.

cies 5 hours ago

People in the dispensary look better (slimmer) than in the wallmart.

  • d-moon 4 hours ago

    You’re also interfacing with folks in a niche service industry here. If you’re a sales rep, you’re definitely being screened to represent what people want to be perceived with using the product.

  • sonicggg 5 hours ago

    Comparing them with the People of Walmart is not setting the bar very high.

yowlingcat 5 hours ago

This is not a great "study" if you can call it that. Let me be specific by pointing a passage that's doing a lot of the heavy lifting:

```

After controlling HDL and LDL cholesterol, uncontrolled high blood pressure, atherosclerotic cardiovascular disease, cocaine use, alcohol use and several other lifestyle risk factors, the researchers found that new cases of diabetes were significantly higher in the cannabis group (1,937; 2.2%) compared to the healthy group (518; 0.6%), with statistical analysis showing cannabis users at nearly four times the risk of developing diabetes compared to non-users.

```

Note "nearly four times the risk of developing diabetes" -- this feels like a dangerous exaggeration of "four times the correlation of having developed diabetes." No controls for diet, exercise, etc. In comparison to a gold standard clinical trial this is about as far as you can go on the other end.

That's not to say that I think that a prospective link doesn't merit deeper research -- far from it. In fact, Novo Nordisk has an anti-obesity drug in phase 2a trials, monlunabant [1], that serves as a CB1 (cannabinoid receptor 1) inverse agonist which has a mechanism of action inverse to THC. The clinical trials are showing that it creates modest weight loss, so it seems that there's likely something to how that receptor is activated that could cause weight gain. What's not clear to me is whether all the other receptors that THC activates create a compound effect at a population health level that leads to net weight gain and the development of diabetes, the inverse, or non-correlated outcomes, and whether those occur across the board or differentially based on genetic makeup.

[1] https://en.wikipedia.org/wiki/Monlunabant

klysm 6 hours ago

You can’t claim that with effect sizes this small

  • ferfumarma 6 hours ago

    The effect size is from 0.6 to 2.2 percent.

    That's 4x.

    That seems quite large to me.

    • yellowapple 3 hours ago

      1% ABV is 10× as much as 0.1% ABV, but neither are gonna get you drunk particularly quick.

sweatypants 4 hours ago

without reading this study in depth my immediate thoughts are: - cannabis is not the direct link with diabetes - cannabis urges munchies > overeating - overeating causes obesity - obesity causes diabetes

bitwize 7 hours ago

"The munchies" have unpleasant sequelae...

  • m0llusk 6 hours ago

    Exactly what is going on here appears to be more complicated than that. For example: https://www.medicalnewstoday.com/articles/325050

    Title: Marijuana users less likely to be overweight or have obesity

    Opening line: New research finds that, despite the common phenomenon of having “the munchies” after using marijuana, cannabis users tend to weigh less and are less likely to be obese.

    This involved 33k participants in the US, so at least one order of magnitude smaller and in a different context.

imchillyb 6 hours ago

> The authors note that more research is needed on the long-term endocrine effects of cannabis use and whether diabetes risks are limited to inhaled products or other forms of cannabis such as edibles.

This study did not differentiate between edibles, which are loaded with sugar, and inhaled cannabis usage. And, since they are not a food product, edibles do not carry the same onus as food for labeling, nor similar regulatory oversight.

This seems a significant flaw in the data gathering and could change the ultimate conclusion of the study.

  • yosame 6 hours ago

    Edibles wouldn't have enough sugar to singularly cause diabetes.

  • DontchaKnowit 5 hours ago

    Thats ridiculous, 50 calories worth of edible is enough to get you high as balls for like 8 hours.

    Tell me youre not a edible user without twlling me youre not an edible user

  • cactusplant7374 6 hours ago

    Is it really possible to get diabetes from eating one piece of candy every day?

  • leptons 6 hours ago

    Not all edibles have sugar, but most seem to be pure candy. It's dangerous too because if the edible tastes so amazing you want to eat another one and then you get way too high. That's why when I used to make "magic brownies" I would make two batches, one of them "plain", so I could eat those after eating the magic one.

    Level Protabs are pretty amazing, so clean and zero sugar. It's literally just THC and a little bit of corn starch pressed into a pill. I break them in half and it gives me a focused creativity boost.

  • gabrielhfrn 6 hours ago

    When you frame it that way, it almost brings the study's findings into question!

    I wonder if it was truly a flaw or if it was a calculated omission.