Skip to main content
SpringerLink
Log in

Post-surgical cannabis use is associated with weight loss among individuals up to 4 years after bariatric surgery

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Introduction

Although cannabis is known to stimulate appetite, it is not clear whether cannabis use may impact weight loss outcomes following bariatric surgery. Although some work has suggested that pre-surgical cannabis use is not associated with post-surgical weight loss, the role of post-surgical cannabis use has not yet been examined. The purpose of this study was to measure pre- and post-surgical cannabis use and determine whether cannabis use was associated with weight loss outcomes following bariatric surgery.

Methods

Patients who underwent bariatric surgery over a 4-year period at a single health care system were invited to complete a survey regarding pre- and post-surgical cannabis use and report their current weight. Pre-surgical weight and BMI were extracted from medical records to calculate change in BMI (ΔBMI), percent total weight loss (%TWL), percent excess weight loss (%EWL), whether participants experienced a successful weight loss outcome, and whether participants had weight recurrence.

Results

Among all participants (N = 759), 10.7% and 14.5% engaged in pre- and post-surgical cannabis use, respectively. Pre-surgical cannabis use was not associated with any weight loss outcomes (p > 0.05). Any post-surgical cannabis use was associated with lower %EWL (p = 0.04) and greater likelihood of weight recurrence (p = 0.04). Weekly cannabis use was associated with lower %EWL (p = 0.003), lower %TWL (p = 0.04), and a lower likelihood of having a successful weight loss outcome (p = 0.02).

Conclusions

Although pre-surgical cannabis use may not predict weight loss outcomes, post-surgical cannabis was associated with poorer weight loss outcomes. Frequent use (i.e., weekly) may be especially problematic. Providers should consider screening patients for cannabis use and educate them about the potential impact of postoperative cannabis use on weight loss following bariatric surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292:1724–1737

    Article  CAS  PubMed  Google Scholar 

  2. Sjöström L, Lindroos A-K, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S, Larsson B, Narbro K, Sjöström CD, Sullivan M, Wedel H (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351:2683–2693

    Article  PubMed  Google Scholar 

  3. El Ansari W, Elhag W (2021) Weight regain and insufficient weight loss after bariatric surgery: definitions, prevalence, mechanisms, predictors, prevention and management strategies, and knowledge gaps—a scoping review. Obes Surg 31:1755–1766

    Article  PubMed  PubMed Central  Google Scholar 

  4. Clapp B, Wynn M, Martyn C, Foster C, O’Dell M, Tyroch A (2018) Long term (7 or more years) outcomes of the sleeve gastrectomy: a meta-analysis. Surg Obes Relat Dis 14:741–747

    Article  PubMed  Google Scholar 

  5. Cooper TC, Simmons EB, Webb K, Burns JL, Kushner RF (2015) Trends in weight regain following Roux-en-Y gastric bypass (RYGB) bariatric surgery. Obes Surg 25:1474–1481

    Article  PubMed  Google Scholar 

  6. Stoklossa JC, Atwal S (2013) Nutrition care for patients with weight regain after bariatric surgery. Gastroenterol Res Pract 2013:256145

    Google Scholar 

  7. Heinberg LJ, Bond DS, Carroll I, Crosby R, Fodor A, Fouladi F, Gunstad J, Mitchell J, Peat C, Steffen K (2020) Identifying mechanisms that predict weight trajectory after bariatric surgery: rationale and design of the biobehavioral trial. Surg Obes Relat Dis 16:1816–1826

    Article  PubMed  PubMed Central  Google Scholar 

  8. Tolvanen L, Christenson A, Surkan PJ, Lagerros YT (2022) Patients’ experiences of weight regain after bariatric surgery. Obes Surg 32:1498–1507

    Article  PubMed  PubMed Central  Google Scholar 

  9. NIDA (2019) Cannabis (marijuana) drug facts. NIDA, Bethesda

    Google Scholar 

  10. Kirkham TC (2009) Cannabinoids and appetite: food craving and food pleasure. Int Rev Psychiatry 21:163–171

    Article  PubMed  Google Scholar 

  11. Beulaygue IC, French MT (2016) Got munchies? Estimating the relationship between marijuana use and body mass index. J Ment Health Policy Econ 19:123–140

    PubMed  Google Scholar 

  12. Bauer FL, Donahoo WT, Hollis HW Jr, Tsai AG, Pottorf BJ, Johnson JM, Silveira LJ, Husain FA (2018) Marijuana’s influence on pain scores, initial weight loss, and other bariatric surgical outcomes. Perm J. https://doi.org/10.7812/TPP/18-002

    Article  PubMed  PubMed Central  Google Scholar 

  13. Shockcor N, Adnan SM, Siegel A, Wise E, Zafar SN, Kligman M (2020) Marijuana use does not affect the outcomes of bariatric surgery. Surg Endosc 35(3):1–5

    Google Scholar 

  14. Worrest T, Malibiran CC, Welshans J, Dewey E, Husain F (2022) Marijuana use does not affect weight loss or complication rate after bariatric surgery. Surg Endosc 36:6931–6936

    Article  PubMed  Google Scholar 

  15. Huang EY, Broderick RC, Li JZ, Serra JL, Ahuja P, Wu S, Genz M, Grunvald E, Kunkel DC, Sandler BJ (2022) Weight loss outcomes are not compromised in bariatric patients using cannabis. Surg Endosc 37(3):1–8

