The National Health and Nutrition Examination Survey (NHANES) reported that 18.5% of children and 39.6% of adults were categorized as obese (2015-2016). These were the highest rates ever documented by NHANES. While there were statistically no significant changes from the 2013-2014 reporting, all in all since 1999-2000 we have seen an increase of nearly 5% in youth and 10% in adult obesity. (1) If secular trends continue, by 2030 an estimated 38% of the world’s adult population will be overweight and another 20% will be obese. (2) Extensive public health efforts are being directed toward addressing obesity, and due to the complexity of obesity, it is likely to be one of the most difficult public health issues our society has faced.

Obesity is associated with increased risk of nearly every chronic condition, from diabetes, to dyslipidemia, to poor mental health.


Diabetes

Excess weight in childhood through early to mid-adulthood are strong risk factors for diabetes. Statistics show that nearly 80% of diabetics are overweight or obese. (3) Obesity itself raises diabetes risk even in the absence of other metabolic dysregulation (insulin resistance, poor glycemic control, hypertension, dyslipidemia). (4)

Heart & Vascular Disease

Heart disease and stroke are the leading causes of death in the US and globally (5) . Studies have consistently shown that obesity is a well-known risk factor for heart disease and ischemic stroke, dyslipidemia and hypertension.

Cancer

Obesity has long been associated with an increased risk of esophageal, colon, pancreatic, postmenopausal breast, endometrial, and renal cancers. (6) Recent research has evidenced that being overweight and/or obesity raises the risk of cancers of the gallbladder, (7) liver, (8) ovaries, (9) advanced cancer of the prostate (10), as well as leukemia. (11)

Trauma & Infection

A study in Pennsylvania of trauma centers (2000–2009) showed severely obese patients had a 30% increased risk of mortality from their trauma than non-obese patients, also doubling the risk for major complications. Supportive studies additionally show the increased risk of infection and infectious disease in obesity. Poorer recovery outcomes are also noted showing a higher risk of contracting influenza, pneumonia, bacteremia, and sepsis. (12) 

Mental Health

There are challenges identifying the role weight plays on our mental health. What is understood Is that obesity is associated with anatomical as well as functional changes in the human brain. In comparing older patients that have a higher body mass index (BMI) against their normal weight counterparts, studies showed atrophy in the frontal lobes, anterior cingulate gyrus, hippocampus, and thalamus in the older, obese group. (13) Being overweight increases the risk of Alzheimer's disease (35%), vascular dementia (33%), or any type of dementia (26%), even higher risk is observed for obesity. (14)

Certain societal and economic factors have influenced the obesity epidemic: reduced physical labor, increasingly sedentary lifestyles, easy access to good tasting calorie-dense foods.

Obesity was once a rare disease that only struck the wealthy, but now it is one of the most common and widespread disease that affects children and adults of varied socio-economic backgrounds all over the world.

 

Know Your Fats

While there is debate about how many types of fats exit, we are going to keep it all simple and just study brown fat and white fat.

White Fat

Our main type of fat and is found in two locations: Subcutaneous (under the skin) and Visceral (around our internal organs). While fat plays several roles including but not limited to temperature regulation, energy storage and protection of vital organs. White fat has receptors for multiple hormones such as insulin, sex hormones, and stress hormones. It also secretes hormones that have a direct impact on our metabolism and immune system. (15)

 

White fat increases when you consume more calories than you burn. This causes weight gain and increased BMI. Having high amounts of visceral fat increases your risk to some of the previously mentioned conditions like heart disease, certain cancers, diabetes, etc. (16)

Brown fat

Brown fat is derived from muscle tissue and has more mitochondria than white fat which is why it’s brown and why it’s a powerhouse of a cell, using its energy (calories) to produce heat. (17) Since brown fat can burn up to 500 calories a day on its own when activated, it can help to maintain a healthy weight. People who are lean and metabolically healthy typically have more brown fat. Adults have small amounts of brown fat and it is mainly located in the neck and upper back region. (18)

 

The "skinny" on cannabinoids

A published study in the scientific journal, Molecular and Cellular Biochemistry, studied the effects of CBD administration on immature fat cells to explore potential benefits on the treatment and prevention of obesity. CBD was found to do the following according to that study (19)

 

  • Stimulate genes and proteins that enhance the breakdown and oxidation of fat.
  • Increase the number and activity of mitochondria increasing the body’s ability to burn calories.
  • Decrease the expression of proteins involved in fat cell generation.

