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Cannabis is famous for its ability to cause hunger — the "munchies" is a common side effect of using the drug recreationally and one of the major reasons for using it medicinally. Over time, though, cannabis has other effects.

Cannabis is increasingly widely valued medicinally. While there's a lot we don't know about the THC molecule, and there's way more than THC in cannabis anyway, one effect that's pretty solidly established is this: Weed makes you hungry, man. That makes it popular for in-jokes for potheads, from the Fabulous Furry Freak Brothers to Harold and Kumar. But it also makes it a very useful medicine for people who have lost their appetites for medical reasons. When there's a drug that can help people who are on heavy chemo for AIDS or cancer to eat again, it makes sense to prescribe it.

I'm not at all disputing that, but there's more to it. Over the long term the effects of cannabis on appetite aren't so straightforward.

Let's start by talking over how cannabis works in general. When you take cannabis, however you take it, the psychoactive molecules, including but not limited to THC (Tetra Hydro Cannabinol, for those of you taking notes), enter your body and they bind to receptor sites. Receptor sites are places where your body is designed to accept certain molecules that are meant to control your physical or mental states. In the case of cannabis, cannabinoids  the "drug" molecules in cannabis  bind to sites that are designed to accept cannabinoids. 

Wait, What  We're Built To Take Cannabis? 

Well, only in the same way that we're built to take heroin, amphetamines or other drugs. 

These substances work on us because they do a similar job to chemicals we produce ourselves. Heroin binds to receptor sites that are designed for "endorphins"  a contraction of "endomorphines", or morphine-like substances that are made inside the body. These are natural euphorics and painkillers that we make inside ourselves to regulate our minds and bodies. Ever gone for a long, hard run and afterwards felt really relaxed and happy - high, in fact? That's endorphins. You were strung out on your own natural morphines. 

Or maybe you've done something terrifying. I abseiled down the side of a tall building when I was 16. At the bottom, I was shaking and excitable, talkative and energetic  just like someone on amphetamines, because I was affected by adrenaline. That's known to American doctors by its other name, epinephrine, and is chemically similar in structure and effect to amphetamines, which is why the effects are so similar. 

In each case, we're talking about "endogenous" analogs of "exogenous" (from the outside) chemicals, and cannabinoids are no different. We have cannabinoid receptors because we make cannabinoids inside ourselves. This isn't just a chemistry class - it's important to understand this to understand how cannabinoids work and the effects cannabis can have on appetite.

And it's not just appetite. The endocannabinoid receptor system controls appetite  but also pain sensation, immune function, stress reaction, and sleep. Oh, and this is the same receptor pathway that also controls muscle and fat metabolism.

Sounds like something we should step carefully around, right? In fact one reason why scientists don't really understand what THC does too well is probably because it does everything.

Cannabis helps reduce anxiety and aids sleep. Since sleep is seriously important in healing and general health, that's an advantage for people who, give that they're on chemo for potentially fatal illnesses, might be a little worried. Score one for marijuana. 

And yes, it stimulates appetite very significantly. 

In the short term.

Trouble is, many medical marijuana users are using cannabis for the long term.

What happens then?

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