Cannabis users face substantially higher risk of heart attack (2025)
acc.org
acc.org
Personally I'd wager a bet it's the tobacco and/or smoking that is the harmful part, but it kind of dumbfounds me they failed to account for "details" like "duration and amount of cannabis use", that feels like a very vital thing to control for. Nothing is good for you in too great amounts, even water, so not taking that into account seems to not really give reliable and trustworthy results.
Also, title needs a 2025.
> The findings are from a retrospective study of over 4.6 million people published in JACC Advances and a meta-analysis of 12 previously published studies being presented at the American College of Cardiology's Annual Scientific Session (ACC.25).
> Kamel and his team conducted the retrospective study using data from TriNetX, a global health research network that provides access to electronic medical records. Their findings indicate that over an average follow-up of over three years, cannabis users had more than a sixfold increased risk of heart attack, fourfold increased risk of ischemic stroke, twofold increased risk of heart failure and threefold increased risk of cardiovascular death, heart attack or stroke. All study participants were younger than age 50 and free of significant cardiovascular comorbidities at baseline, with blood pressure and low-density lipoprotein (LDL) cholesterol levels within a healthy range and no diabetes, tobacco use or prior coronary artery disease.
> This retrospective cohort study utilized the TriNetX health research network, which aggregates deidentified electronic medical records from health care organizations worldwide.
> 1) The cannabis-user group with cannabis use diagnoses (International Classification of Diseases, 10th Revision: F12.1, F12.9, F12.90).
You can't expect them to work miracles and come up with data they didn't have. They produced a valuable piece of research furthering our understanding of the cardiovascular risks of cannabis use based on a very large existing dataset that was available to them.
Of course they would love to be able to answer the question of whether smoking is worse for your heart than edibles and so on, and they stated they would like to do this in a future study. But that costs time and money to create an entirely new dataset, and you know what funding for science is like these days.
There's plenty of other evidence in the literature on the cardiovascular effects of THC if you want to see what our current understanding is there. TL;DR: smoking is worse than vaping or edibles; myocardial infarction risk spikes within the first few hours of using cannabis; but the risks are not limited to inhalation because THC itself has physiological effects that raise cardiovascular risk factors (increased heart rate, endothelial dysfunction, platelet activation raising clotting risk, inflammation and oxidative stress, etc.).
Still good data, but I don’t think it’s predictive for what cannabis use leads to (unless you assume that taking up cannabis makes you proportionately more likely to also take up whatever the confounding factors were).
Information like this get collected at a point in time and never goes away. People have EMR fatigue and click though the questions. Anecdotal point, several years ago I accidentally stated that I drank enough to be considered a severe alcoholic. Even after correcting it at my next visit, it never really goes away, I get asked lifestyle questions relating to alcoholism.
Similarly advocacy against drunk driving, a noble cause, juiced up the stats. If you run over and injure a guy on the sidewalk carrying a sealed bottle of liquor, it will be labeled “alcohol related” more often than not based on officer discretion. If it’s fatal, the autopsy will take that conclusion if any party has a 0.01 BAC.
After reading the study, should we update our posterior on the hypothesis that cannabis use causes cardiovascular disease to nudge it in the direction that it does? Yes - that's just Bayes' theorem. Does the probability go to 95%+? No, of course not; I'm not claiming otherwise. It's still useful research.
Also, worth noting that MI risk spikes several-fold within the first hour after cannabis use (and that's not caused by cocaine).
I assume guy 1 has a significantly higher chance of whatever, despite now trading lots of money ... while the other two still do what they did, with teen kids and Moms and all that ...
it's not the cannabis.
hey do your bodies crave liquor when you suffer from a blood knot? but stop when it's gone?
A stoner would smoke half-a-joint and then easily eat a pound of processed meat, then send a whole bag of chips down the hatch, washing it down with two or three pints of beer, and twenty minutes later will be eating ice cream directly from the bucket.
Food is the worst and most dangerous drug of modern human history. It has killed more animals, insects, and humans than any other drug. Cocaine compared to it is a kindergarten party.
I'd like to say that's a little bit of an exaggeration but I also feel like a joint and $25 for taco bell at 1am wouldn't help my case...
(Sadly speaking from experience)
Everyone I knew who developed coke problems had drinking problems first. Bar none.
Confounding migraines for weed prescriptions and very real stroke risk and a desire for low THC marijuana isn't going to be a happy show I want to go through watching that happen to friends.
