Sana Toor, FCLC 2025

MAJOR: Natural Sciences

BIO: I am a junior majoring in natural sciences with a concentration in cell and molecular biology on the pre-medical track. I am a research assistant to Dr. Natasha Burke at the Fordham Burke Health and Wellness Lab. I also earn my pre-medical clinical hours as a certified EMT at Fordham University EMS (FUEMS) and Richmond County Ambulance and hold the treasurer position at LCEMS. Lastly, I worked as a producer for a neuroscience-based podcast called "Exploring Reality, Maybe."

PROJECT TITLE: The Effect of Marijuana Use on Appetite: A Literary Review of Cannabinoid Hyperemesis Syndrome and the Endocannabinoid System

MENTOR: Natasha Burke, Department of Psychology

ABSTRACT: Cannabinoid Hyperemesis Syndrome (CHS) is a recently identified condition characterized by episodic vomiting in long-term, daily marijuana users. This review explores the underlying mechanisms and potential co-morbidities associated with CHS. Chronic marijuana use in some users can lead to desensitization of cannabinoid receptor type 1 (CB1) and TRPV1 receptors, as well as alterations in endocannabinoid enzymes. The research focuses on 18 CHS cases, analyzing demographics, cannabis use patterns, and symptomatology.

The biphasic effects of marijuana, dose-dependent outcomes, and distinctions between CHS and Cyclic Vomiting Syndrome are discussed. Cannabis is regarded as an antiemetic as well as a pro-emetic, indicating dose-dependent paradoxical outcomes in nausea and vomiting. Additionally, The endocannabinoid system's involvement in appetite regulation is highlighted, suggesting potential links between cannabis use and eating disorders. Several case reports which are reviewed in this study explore the unique intersections of cannabis use and anorexia nervosa in women, highlighting the complex interplay between substance abuse, appetite regulation, and disordered eating behaviors and emphasizing the need for further research in this area. 

Correctly diagnosing patients with co-morbidities of substance abuse and eating disorders, such as CHS, is crucial due to overlapping symptomatology. Attributes such as severe emesis, weight loss, morning sickness, and long-term cannabis use can mimic or be misinterpreted as symptoms of other conditions, including eating disorders like Bulimia Nervosa. Identifying the specific etiology is essential for effective treatment and management strategies, emphasizing the importance of thorough evaluation and differential diagnosis in patients presenting with cyclic vomiting and substance abuse histories.