Obesity and Drug and Alcohol Addiction

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obesity and alcohol
Substance abuse and addiction are both linked to many other disorders and ailments. Mentally ill individuals are more likely to be substance abusers than the general population, as are individuals who live in poverty or grow up with substance abusing parents. These factors have become common knowledge over the years; however, some factors are frequently overlooked, such as the link between substance abuse and obesity. It runs deep, and many are unaware that the two factors influence one another and often perpetuate each other’s growth. Among American adults aged 20 or older, 35.7 percent are considered to be obese, and 6.3 percent are extremely obese.[1] Obese is classified as having a body mass index of 30 or higher.

Supporting Evidence

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A 2011 report noted West Virginia had the most drug-related overdose deaths out of any American state, at 28.9 per 100,000 people.[2] In addition, rates of obesity are highest in the Mountain State, too. It was tied with Mississippi in 2013 with 35.1 percent of adults being obese.[3] Furthermore, 15.6 percent of high school students, 18.5 percent of the 10-17 age group, and 14 percent of those 2-4 years old in low-income families are obese.[4]

A national poll of adults taken in 2011 regarding their top health concerns for children today resulted in childhood obesity being the number one worry at 33 percent, followed by drug abuse in the number two slot, also at 33 percent.[5] How often do obesity and substance abuse intertwine? Among bariatric surgery candidates in one study, 32.6 percent reported a history of lifetime substance use disorders — a rate more than two times the general population.[6]

In another study, 54 percent of individuals in a residential alcoholism treatment program were obese or overweight.[7] In fact, addiction and obesity are so bound to one another that newer research on the latter is bringing to light a new question altogether — is obesity the result of a food addiction? At the root of both, dopamine receptors respond abnormally to a stimulus — in either case, drugs/alcohol or food — and the reward system induces a continual desire to keep seeking the good feelings that come from feeding cravings. Between 1990 and 2013, rates of alcohol misuse among the obese population have doubled from 6.2 percent to 14.3 percent.[8]

Causation or Correlation?

Much the same as the chicken and the egg, it’s hard to say which comes first — substance abuse or obesity. The truth is that it’s not clear-cut for everyone; some people will start out overweight and some will end up that way. Substance abuse can contribute to obesity. Some substances can actually ramp up a person’s appetite and cause the person to binge eat, often at abnormal hours.

Individuals with binge eating disorders (BED) may be more likely to be obese, with 30.1 percent of participants in one study of BED patients participating in weight management programs.[9] BED is likely more common among substance abusers than the general population, too. In fact, per the American Psychological Association, up to 60 percent of those with an illicit drug use problem also have mental health issues.[10]

Likewise, BED may be far more common among substance abusers than the general population. In a study of females in treatment for alcohol abuse, 36 percent had BED.[11] One substance known for producing trademark “munchies” is marijuana. Research shows heavy marijuana users actually consume 40 percent more calories than non-marijuana users.[12] The plant-based drug is actually used medicinally for ill patients who have diminished appetites they need help regaining. Among cancer patients taking THC — the active ingredient in marijuana — 64 percent reported an increased appetite versus only 50 percent among those taking placebos.[13]

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Other drugs may actually help a person lose weight, such as stimulants like Adderall and methamphetamine. In fact, a lot of people abuse them on purpose to try and take advantage of the weight loss effects, which occur by way of a decreased appetite and accelerated heart rate. Known for boosting energy levels and turning the average suburban housewife into something of a supermom, a range of people – from the typical street dealer to the carpool driver – have been abusing Adderall for a while now.

Sales for Adderall XR more than doubled between 2002 and 2007, from 4.2 million to 9.5 million.[14] While this method of weight loss may work for some substance abusers, a serious downside follows it. First and foremost, this method of weight loss isn’t sustainable, even if the drug is continually abused. Over time, the body will grow tolerant of the stimulant drug and stop dropping pounds. This is in addition to the myriad of health issues that occur due to stimulant use.

Other addicts may abuse diet pills to attempt to lose weight. Many will use over-the-counter diet supplements like Alli or other caffeine-based diet pills and drinks, all the while believing they’re safer because they’re OTC. It is entirely possible to get hooked on these drugs though.