It makes a mockery of real medical issues.
Doctors and health care should be involved in drug use and advising patients, maybe even clean supplies or other things.
But we got the ACA of public health options with medical marijuana. And I want to remember Obama and others for inspiring us, not hacks.
A lot of people won't be believed in time.
Cannabis is a multi purpose drug, cocaine is party drug and/or a "I haven't slept, don't want the 8 hour+ commitment of speed, but need to stay awake" drug.
The overlap of pot users and cocaine users is rather small in my anecdotal experience.
In the movies the drug dealer has an overcoat with every common drug ready to sell at any point. In reality people stick to one or products because there not dealing with multiple suppliers and carrying products for months until the right buyer comes along, they buy in bulk and sell quickly.
Were I to pick a gateway drug into cocaine, it would be alcohol. It becomes a way to infuse more energy in a later night, which is usually one of alcoholic revelry.
When cannabis is just in a store and it's the only thing there, many potheads just stay in the pothead bubble.
I didn't want my kids to have any reason to know the types of people we had to deal with.
Myself I have been involved with weed a long time and never seen cocaine though my son did go into town one night and lock himself out of his car and have an experience we call "the night of the living baseheads."
The best drug dealer at my old school was a guy who would take chances nobody else would; I knew him somebody who dealt weed, psychedelic mushrooms and acid to my friends although I was persona-non-gratis with him because he was seriously criminally minded and led a gay bashing gang that mostly bashed straight people who were perceived as allies [1], although it took just one snarky comment (my case) or advising somebody being shot at with a paint pellet gun to see the police (the popular president of the paint pellet gun club.)
He eventually got caught bashing in an RA in the face with a rock shot with one of those rubber band catapults people use to shoot water balloons at the beach. He was banned from campus but I saw him once when he was dropping off a delivery for a friend. My friend later told me that he'd been caught on videotape dealing 3kg of cocaine to an undercover cop and he did time.
That's an unusual case. Except for that guy and the Vietnamese kid who took money and never delivered the weed to my wife when she was in high school, all the pot dealers I knew were basically responsible and law-abiding people who only dealt pot and other soft drugs. Funny somebody dropped a dime on the later.
[1] this was the 1980s during peak AIDS panic and I guess they were afraid if they spilled gay blood they might get AIDS or something
There were Conservative politicians who got up and publicly said that toddlers would die cause they'd eat marijuana plants grown by their parents!
I wouldn't blame the business plans so much. A lot of them applied for licenses but didn't get theirs approved till after the huge players did. By then, the market had already consolidated.
Your parent's comment makes no sense.
Water can kill you, too! It does not mean that drinking water is bad.
The popularity of cannabis doesn’t justify pretending it’s entirely harmless.
Consumed as an inhalant it’s impossible to claim that it won’t have similar negative impacts to putting anything in our lungs which isn’t clean air.
Consumed orally the harm will be in the dose. But there no evidence that the doses people consume for their pleasurable effect are within the safe range long term.
I am sure based on the available evidence cannabis is less harmful than alcohol, but it’s so unproductive that any research on its harms is immediately shouted down by fans who want to pretend it’s “water”.
The thing is we don't know without doing more research, which I genuinely appreciate the authors essentially calling out point blank. They're not saying cannabis is bad, they're saying that looking at the thin amount of valid data we have available thus far, there's definitely a correlation there worth investigating further.
> I've smoked cannabis daily for maybe 15 years [...] Visited a cardiologist like two months ago and have perfectly fine heart despite the smoking.
And that was a physical change. Heart attacks happen because of electrocardiac issues as well.
Trust doctors with a grain of salt. There are many bad doctors that market themselves as good doctors, but are in reality terrible providers.
I recently had a scare, where I was encouraged by two separate general practitioners to seek immediate care with an ophthalmologist. I visited the ophthalmologist who I was referred to and they said everything was great, then booked my next appointment for a year out. Four days later, I started losing vision in my right eye.
After visiting a competent ophthalmologist, they were flabbergasted by what the other did. Ten appointments within 2 weeks later with the new specialist and we're undoing the damage that was easily preventable.
In short, some doctors are borderline DANGEROUS, but it's difficult to distinguish them with the ample legal protections they receive.
Anyhow, hope your brother recovered well.