 

Certain cannabinoids, like CBD have been shown to eliminate hunger and cravings while other cannabinoids like THC increase appetite. Terpenes in combination with cannabinoids, produce the desired entourage effect, supporting the endocannabinoid systemic efficiency. This harmonic balance supports weight management at a cellular level, but it also contributes to reducing mental triggers like anxiety and stress. (20)

 

To elaborate further, cellular studies on cannabinoids and terpenes have shown that these compounds help reduce oxidative stress (21) and improve pancreas function. Pancreatic function suffers when our immune system attacks the insulin producing beta cells of our pancreas. When beta cells are destroyed, the sugar we consume over burdens the blood plasma and compromises proteins throughout the body - a process known as glycation. This leads to the onset of diabetes type 2 and a multitude of serious complications, i.e., heart and vascular disease, nerve damage, kidney damage, blindness, osteoporosis, foot, skin and mouth infections and pregnancy complications. (22)

 

Research shows that phytocannabinoids have a blocking effect on the TH-1 lymphocyte, a specific type of immune cell responsible for the destruction of the beta cells while simultaneously causing TH-2 cells, the more beneficial helper and anti-inflammatory immune cells, to positively alter the size of the beta cell toward growth. (23) As a result, cannabinoids from full spectrum hemp oil have been shown to decrease the need for insulin in type 1 diabetes by a full 58%. (24) There is supporting evidence that cannabinoids like CBD have also had an impact on successfully reversing type 2 diabetes (25); fostering better glucose and lipid breakdown and increasing insulin sensitivity. (26)

 

As more studies look at the effects of CBD and other cannabinoids on hunger, fat burning, carbohydrate utilization, energy metabolism, and related diseases, there is every reason to believe that cannabinoids such as CBD will emerge as a safe and effective alternative to fight unwanted weight gain and the obesity epidemic that now plagues the United State and the rest of the world.

 

References

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  3. American Diabetes Association Standards of Medical Care in Diabetes—2012. Diabetes Care. 2012 Jan 1;35(Supplement 1):S11–63
  4. Bell JA, Kivimaki M, Hamer M. Metabolically healthy obesity and risk of incident type 2 diabetes: a meta-analysis of prospective cohort studies. Obes Rev. 2014 n/a – n/a
  5. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet. 2012 Dec 15;380(9859):2095–128.
  6. Vainio H, Bianchini F. Weight control and physical activity.IARC Press; Lyon: 2002. 
  7. Larsson SC, Wolk A. Obesity and the risk of gallbladder cancer: a meta-analysis. Br J Cancer [Internet] 2007 Mar 20; [cited 2014 Apr 24]; Available from:http://www.nature.com/doifinder/10.1038/sj.bjc.6603703
  8. Larsson SC, Wolk A. Overweight, obesity and risk of liver cancer: a meta-analysis of cohort studies. Br J Cancer. 2007 Oct 8;97(7):1005–8. 
  9. Olsen CM, Green AC, Whiteman DC, Sadeghi S, Kolahdooz F, Webb PM. Obesity and the risk of epithelial ovarian cancer: a systematic review and meta-analysis. Eur J Cancer Oxf Engl 1990. 2007 Mar;43(4):690–709. 
  10. Discacciati A, Orsini N, Wolk A. Body mass index and incidence of localized and advanced prostate cancer--a dose-response meta-analysis of prospective studies. Ann Oncol Off J Eur Soc Med Oncol ESMO. 2012 Jul;23(7):1665–71. [
  11. Larsson SC, Wolk A. Overweight and obesity and incidence of leukemia: a meta-analysis of cohort studies. Int J Cancer J Int Cancer. 2008 Mar 15;122(6):1418–21. 
  12. Glance LG, Li Y, Osler TM, Mukamel DB, Dick AW. Impact of Obesity on Mortality and Complications in Trauma Patients. Ann Surg. 2014 Mar;259(3):576–81.
  13. Raji CA, Ho AJ, Parikshak NN, Becker JT, Lopez OL, Kuller LH, et al. Brain structure and obesity. Hum Brain Mapp. 2009 NA – NA.
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  17. Collins, D. (2013). Brown Fat, White Fat, Good Fat, Bad Fat. NIH Director's Blog. Retrieved 29 May 2019, from https://directorsblog.nih.gov/2013/03/26/brown-fat-white-fat-good-fat-bad-fat/
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  20. Mart, M. (2017). Cannabis for Weight Loss? Learn More About CBD's Role as an Appetite Suppressant. Mary Mart. Retrieved 29 May 2019, from https://www.marymart.com/cannabis-for-weight-loss/
  21. Pellati F, Borgonetti V, Brighenti V, Biagi M, Benvenuti S, Corsi L. Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer. Biomed Res Int. 2018;2018:1691428. Published 2018 Dec 4. doi:10.1155/2018/1691428
  22. Fournet M, Bonté F, Desmoulière A. Glycation Damage: A Possible Hub for Major Pathophysiological Disorders and Aging. Aging Dis. 2018;9(5):880–900. Published 2018 Oct 1. doi:10.14336/AD.2017.1121
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  24. Can Cannabis Treat, Or Even Prevent Diabetes?. (2019). Forbes.com. Retrieved 29 May 2019, from https://www.forbes.com/sites/andrebourque/2018/12/05/can-cannabis-treat-or-even-prevent-diabetes/#3cfe26674a52
  25. Stanley CP, e. (2019). Cannabinoids alter endothelial function in the Zucker rat model of type 2 diabetes. - PubMed - NCBI . Ncbi.nlm.nih.gov. Retrieved 29 May 2019, from https://www.ncbi.nlm.nih.gov/pubmed/24120371
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