Of specific concern are prescription weight loss medications, such as phentermine. This drug acts as an appetite suppressant, and it is actually quite similar to methamphetamine in its chemical structure. In the last decade, the Food and Drug Administration has locked down on this specific drug rather harshly due to people buying it illegally, mostly on the Internet. It is intended to be prescribed to patients who qualify as obese and have a body mass index of 27 or more, but some weight loss clinics and doctors around the nation continue to prescribe it to thin individuals. During the time that the individual is losing weight, she is actually destroying her metabolism. Thus, after a period of weight loss, she will start packing on pounds and may very well end up heavier than she was to begin with and have an even harder time shedding those extra pounds.

Is Mental Illness a Factor?

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Mental illness may very well play a role in the development of obesity. Certain mental health disorders are more prevalent among the obese population, specifically depression. A 2014 study touted that 43 percent of adults suffering from depression in America were also obese, and this number jumped to 55 percent for those who were taking antidepressants.[15] We already know there is a strong correlation between mental health disorders and substance abuse. Around 37 percent of all alcoholics and 53 percent of all drug addicts have at least one serious mental health disorder.[16]

Self-esteem might have a pretty important role in the development of substance abuse disorders as well as mental and physical health issues. Case in point, one study reported that 11-year-old children with very low self-esteem were 1.6 times more likely to meet the criteria for a diagnosis of addiction by age 20.[17] The National Association for Self-Esteem publishes, “Low self-esteem either causes or contributes to neurosis, anxiety, defensiveness, and ultimately alcohol and drug abuse.”[18]

Behind the scenes of obesity, the overweight individual is often unhappy with his appearance, as well as how he feels. Negative self-perceptions easily lead to negative behaviors like drug or alcohol abuse. These feelings can also lead to the development of mental health disorders. Those who deal with obesity are at a 25 percent increased risk for dealing with mood and anxiety disorders,[19] and around 20 percent of Americans with mood or anxiety disorders have substance abuse problems.[20]

A good number of the obese population of America came to be overweight due to environmental inputs that slowly changed the way they viewed themselves and what the world expects from them. Fat-shaming pictures are everywhere; celebrities can’t gain or lose weight without being scrutinized for it. Pregnant women are even made fun of in the media if they don’t maintain a certain figure while carrying their babies. And if someone loses too much weight, rumors of eating disorders and/or drug abuse are rampant. In a world where you can’t win, what are you supposed to do?

Many people grow up battling weight issues their entire lives that leave emotional scars far deeper than outsiders understand. Some people will turn to drugs and alcohol to numb the way they feel about themselves or to cope with the way others have made them feel.

Genetics and Food Addiction

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Substance abuse in your family can predispose you to obesity later in life. In one study, women who had a history of alcoholism in their family were nearly 50 percent more likely to be obese than women who did not have this history.[21]

Among those who are obese, overeating is a common problem. Many people are totally unaware that food addiction is a real and treatable disorder. A 2014 study noted that 5.8 percent of female participants met the criteria for food addiction.[22] Contrary to popular belief, food addictions are commonly seen in both anorexic and bulimic patients. In fact, estimations of co-occurring eating disorders and substance use disorders are proof of this. In one study, 27 percent of individuals suffering from anorexia nervosa had a lifetime history of a substance use disorder, 36.8 percent of bulimic individuals did, and 23.3 percent of those with binge eating disorders.[23] Likewise, people with one addiction are more likely to develop another.

Synchronistic Treatment

The addiction treatment experience doesn’t have to be unpleasant. Withdrawal can certainly be an uncomfortable experience, especially if you don’t have trained support by your side helping you to get through it. Medicated-detox and alternative therapy options can actually make your detox experience pretty comfortable, and the entire process should be overseen by consulting physicians.

Drug and alcohol abuse poses serious risks to your health, and being obese only compounds those risks. Obesity remains the second-leading cause of preventable deaths in the nation, with around 300,000 dying from obesity-related causes every year.[24] During treatment for addiction, patients can also tackle the issues that may make them more inclined to overeat, eat the wrong foods, or skimp on physical activity. Sometimes the medications certain people are on — when already treating co-occurring disorders — can be a source of the problem when it comes to stubborn weight gain. A simple change in medication may result in the desired weight loss.