This is likely even more true in modern times with such high rates of anxiety and other similar disorders paired alongside the internet - there's going to be a lot of hypochondriacs suddenly thinking, and subsequently claiming, that they have every symptom of [something awful].
Doctors have very little in the way of legal protections, but malpractice has to actually be malpractice. A recent study on the topic found that in low risk occupations, 75% of doctors end up getting sued for malpractice over their career, and in high risk it bumps up to 99%. [1] When people don't like the outcome, they sue, but in most cases the outcome was largely unpreventable even with a high standard of care.
[1] - https://www.reuters.com/article/us-doctors-idUSTRE77G5YS2011...
i.e. is there a symptom, question or quick, cost-effective and reliable test that can distinguish horses from Zebras in this situation.
A: Doctor
Bingo.
Some medical practitioners were the bottom of the class.
No different than mechanics.
Can’t hero-worship.
Eeesh...sorry about that. Been there my whole life. It too ten years to get an appointment with a Hematologist and was finally diagnosed with Erythrocytosis which I told them I had but always said my HCT levels were "not really that high". The Hematologist looked at my records and wondered why they did not send me in twenty years ago. I am on Medicare which makes it much more difficult.
> Anyhow, hope your brother recovered well.
My whole family disowned me for no other reason than me having a serious mental illness so I do not care. But thanks.
Mostly it's been smoking, though I've had access to edibles and was lately impressed by cannabis beverages that contain 10mg of THC and some CBD that give an experience competitive to drinking alcohol. I find it easy to not use it if is not around, but once I get into it I will keep using it and quitting is a few days of hell followed by almost forgetting it ever existed. But maybe I get depressed a bit a few months later and think "I will feel better if I use" and then I will use for a few weeks to months, start feeling strung out and quit. Never dabbed, I haven't found a vape I like the way I like smoking but for me it has always been green weed, not extracts. It is legal to grow in NY and I know enough amateur and pro growers who owe me a favor that I rarely have to pay for weed and don't expect to ever go into a dispensary.
I do know that I gain/lose several kg of wait depending on if I am using cannabis. Despite being rather athletic and having a lot of lean muscle mass I have many signs of "metabolic syndrome" including somewhat high blood sugar, blood pressure, etc. [2] I am off cannabis now and just started Zepbound which I am hoping will help with my metabolic syndrome.
[1] once i got into a biosignals hobby and started looking at EEG traces to evaluate heart rate variability where I often can't make out the P wave on a two or three lead ECG, how can you say 20 beats out a million were bad with any accuracy?
[2] with somewhat aggressive pharmacological treatment including high dose fish oil without which my triglycerides would have another 0 on the right; showed up my docs with a sheaf of pubmed abstracts, switched to Montelukast as my asthma controller because it may be cardioprotective whereas my academic advisor and galactic astronomer Edwin Salpeter and his daughter wrote a paper finding LABAs are probably the opposite; my pulmonologist switched me to using a LABA/Steroid inhaler for rescue because a recent study has shown that the holy grail of "just one inhaler" has been attained for a lot of people and the LABA isn't much slower to hit than Albuterol. Also added Nebivolol as a BP med which I think should be more popular than it is.
https://en.wikipedia.org/wiki/Smoke_Two_Joints
by the Toyes!
Yet I only see about .5-1% of the population in my area these days wearing any kind of mask/N95 respirator in public.
This is flat wrong, but also a demonstration of how far the Back To Normal propaganda propagated, because it's a common misconception. They protect both; especially at an N95 level of filtration.
> B - what % of the population leaves the house when they feel sick enough that they should wear a mask?
For starters, ~40% of COVID infections are asymptomatic (and still carry the same aforementioned long-term risks).
Anybody curious might consider scanning the sticky posts on /r/zerocovidcommunity for more information and links to external sources.
Growing up I definitely knew some people who had their demons who turned to drugs.
However we also had a lot of people who were in good situations who picked up drugs for purely recreational reasons. One of my friends at the time even boasted that drugs were actually more appropriate for people like him who were educated, in good situations, and rational (his description of himself) because they knew how to manage themselves and their usage better. He even had links to some subset of the rationality community who had become pro-recreational drugs with a lot of justifications.
His turn to drug use marked the end of his promising academic career. He started struggling with mental health in ways that were obviously related to the drugs. Holding a job had never been a problem until he starting smoking, which marked his turn toward job struggles. His friends and family relationships started declining and falling apart.