    Google Scholar 

  16. Ambwani S, Boeka AG, Brown JD, Byrne TK, Budak AR, Sarwer DB, Fabricatore AN, Morey LC, O’Neil PM (2013) Socially desirable responding by bariatric surgery candidates during psychological assessment. Surg Obes Relat Dis 9:300–305

    Article  PubMed  Google Scholar 

  17. Cuttler C, Spradlin A (2017) Measuring cannabis consumption: psychometric properties of the daily sessions, frequency, age of onset, and quantity of cannabis use inventory (DFAQ-CU). PLoS ONE. https://doi.org/10.1371/journal.pone.0178194

    Article  PubMed  PubMed Central  Google Scholar 

  18. Christian NJ, King WC, Yanovski SZ, Courcoulas AP, Belle SH (2013) Validity of self-reported weights following bariatric surgery. JAMA 310:2454–2456

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Brethauer SA, Kim J, El Chaar M, Papasavas P, Eisenberg D, Rogers A, Ballem N, Kligman M, Kothari S, Committee ACI (2015) Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg 25:587–606

    Article  PubMed  Google Scholar 

  20. Cadena-Obando D, Ramírez-Rentería C, Ferreira-Hermosillo A, Albarrán-Sanchez A, Sosa-Eroza E, Molina-Ayala M, Espinosa-Cárdenas E (2020) Are there really any predictive factors for a successful weight loss after bariatric surgery? BMC Endocr Disord 20:1–8

    Article  Google Scholar 

  21. Athanasiadis DI, Martin A, Kapsampelis P, Monfared S, Stefanidis D (2021) Factors associated with weight regain post-bariatric surgery: a systematic review. Surg Endosc 35:4069–4084

    Article  PubMed  Google Scholar 

  22. Vidot DC, Prado G, De La Cruz-Munoz N, Spadola C, Cuesta M, Messiah SE (2016) Postoperative marijuana use and disordered eating among bariatric surgery patients. Surg Obes Relat Dis 12:171–178

    Article  PubMed  Google Scholar 

  23. Center for Behavioral Health Statistics and Quality (2022) Results from the 2021 National Survey on Drug Use and Health: detailed tables. Substance Abuse and Mental Health Services. Center for Behavioral Health Statistics and Quality

  24. Miller-Matero LR, Armstrong R, McCulloch K, Hyde-Nolan M, Eshelman A, Genaw J (2014) To eat or not to eat; is that really the question? An evaluation of problematic eating behaviors and mental health among bariatric surgery candidates. Eat Weight Disord Stud Anorex Bulim Obes 19:377–382

    Article  Google Scholar 

  25. Schauer GL, Njai R, Grant-Lenzy AM (2020) Modes of marijuana use—smoking, vaping, eating, and dabbing: results from the 2016 BRFSS in 12 states. Drug Alcohol Depend 209:107900

    Article  PubMed  Google Scholar 

  26. Goodman S, Wadsworth E, Leos-Toro C, Hammond D (2020) Prevalence and forms of cannabis use in legal vs. illegal recreational cannabis markets. Int J Drug Policy 76:102658

    Article  PubMed  Google Scholar 

  27. Reboussin BA, Wagoner KG, Sutfin EL, Suerken C, Ross JC, Egan KL, Walker S, Johnson RM (2019) Trends in marijuana edible consumption and perceptions of harm in a cohort of young adults. Drug Alcohol Depend 205:107660

    Article  PubMed  PubMed Central  Google Scholar 

  28. Mason NL, Theunissen EL, Hutten NRPW, Tse DHY, Toennes SW, Jansen JFA, Stiers P, Ramaekers JG (2021) Reduced responsiveness of the reward system is associated with tolerance to cannabis impairment in chronic users. Addict Biol 26:e12870

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study was funded by the American Society for Metabolic and Bariatric Surgery Foundation.

Author information

Authors and Affiliations

  1. Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA

    Lisa R. Miller-Matero, Eve DePascale, Jordan M. Braciszewski & Erin N. Haley

  2. Center for Health Policy & Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA

    Lisa R. Miller-Matero, Logan Zelenak, Jordan M. Braciszewski, Leah M. Hecht, Erin N. Haley & Amy M. Loree

  3. Wayne State University School of Medicine, Detroit, MI, USA

    Kaitlin Ross, Camila Arellano & Arthur M. Carlin

  4. Department of Surgery, Henry Ford Health, Detroit, MI, USA

    Arthur M. Carlin

Authors
  1. Lisa R. Miller-Matero
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kaitlin Ross
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eve DePascale
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Camila Arellano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Logan Zelenak
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jordan M. Braciszewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Leah M. Hecht
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Erin N. Haley
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Amy M. Loree
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Arthur M. Carlin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lisa R. Miller-Matero.

Ethics declarations

Disclosures

Lisa R. Miller-Matero, Logan Zelenak, Arthur M. Carlin, and Jordan M. Braciszewski received funding from ASMBS Foundation. Kaitlin Ross, Eve DePascale, Camila Arellano, Leah M. Hecht, Erin N. Haley, and Amy M. Loree declare that they have no conflict of interest to declare.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miller-Matero, L.R., Ross, K., DePascale, E. et al. Post-surgical cannabis use is associated with weight loss among individuals up to 4 years after bariatric surgery. Surg Endosc 37, 6315–6321 (2023). https://doi.org/10.1007/s00464-023-10126-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-023-10126-6

Keywords

Search

Navigation