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Others will benefit from psychotherapy to help break the food patterns they’ve developed over the years and retrain themselves to eat right. Even bariatric surgery is a viable treatment option, and one that a reported 113,000 people take advantage of annually in the United States.[25] Interestingly, individuals recovering from bariatric surgery are at an increased risk of cross-addiction — transferring their food addiction to another substance — with 9.6 percent of 1,945 of these patients meeting the criteria for an alcohol use disorder two years after surgery, up from 7.6 percent prior to surgery.[26]

Being obese puts one at higher risk for:

  • Developing type II diabetes
  • Suffering from cardiac troubles
  • Developing insulin resistance
  • Having a stroke
  • Predisposal to joint and bone pain
  • Developing sleep apnea
  • A heightened chance of developing certain cancers
In treatment, patients can learn how to feed their bodies with nutrition that fuels them. Likewise, they can learn which foods to avoid and how certain foods can affect mood negatively. With the help of personal trainers and nutrition experts, patients can strengthen their resistance to relapse.

Citations

[1]Overweight and Obesity Statistics.” (2012 October). National Institute of Diabetes and Digestive and Kidney Diseases. Accessed April 8, 2015.

[2]Prescription Drug Abuse: Strategies to Stop the Epidemic.” (2013 October). Trust for America’s Health. Accessed April 8, 2015.

[3]West Virginia.” (n.d.). The State of Obesity. Accessed April 8, 2015.

[4] Ibid.

[5] Velardo, M. (2011 August 16). “Drug abuse equals child obesity as top health concerns.” Accessed April 9, 2015.

[6] Barry, D., Clarke, M. & Petry, N. (2009). “Obesity and Its Relationship to Addictions: Is Overeating a Form of Addictive Behavior?” American Journal of Addiction. Accessed April 8, 2015.

[7] Ibid.

[8] Sansone, R. & Sansone, L. (2013). “Obesity and Substance Misuse: Is There a Relationship?” Innovations in Clinical Neuroscience. Accessed April 8, 2015.

[9] VanBuskirk, K.A. & Potenza, M.N. (2010). “The Treatment of Obesity and Its Co-occurrence with Substance Use Disorders.” Journal of Addiction Medicine. Accessed April 8, 2015.

[10]Comorbid Drug Abuse and Mental Illness.” (n.d.). American Psychological Association. Accessed April 8, 2015.

[11] VanBuskirk, K.A. & Potenza, M.N. (2010). “The Treatment of Obesity and Its Co-occurrence with Substance Use Disorders.” Journal of Addiction Medicine. Accessed April 8, 2015.

[12] Thomas, J. (2001 June 11). “Marijuana Munchies Mean Meager Menus.” HealthDay. Accessed April 9, 2015.

[13] Chan, A. (2011 February 23). “Marijuana’s Active Ingredient Improves Cancer Patients’ Appetites.” Live Science. Accessed April 9, 2015.

[14] Newman, J. (2008 August 20). “Speed diet: Women using ADD drugs to get thin.” NBC News. Accessed April 9, 2015.

[15]Obesity and Depression Often Twin Ills, Study Finds.” (2014 October 16). Health Finder. Accessed April 9, 2015.

[16]Substance Abuse and Co-occurring Disorders.” (n.d.). National Alliance on Mental Illness. Accessed April 8, 2015.

[17] Elish, J. (n.d.). “Sociologists find low self-esteem at age 11 predicts drug dependency at 20.” Florida State University News. Accessed April 9, 2015.

[18] Reasoner, R.W. (n.d.). “Review of Self-Esteem Research.” National Association for Self-Esteem. Accessed April 8, 2015.

[19]Obesity associated with psychiatric disorders, decreased odds of substance abuse.” (n.d.). PsychCentral. Accessed April 9, 2015.

[20]Substance Abuse.” (n.d.). Anxiety and Depression Association of America. Accessed April 9, 2015.

[21] Zeltner, B. (2012 September 18). “Children of alcoholics face increased addiction risk, other health problems.” Cleveland.com. Accessed April 8, 2015.

[22] Gunnars, K. (n.d.). “How Common is Food Addiction? A Critical Look.” Authority Nutrition. Accessed April 9, 2015.

[23]Clients with Substance Use and Eating Disorders.” (n.d.). Substance Abuse and Mental Health Services Administration. Accessed April 9, 2015.

[24]Food for Thought: Obesity and Addiction.” (2012 April 20). Brain Facts. Accessed April 9, 2015.

[25] Livingston, E.H. (2010 September). “The incidence of bariatric surgery has plateaued in the U.S.” American Journal of Surgery. Accessed April 9, 2015.

[26] King, W.C., Chen, J.Y., Mitchell, J., Kalarchian, M., Steffen, K., Engel, S., Courcoulas, A., Proies, W. & Yanovski, S. (2012). “Prevalence of alcohol use disorders before and after bariatric surgery.” JAMA. Accessed April 8, 2015.

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