Substance abuse and weight control: Do they really have opposing effects?

Abstract

Addiction to alcohol and cigarettes has been associated with being overweight and obese. Considering the compulsion for food and drugs may share the same neuronal pathway in the brain, this relationship is expected, but the empirical literature is mixed regarding directionality of the relationship between substance abuse and weight control, and it has never been studied directly. In order to address this gap, a systematic was conducted (quantitative) and resulted in a narrative report to summarize the effects of substance abuse treatment on body mass and the effect of weight control on substance abuse (due to the heterogenity of the studies designs, no meta-analysis was performed). Searches of PubMed, Web of Science, and CINHAL databases led to the inclusion of 9 studies out of 48 results. Three of these studies dealt with effects of substance abuse treatment on body weight, three dealt with effects of weight management treatment on substance use, and three studies dealt with both. Among the six studies testing drug interventions on smoking cessation only one increased body mass, while two of them reported a reduction in body weight and BMI of the abstinent subjects being treated, and three of them did not show any change at the intervention follow-up. The six studies testing interventions for weight reduction did not increase addiction to cigarettes or alcohol; and evidence from two of them these studies pointed to a higher number of smoke-abstinent individuals and reduced number of cigarettes per day with the intervention. The evidence collected from interventional studies showed that weight management and drug abuse treatment can be complementary to each other and may be a good combination to treat addiction in overweight and obese individuals. Considering none of the interventions designed for weight control led to increased addiction for substances, despite some risk of weight gain, the interventions did not lead to risk of increased substance abuse. • Most drug interventions for cigarette cessation did not increase body mass. • The RCTs showed reduction in body weight and BMI in abstinent subjects under drug treatment. • None of the diverse interventions aiming weight reduction, increase the addiction for cigarette or alcohol.