Feasibility and Tolerability of Nabilone for the Treatment of Obesity: A Randomized Controlled Pilot Trial
Bibliographic record
Abstract
Introduction: In epidemiological studies, people who use cannabis have a lower prevalence of obesity. Furthermore, the endocannabinoid system is recognized as a potential target for obesity treatment and partial agonism of the cannabinoid type-1 (CB 1 ) receptor may reduce body weight. We thus hypothesized that 12 weeks of pharmacotherapy with the partial CB 1 receptor agonist nabilone would reduce body weight, relative to placebo, in adults with obesity. Methods: We conducted a randomized, double-blind, placebo-controlled pilot clinical trial that investigated the feasibility, tolerability, and efficacy of 12 weeks of treatment with nabilone compared with placebo in adults with obesity. Otherwise healthy adults aged 25–45 years with obesity were randomized in a 1:1:1 ratio to one of three parallel treatment arms: high-dose nabilone (6 mg/day), low-dose nabilone (2 mg/day), or placebo. Safety and feasibility outcomes included adverse events (AEs), number of dropouts, and medication adherence per treatment arm. Efficacy outcomes included body weight, body mass index (BMI), and waist circumference. Secondary outcomes included gut microbiome changes, blood biomarkers (e.g., glucose and insulin levels), and mood. Results: Overall, 18 participants were randomized and 15 participants received at least one dose of drug (4 high-dose arm, 5 low-dose arm, 6 placebo). The trial was terminated early due to poor tolerability of the medication (e.g., all four participants allocated to high-dose nabilone withdrew due to AEs). Only eight participants completed per protocol (four in the low-dose arm and four in the placebo arm). Using data from completers only ( n = 8), we saw a significant treatment effect on body weight ( p < 0.001) and BMI ( p < 0.001) that appeared to be driven by greater decreases in the low-dose arm ( n = 4) relative to placebo ( n = 4). Based on the Bray–Curtis dissimilarity, the low-dose arm showed a greater change in the overall fecal microbiome composition compared with the placebo arm ( p < 0.05). Discussion: This pilot trial found poor tolerability of nabilone pharmacotherapy (especially at 6 mg/day) for adults with obesity who had not used any cannabinoid drugs for 6 months prior to enrolment. Preliminary results suggest a possible impact of nabilone on the gut microbiome.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".