He’s not the only one I know like this. The first person I knew who had to go to rehab for drug addiction was a happy, successful guy who started using drugs as a way to party more and for longer. He thought his life was awesome and he was invincible.
I think there’s become a belief that drug use is purely a symptom, but I’ve seen enough people go from happy to falling apart as an obvious result of the drug use. Most of the people I know who started using drugs didn’t do it at their homes in private to cope, they started doing it at parties with friends.
This is even well known with alcohol: There is common belief that being a “social drinker” is a different risk profile than someone who does their drinking alone.
I think it’s a comforting idea that we tell ourselves that nobody chooses to use drugs, they are driven to do so by circumstances out their control. We like removing blame from people and hoisting it on to the world. I don’t think it’s always true, though. Many people use drugs because drugs are rewarding (at first) and they like the way the drugs make them feel. The negative consequences come later.
I can have fun without drugs.
Yes!!! I love this approach! unironically
The US a survival society where the first time you trip, you're fixed to that level unless you have benefactors.
Going on an actual calorie restricted diet while consuming cannabis is basically impossible for me.
Then instead of walking 60 minutes I end up sitting and listening to music.
There is really not anything for me that correlates with healthy behavior when I smoke.
Set and Setting are also relevant too. If you do it a soecfic way with other soecific tools and activities while on it, that all gets packaged and reinforced.
As the other comment says: set and setting. And it works both ways, you can take some memento with you, and when you're being quiet and introspective and you're feeling good fondle some fob: a keychain, a rosary, buddhist prayer beads, some macrame you're working on, it doesn't matter. Point is later when you're in a different situation, you can replay that ritualistic behavior and it will probably reach in and remind your body, which will then remind you mind. This is human nature: it's known that e.g. humans remember / forget things when passing through doorways, and some forms of acting use cues like this especially for emotional resonance.
Well, Id guess these are reasons for any case of substance missuse?
I have not met ANY regular drug user (regardless which drugs), who didnt had "frictions with parents" early in their life. (and some for which its still persisting into their 40ies)
I am lonely. Weed makes me to fucked to care.
I’m not sure what the first sentence is after, but this one reminded me of Michael Phelps.
^^ many of those are boring people.
but sure, still lets make to account by other "legal" substances (alco, tobacco, cocaine, pharmaceutics and other "lifestyle choices" infecting cardiovascular system) and way they are consumed(smoked, ingested, pure or with say tobacco)
would love see data for a group who consumes cannabis by ingestion and especially not via smoking!
also- do they differ different thc/cbd grades used (high/low thc, "medical")?
im regards "research demonstrates something does this.." for many years alcohol was considered "healthier" over non consumption, just becauses non-drinkers were together with those of abstinent ex-alcholics.. thus average score was lower than for those who drunk minimal amounts and were considered "healthier".
Hemp, meaning very low THC, higher terpene (read as: “essential oils“ and CBD content, is for you (and most!).
i find if you persist with it, the anxiety goes away and then you feel cannabis cured me!
I would assume that cannabis use correlates with a few other important heart health variables and we would expect the odds ratio to be lower when accounting for those (alcohol doesn't have an OR more than 1.0, tobacco smoking ~1.5)
I'm sure that cannabis use is bad for cardio health but the reported odds ratio is very high. I personally do not use cannabis.
Anecdotal of course, many could probably bring up counter-stories too, but I do think you bring up a good point, it seems to me a completely sedentary lifestyle seems to be way more destructive to your health than moderate usage of various drugs and/or eating habits. People who just walk a bit daily already seem way healthier and happier than peers in their same age.
At some point in time, it's important to realize that not everyone optimizes for longevity, correctness, rationalism, and so on, and they just simply do what makes them feel good within the limited life that they have.
Nothing is intrinsically harmless. Cannabis can be devastating. But I was just sitting here doing work one day, got a hemorrhage in my eye, and lost half the sight in it. Otherwise, I'm supremely healthy. The cause: a gene.
That's just wrong. Why do you think their force retirement ages are so low?
So why don't we?
Edit:
Realized this comment sounds like fear mongering, so decided to dig up some actual sources. The wiki page I needed to find was:
https://en.wikipedia.org/wiki/Effects_of_cannabis
Also, the CDC page mentions it:
https://www.cdc.gov/cannabis/health-effects/heart-health.htm...
