A pilot study of the effects of cannabis on appetite hormones in HIV-infected adult men

RationaleThe endocannabinoid system is under active investigation as a pharmacological target for obesity management due to its role in appetite regulation and metabolism. Exogenous cannabinoids such as tetrahydrocannabinol (THC) stimulate appetite and food intake. However, there are no controlled observations directly linking THC to changes of most of the appetite hormones.ObjectivesWe took the opportunity afforded by a placebo-controlled trial of smoked medicinal cannabis for HIV-associated neuropathic pain to evaluate the effects of THC on the appetite hormones ghrelin, leptin and PYY, as well as on insulin.MethodsIn this double-blind cross-over study, each subject was exposed to both active cannabis (THC) and placebo.ResultsCompared to placebo, cannabis administration was associated with significant increases in plasma levels of ghrelin and leptin, and decreases in PYY, but did not significantly influence insulin levels.ConclusionThese findings are consistent with modulation of appetite hormones mediated through endogenous cannabinoid receptors, independent of glucose metabolism.

► Smoked cannabis exerts orexigenic action by modulating appetite hormones in humans.
► Insulin levels were not significantly affected by cannabis administration.
► The increase in ghrelin was dependent on Delta-9-THC serum concentrations.