Cannabis Use Associated with Lower Prevalence of Metabolic Syndrome

A recently published study found that cannabis use is associated with lower prevalence of both metabolic syndrome (MetS) and abdominal obesity in individuals with schizophrenia (1). MEtS is common in schizophrenia and is characterized by multiple risk factors including obesity, hypertension, dyslipidemia, and insulin resistance, the study explains. The syndrome is linked with higher risk of cardiovascular disease and type 2 diabetes.

Some studies have associated cannabis use with better cardiometabolic health in the general population compared with non-cannabis users, yet is also associated with worse psychosis outcomes. Additionally, studies have suggested that cannabis users with psychotic disorders may have better metabolic health than non-users, indicating more research is needed on the relationship between recreational cannabis use and MetS in people with a psychotic disorder. The resulting study, “Cannabis use and cardiometabolic risk in schizophrenia,” was published in Schizophrenia Research in November 2025.

Study Design

The cross-sectional analysis involved 988 individuals with schizophrenia from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study, which was a multi-phase, randomized controlled trial conducted across multiple sites in the US between 2001 and 2004. These participants had provided a hair follicle sample for the testing of long-term use of THC.

Individuals with THC detected in the hair follicle were categorized as cannabis users, while those without THC were deemed non-users. As the study explained, using liquid chromatography-mass spectrometry (LC-MS), THC metabolites can be detected in a sample up to 90 days after use. Substance use was also collected in questionnaires.

Blood samples were also taken for lipid levels and body mass index was recorded.

Results: Lower MetS in Cannabis Users

The results indicated that the prevalence of MetS was significantly lower in cannabis users compared to non-users, according to data from hair follicle analysis and self-reported cannabis use.

Highlighted results include:

• The prevalence of MetS in this group was high (58.4 %)
• Out of the total number of participants, 146 (14.8 %) tested positive for cannabis, and 842 (85.2 %) tested negative
• Cannabis-positive participants also demonstrated smaller waist circumference, lower median weight, higher HDL levels, lower triglycerides, and lower resting heart rate

The link between cannabis use and lower prevalence of MetS remained even after adjusting for covariates.

Limitations to the Study and Conclusions

The researchers noted that the hair follicle analysis avoided recall bias, but it does not capture very recent exposure, dosage, potency, or use patterns.

Overall, the results pointed to a link between past cannabis use and MetS. “In summary, our findings demonstrate a significant association between cannabis use and a lower prevalence of metabolic syndrome in individuals with schizophrenia,” the researchers concluded.

The researchers advised that the association was not causality. Longitudinal data is needed to confirm the causality between the two, they noted, as well as a cautious approach to understanding the results. “The relationship between cannabis use and cardiometabolic health in schizophrenia is likely multifactorial, influenced by biological, pharmacological and behavioral traits that remain poorly understood,” they explained, also noting that MetS did not predict cannabis use in this study group. “These results highlight the need for a nuanced understanding of cannabis use in schizophrenia across all symptom and clinical domains, particularly as rates of use continue to rise. Future research should investigate the long-term cardiometabolic effects of both cannabis use and cessation, and assess the potential for targeted metabolic interventions during this critical period.”

Reference

1. Paris, J.; Laurendi, O.; Arnet, V.; Galletly, C. Cannabis use and cardiometabolic risk in schizophrenia, Schizophrenia Research, 2025. 287, 54-62, DOI: 10.1016/j.schres.2025.11.013.