And links to this paper (though I can't read past the abstract bc no institutional access):
There's a mind body connection that an altered state can throw into disarray.
Under the influence of cannabis, one may be a lot more aware of physical pain, dehydration, and so on. The key word is aware. Suddenly becoming aware of the fact that you are stressed out, you are carrying tension, can lead to something of a latent processing effect of some of these suppressed or physically felt emotions.
However, if you're generally not tense, ingesting cannabis itself does not always raise the heart rate. I can validate this myself right now, given I wear an Apple Watch and can vaporize cannabis. Looking at my historical data, there is no relationship, and my resting heart rate remains in the 40s.
It's anecdotal, but at the same time we need to be careful with something that acts on the physical, the mental, and dare I say it, the spiritual. If we focus too much on one dimension, we lose the important synergy from processing all dimensions.
From what I have seen, there are no side effects at all. They go back to smoking when the opportunity arises, but that's another story.
You haven’t seen enough.
Worth trying a tiny dose, from what I understand.
Exploring what he’s self-medicating (and if it can actually be addressed otherwise), is worthwhile, too.
Brain and body/physiology are careful balancing acts!
People quit cigarettes without incident, too!
There's always been a pragmatic center on cannabis, especially if you're somewhere where it's legalized.
In Canada, we have legal cannabis.
https://www.canada.ca/en/health-canada/services/drugs-medica...
When it was legalized, there was a documentation push and clear presentation of the downsides. In fact, as above, the language is mostly presented in the negative.
This matches the general sentiment of the broad population.
And let's not conflate things. The article is discussing smoked cannabis. This does not invalidate the essential substance and benefit of the experience. If we remove the ingestion method from the basket of effects, it's a different discussion.
Not all positive, yet smoking is clearly not good for you.
Full stop, no matter what it is.
Substances approved by the FDA are done based on specific treatments, with multiple trials and approval per use case
Substances declared scheduled are illegal by the substance itself, instead of per use case
paradoxically because there is no FDA approved use case and almost no way to get one
meaning that places in the US that diverge in legality and are ignored by the federal government have done so without any clinical trial, which would be some level of peer reviewed objective information by use case instead of the whole substance
we can’t even get a simple list of side effects, or a disclaimer about what kind of users shouldn’t use it
only anecdotes
that annoys me and it’s not just about weed
(Literally the person currently responsible for the branch of government that keeps illegal drugs out of the country is an investor in a Kratom company)
https://www.med.stanford.edu/news/all-news/2022/04/marijuana...
Now I stimulate the Vegas nerve in the morning and at night with breathing regiments
Its hard to quit as there is a lot it does for you neurologically like caffeine does but I finally realized it was giving me neuroinflammation and wrecking my sleep quality so I stopped. Likely other long term health problems but those are harder to see/feel.
Now my body does biphasic sleep and I journal at night and read books. Never liked to do either. Get crazy amounts of energy now and people constantly comment on the difference in me.
Goodluck, you can in fact regulate this shit out of your daily habits if you find a way to do a cellular reset. Its not easy.
I quit smoking cigarettes and checked drinking way way easier than cannabis
I blame the Ritalin to adderall to wellbutrin train of drugs for most of that but certainly cannabis served a purpose for me and likely kept me "healthier" in ways but its also not a good long term play
I feel "high" now just being sober it's pretty nice
[1] https://link.springer.com/article/10.1186/s42238-025-00277-9
After the experience I felt kind of weird and "slow" for several days. Later I found out that there is also a genetic risk of schizophrenia in my family. No way I'm going to touch anything with THC ever again. I've tried CBD oil though and that was okay, slightly calming effect. But ultimately I prefer beer over that too.
We (general West) have no overarching myth or support system to help people navigate this type of pure madness. We have a psychological framework, and anything that interferes with our capacity to construct an I, a me, an ego in real time is seen in the most ultimately negative terms. And the experience is terrifying, such to support these terms.
Though, if through meditation, through religious constructs, or similar, there is a learned capacity to sit with the experience, it is considered less of a breaking and more of a liberation.
Wouldn't recommend it, wouldn't prescribe it. Though this decoupling of self from experience isn't a universal ill.
I think weed should be legal and for the majority of people used in moderation it's going to be fine, but at the end of the day it's a psychoactive drug. It's probably not optimal to use it daily and in particular waking and baking every day is asking for trouble.
