The US Food and Drug Administration permits the use of the drug Marinol for treatment of two things: weight loss and the vomiting and nausea connected with chemotherapy. For patients with HIV, a slight loss of even 5 percent of their normal body weight is oftentimes a threat. Death due to wasting happens when patients’ weight plunges, with the loss exceeding one third of their average body weight.
AIDS wasting syndrome is defined by the Centres for Disease Control and Prevention as the “involuntary loss of more than 10 percent of body weight.” It is accompanied by diarrhea or fever lasting more than 30 days, and it is not connected to other forms of illness. Cachexia and starvation are two different physiological occurrences that, when combined, cause wasting to happen.
Cachexia happens when there is tissue injury, which results in an uneven loss of lean tissue mass (for instance muscle or liver). A similar process also transpires during the late stages of cancer. On the other hand, starvation is the result of nutrient or food deprivation. This results in a depletion of body fat even before lean tissues become run down. The difference between the two processes is that while starvation can be treated by eating, cachexia necessitates controlling the disease that prompted it and synthetically stimulating the metabolism of the body.
Possibly as a result of the body’s response to viral infection, people actually begin losing muscle and some lean tissues prior to developing full-scale AIDS, research indicates. Some opportunistic infections such as ulcers of the throat, esophagus, or mouth make eating difficult. Some infectious organisms cause diarrhea, which decreases nutrient absorption, as with the overpopulation of microbes that innately dwell in the digestive tract. Fatigue, poverty, and depression may worsen malnutrition in patients suffering from AIDS.
The benchmark therapy for wasting due to AIDS concentrates on enhancing the patient’s appetite, most of the time using megestrol acetate (Megace) and Marinol, which is prescribed far less often. According to clinical studies, Megace encourages weight gain in a more effective manner than Marinol. Patients do not get any additional benefit by combining the drugs. Megace intakers usually increase their food consumption by approximately 30 percent but typically gain back mostly fat rather than muscle mass or lean tissue. Similar to Megace, Marinol has the ability to reverse starvation, but it has no effect on cachexia. t is presumed that the same holds true with marijuana.
At present, only THC is the single cannabinoid that has gone through evaluation in the clinic for its influence in enhancing appetite, thus counteracting the wasting caused by AIDS. AIDS patients as well as other cancer patients who used Marinol in combating wasting and chemotherapy-induced nausea reported that they would rather smoke marijuana than swallow THC. For them, smoking permits them to inhale just the right amount of the drug to ease their symptom. Patients also mention “the munchies,” which is popular among marijuana users and is also documented in the laboratory experiments of healthy, normal adults who increased their appetite and also gained weight while taking marijuana. It is unfortunate, however, that there have been no controlled research studies on the benefits of smoking marijuana on appetite stimulation, weight gain, or body composition in patients with HIV. Although marijuana derivatives don’t seem to overturn cachexia, they could potentially form part of a combined treatment for wasting that would help boost patients’ food intake while they go through physical therapy.