Exploring the munchies: An online survey of users’ experiences of cannabis effects on appetite and the development of a Cannabinoid Eating Experience Questionnaire

Abstract

Background: Cannabis intoxication is commonly reported to increase appetite and enhance appreciation of food (the ‘munchies’). These effects are attributed to activation of the endocannabinoid system. However, the psychological changes that underlie these phenomena are under-researched. We report here the results of an extensive online survey of cannabis users with an exploratory Cannabinoid Eating Experience Questionnaire (CEEQ). Method: Frequent cannabis users completed a 46-item questionnaire about their eating behaviour under the influence of cannabis. An English-speaking sample ( n=591) provided data for the initial exploratory validation of the scale. A second Dutch-language survey ( n=163) was used for confirmatory factor analysis. Test-retest reliability was based on a third English-speaking sample ( n=40) who completed the revised, 28-item CEEQ twice across 2 weeks. Results: Principal components analysis provided a two-factor solution. Factor 1 (hedonic) comprised 14 items that related primarily to the enjoyment and altered sensory aspects of eating. Factor 2 (appetitive) comprised a further 14 items related to motivational factors that instigate or promote eating. The two-factor structure was supported by confirmatory factor analysis. Both the hedonic and appetitive subscales had good internal reliability (α=0.92 for each subscale, in two independent samples). Good test-retest reliability was obtained for the revised 28-item questionnaire ( ps<.01 for Total CEEQ and each subscale). Conclusion: The Cannabinoid Eating Experience Questionnaire provided a valid, reliable assessment of the psychological features of cannabis-induced alterations to appetite. Our data confirm that cannabis principally influences the motivational factors that lead to the initiation of eating and the hedonic factors implicated in maintaining eating.

Efficacy of medicinal cannabis for appetite-related symptoms in people with cancer: A systematic review

“…21 Previous reviews have also focussed on a narrow range of appetite-related endpoints, overlooking sensory and hedonic factors such as taste, smell, satiety, food preferences, intake and enjoyment (subsequently termed appetite-related symptoms). 16,22 The reviews have also given little consideration to heterogeneity among cannabis interventions, including product, dose and mode of administration. Only one study reviewed safety in palliative populations however, did not specify how this was measured.…”

The conserved endocannabinoid anandamide modulates olfactory sensitivity to induce hedonic feeding in C. elegans

“…Cannabinoids are known to cause hyperphagia (Williams et al, 1998;Williams & Kirkham, 1999) and hedonic amplification, which is defined as selective preference for more palatable foods over calorically equivalent alternatives. Cannabinoid-mediated hedonic amplification has been observed in humans (Foltin et al, 1988;Roberts et al, 2019), rats (De Luca et al, 2012;DiPatrizio & Simansky, 2008;Higgs et al, 2003;Jarrett et al, 2005;Mahler et al, 2007), and mice (Barbano et al, 2009). It was long assumed that the nematode Caenorhabditis Elegans did not have a working endocannabinoid system because, even though it synthesizes both AEA and 2-AG (Lehtonen et al, 2008), no receptor could be identified (McPartland & Glass, 2003).…”

The munchies: Marijuana legalization and food sales in Washington

“…Sabia et al (2017) provide evidence that medical marijuana laws (MML) are associated with a 0.3% to 0.6% decrease in BMI scores and a reduction of 2% to 6% in obesity. Finally, Roberts et al (2019) find that sustained marijuana use over time may result in a less significant effect on appetite, although this may be associated with the frequency of use rather than age. Roberts et al (2019) also find increased appetite for all foods, which contradicts previous findings for marijuana users' preference for sweet, calorically dense foods.…”

“…Second, we examine changes in aggregate spending patterns of three broad food categories: taxable food sales, non‐taxable food sales, and restaurant sales. These categories are designed to examine overall changes in food spending patterns because, as noted by Roberts et al (2019), marijuana users may experience an increase in appetite for a variety of foods, not only ice cream, cookies, and chips. Third, we examine shifts toward or away from our food categories that may be related to the observed increase in aggregate marijuana sales rather than estimate changes for one type of food in isolation.…”