Cocaine Use Linked to 'Profound' Metabolic Change

Recovering Addicts May Experience Dramatic Weight Gain

Megan Brooks

August 14, 2013

Long-term cocaine use causes profound metabolic changes that reduce the body's ability to store fat, keeping users lean, but setting them up for potentially dramatic weight gain during recovery, new research suggests.

"Our findings challenge the widely held assumptions that cocaine use leads to weight loss through appetite suppression. Rather, they suggest a profound metabolic alteration that needs to be taken into account during treatment," Karen D. Ersche, PhD, from the Behavioural and Clinical Neuroscience Institute at the University of Cambridge, in the United Kingdom, said in a statement.

The study was published online August 3 in the journal Appetite.

The study team examined the body composition, diets, and eating behaviors as well as plasma leptin levels of 65 adult men; 35 of them were cocaine dependent, and 30 had no personal or family history of illicit drug use.

"We found that cocaine-dependent men reported a preference for fatty foods and carbohydrates as well as patterns of uncontrolled eating, but their body fat was significantly reduced compared with those in their non–drug using peers," Dr. Ersche told Medscape Medical News.

Relapse Factor?

The researchers also found that the longer the men had been using cocaine, the lower their plasma levels of the hormone leptin, which helps regulates appetite and energy use.

"A decrease in plasma leptin together with a high fat diet suggests an impaired energy balance, leading to weight gain rather than weight loss," Dr. Ersche said.

Dr. Karen Ersche

"We believe that chronic cocaine abuse directly interferes with metabolic processes, resulting in an imbalance between fat intake and storage. This dysfunction in fat regulation is likely to be unnoticed in clinical practice, and it could lead to excessive weight gain when the active use of cocaine is discontinued during recovery," she added.

The stress caused by this "conspicuous body change can also contribute to relapse. It is therefore important that we better understand the effects of cocaine on eating behavior and body weight to best support drug users on their road to recovery."

"This research has clear implications for our understanding of how the body processes fat during chronic cocaine dependency and also how the body adjusts during withdrawal and recovery from dependency," Professor Hugh Perry, chair of the Neuroscience and Mental Health Board at the Medical Research Council, who was not involved in the study, said in a statement.

"Credible scientific studies like this one, which help to dispel misconceptions and address common preconceptions with reliable data, can only benefit individuals in the longer term," he added.

The study was funded by the Medical Research Council. The authors report no relevant financial relationships.

Appetite. Published online August 3, 2013. Full article

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