Food Cravings Persisted After Dronabinol’s Calorie Effect Faded in a Small Trial
In a seven-person controlled study, repeated oral THC increased reported food cravings even after its initial increase in measured caloric intake was no longer apparent. Appetite-related self-report and actual food consumption did not tell the same story.
The participants served as their own comparison
Seven HIV-positive men who regularly smoked marijuana completed two residential stays with dronabinol or placebo. Dronabinol supplied oral THC four times daily. Investigators compared the first and second eight-day phases of each stay. Food reporting was checked through observation and examination of discarded packaging.
The early calorie effect did not persist
Dronabinol increased daily caloric intake during days one through eight, largely through more eating occasions. There was no corresponding significant intake increase during days nine through sixteen. Cravings for selected food categories remained elevated across both phases, and mood-related drug effects also persisted.
Selective tolerance was an interpretation
The authors favored tolerance to the intake and sleep effects, rather than uniform tolerance to all THC effects. They considered food boredom as an alternative, although placebo intake and the range of available foods argued against it. Persistent craving therefore could not be used as proof of sustained nutritional benefit.
The trial did not establish a general dosing rule
The sample was small, male, medically selected and already familiar with cannabis. Participants were not anorexic at baseline. The regimen did not demonstrate sustained weight gain or establish outcomes in cannabis-naïve patients. The findings support measuring food intake and weight directly when evaluating a claimed appetite benefit, rather than treating favorable subjective reports as a complete efficacy assessment.
Related analysis: Cannabis Tolerance Claims: Questions to Ask Before Relying on Expert Testimony.
Primary research
Efficacy and tolerability of high-dose dronabinol maintenance in HIV-positive marijuana smokers: a controlled laboratory study. Psychopharmacology (2010). DOI: 10.1007/s00213-010-1995-4.
