Weight loss is actually one of the two signs by which the United States Food and Drug Administration has permitted the drug Marinol to be out in the market, the other is vomiting and nausea connected with chemotherapy. For patients with HIV, the slight loss, say, a little as 5 percent of their normal body weight oftentimes appear to be a threat and death due to wasting in general happens when patients plunge 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” which is accompanied by diarrhoea or fever lasting to more than 30 days and is not connected to other forms of illnesses. Cachexia and starvation are two different physiological procedures that when combined can make wasting happen. Cachexia happens when there is tissue injury and this result to an uneven loss of lean tissue mass for instance muscle or liver whereby 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 to 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 simply 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 muscles and some lean tissues prior to developing full-scale AIDS as per research indications. Some opportunistic infections such as ulcers of the throat, esophagus, or mouth make eating very hard. Some infectious organisms actually cause diarrhoea which decreases nutrient absorption, as is with the overpopulation of microbes that innately dwell in the digestive tract. Further, 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, with megestrol acetate (Megace) and Marinol which is prescribed rather far less often. According to clinical studies, Megace encourages weight gain in a more effective manner than Marinol; also patients do not get any additional benefit by combining the drugs. Megace intakers usually amplify their food consumption by approximately 30 percent but increase mostly in 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 and it is presumed that the same applies with marijuana.
At present, only THC is the single cannabinoid that has gone through evaluation in the clinic for its influence to enhance appetite and thus counter wasting caused by AIDS. AIDS patients as well as other cancer patients who experienced using Marinol in combating wasting and chemotherapy-induced nausea reported that they would rather smoke marijuana than having to 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 gained not only appetite but also weight whilst taking marijuana. It is unfortunate, however, that there have been no controlled researches on the benefits of smoking marijuana on stimulating appetite, gaining weight, or body composition in patients with HIV. Although marijuana derivatives don’t seem to overturn cachexia, they could be a potential in forming part of a combined treatment for wasting that would help boost patients’ food intake while they as they go through physical therapy.