Also a case to be made that modern strains are worse. I fully believe that the risk of losing the plot is higher when you're smoking some lemon sherbet bubblegum flavours every day instead of old fashioned moroccan hash
it's as stupid as smoking/vaping and not even black box warnings will get people to stop
now if you need pain management I can respect that 100%
but you need to investigate Palmitoylethanolamide and Geraniol as alternatives
Yes, people want to recreate, doing all kinds of activities with various levels of risk. They don't need to concern themselves with whether you can respect it.
It seems to me that cannabis users aren’t seeing the benefits of the aforementioned group. My experience of cannabis stoners is that it’s used to numb out and for escapism, which certainly aligns with what you’re saying.
there are far better, legal supplements to treat that anyway, less expensive too
dope activates AMPK in the brain/CNS and turns off AMPK in the body/heart it's an incredibly stupid thing to do to yourself (also why people get "the munchies")
literally why it's called dope (before dope meant "cool")
Marijuana is dirt cheap compared to any prescription medication, at least in the US.
about the 'study': I do not trust anything that comes out of meta studies given how many base studies are found to be either garbage or very lacking in controls. And without knowing an accurate life history it is hard to rule out or quantify damages done much earlier in life.
I don't think blanket advice like this is helpful. For me indicas increase my anxiety significantly while sativas do the opposite.
While not universally true, it seems that many of the sativas for sale are very high THC which probably is a primary factor. Other factors are terpenes, though there is still a lot of debate on whether it these are real or imagined effects.
Moderate THC (15-20%) indica or indica dominant hybrid flower, using a flower vape, IMHO, is the best way to go. Always a good idea to read strain reviews prior to purchase (or growing) as people will note those that have caused them to be anxious, sleepy, hungry, horny, etc.
People can also have very different reactions when taking a drug (weed, shrooms, lsd, etc) alone vs with friends, something to consider as well.
[Strain sativa/indica can sort of be an indicator, but going by the dose of each active ingredient is the more scientific approach]
Point being, ymmv.
Gummies and other edibles though require processing in the liver before they become active in the body (they are converted to a slightly different form of THC) so you would need to consider whether there are any negative effects on liver health from edibles and then compare to the various 'inhaled' methods.
General friendly advice - for anything not flower, try to get things that are made by live rosin (not resin) as they are the cleanest and should not involve the use of any hydrocarbon solvents for extraction. Live resin would be next, though it does use hydrocarbons. Distilliates which are often in vape cartridges are almost always made with hydrocarbons. While the production method shouldn't matter if everything is done 100% properly, it does require trust that all the butane, etc has been fully removed from the final product.
i don't beleive edibles are any safer
> Since both studies were limited by their retrospective nature and the meta-analysis was limited by the challenges inherent in pooling data from multiple studies, researchers said that additional prospective studies would help to confirm the findings and determine which groups may face the highest risk.
Here's the thing that both the alarmists and the naysayers keep ignoring: all this data is new, it's recent, and decades of effective global prohibition have meant the only sources of reliable data came from either post-war/pre-prohibition studies (often by Defense Departments) or from "anecdata" gathered retrospectively among large cohorts. We still lack a substantial amount of direct, quality, long-term data on drug use and Nth-order impacts on the body, and these studies are the first steps towards getting more data from higher quality research to draw better conclusions from.
If anything, I try to be quite open with my Doctors about my own use precisely because I know that data is thin and dated, and any contributions from patients in an honest manner is going to help draw better conclusions for healthcare guidance tomorrow. Letting alarmists use these thin precursors as justification for a return to total prohibition is the wrong move.
What I like more is some of the people that will agree with me would crucify if the topic was about ADHD meds.
All noise, zero signal, anytime pot (especially) or other drugs are mentioned.
https://en.wikipedia.org/wiki/Rimonabant
which blocks the receptor that THC binds to and led to weight loss and further improvements of the “metabolic syndrome” beyond weight loss alone. Unfortunately it caused major depression in some people including suicide.
So looking at it that way it would be no surprise that cannabis causes weight gain and metabolic syndrome and in fact my experience is that if I am using cannabis I get a few kg. I think that is the THC and on top of that if you are smoking you are inhaling small particles that turn your blood into sludge (e.g. your blood is a “complex fluid” with cells in it that can be damaged) and doing damage to your lungs and capillaries and promoting inflammation and all that.