Doctor warns of potential interactions between GLP-1 drugs and cannabis

An estimated 11% of Americans are taking a GLP-1 drug for weight loss or other medical conditions, while at least 13% of people in the U.S. say they use marijuana. 

With both drugs rising in popularity, a physician and cannabinoid specialist is sounding the alarm on the potential interactions between cannabis and GLP-1s for a small percentage of people who use both. 

What to know about GLP-1s and cannabis

Big picture view:

Dr. Jordan Tishler, a cannabis physician and president of the Association of Cannabinoid Specialists, said he believes it’s important for doctors to ask their patients about cannabis use before prescribing a GLP-1. 

That’s because both drugs slow stomach emptying, which could lead to bloating and discomfort in mild cases, and in rarer instances nausea and vomiting, both of which are already listed as potential side effects when taking GLP-1 drugs.  

What they're saying:

"I mean, cannabis gets at the moment a fairly rosy glow, which medically speaking, it's a very useful substance, but no medicine is scot-free," Tishler said. 

RELATED: Hospital visits rise among frequent marijuana users with severe nausea, vomiting

"You know, we like to think of our brains as being the big bunch of neurons, right? And we tend to think of our gastrointestinal tract as kind of a tube, right," Tishler explained. "But it turns out that there are as many neurons in the GI tract as there are in our brains. I don't know exactly what that means in the grand scheme of things, but the idea that cannabinoids would have a significant effect on your GI tract one way or the other, just as they do with our central nervous system, makes a lot of sense."

For people with diabetes, the risk could be greater, Tishler explained, because diabetes also sometimes causes delayed stomach emptying, or gastroparesis. 

Based on his clinical observations thus far, Tishler said he doesn’t believe the issue is a medical emergency, but it’s something he hopes doctors and public health experts will study more so they can educate their patients. 

"I think it's more a matter of nuance that my colleagues in medicine need to just be forewarned so that, you know, before you write the prescription for a GLP-1, you say to the patient, what are your other medications? Does it include cannabis?" Tishler said. "You know, in a very non-judgmental way, of course, but just to say, look, you know, these medicines can interact with other medicines and I need to understand everything that you're taking in order for me to give you good advice. 

"And the advice probably is still take the GLP-1 along with your cannabis and, you know, I can't put a number, but I would guess it's in the high 90 percent, you're going to be fine, right?" he continued. "But you want to warn the patient so that if something does come up, then they can come back to you and say doc, you know what? You’re right. This became a problem for me."

How do GLP-1 drugs work? 

The backstory:

GLP-1s is a class of drugs that include semaglutide (Ozempic, Wegovy, Wegovy pill), tirzepatide (Mounjaro and Zepbound), and orforglipron (Foundayo). They were initially prescribed to treat Type 2 diabetes, but have soared in popularity because of weight loss. Wegovy, Zepbound and Foundayo are FDA approved for weight loss, while Ozempic and Mounjaro are approved for Type 2 diabetes. 

The drugs work by mimicking the actions of hormones, found primarily in the gut, that kick in after people eat. The hormones help regulate blood sugar by triggering the pancreas to release insulin, another hormone, and slowing the release of sugar from the liver. People who are overweight or have obesity can become insulin-resistant, which means the body doesn’t respond to insulin properly.

The obesity drugs lower blood sugar and slow down digestion, so people feel full longer. They also affect signals in the brain linked to feelings of fullness and satisfaction, tamping down appetite, food-related thoughts and cravings.

Because people feel full longer, they eat less and lose weight.

However, it appears that if people taking the drugs stop, most regain the weight they lost — and the health problems that come with weight gain.

What is cannabis hyperemesis syndrome? 

Dig deeper:

As cannabis becomes legal in more states and more people use it daily, the Centers for Disease Control and Prevention recently warned Americans about a rise in cannabinoid (or cannabis) hyperemesis syndrome, also known as CHS. It’s an often debilitating condition that affects a small but growing number of chronic marijuana users. 

RELATED: Cannabis hyperemesis syndrome: Marijuana-linked condition on the rise

People with CHS experience severe nausea and vomiting, in some cases 20-24 times a day. It can last days or even weeks and is hard to control – often the only thing that brings relief is a hot shower or bath. 

Diagnosing cannabis hyperemesis syndrome 

In National Library of Medicine literature, doctors outlined the following criteria for diagnosing CHS: 

• Long-term cannabis use (often daily)
• Cyclic nausea and vomiting
• Relief when stopping marijuana
• Hot showers/baths relieve symptoms
• Abdominal pain

By the numbers:

Past research has suggested that an estimated 2.75 million Americans suffer from CHS each year, and that hospital emergency room visits have been rising as daily recreational marijuana use has increased. According to the CDC, the condition is being discussed more now because it got its own diagnostic code in October 2025. 

Some experts believe the condition has been underdiagnosed, possibly because doctors may not have understood patients' marijuana use or because they attributed the suffering to a different illness. 

The other side:

Tishler, however, said he believes the opposite is true: that ER doctors are over-diagnosing CHS.

"It's become a little bit of a knee-jerk problem," he said. "If you're vomiting and you go to an emergency room or urgent care and you actually tell them that you're using cannabis, there's a high likelihood they're going to pin the problem on cannabis without bothering to really think this through."