In much the same way that first-year college students gain the dreaded freshman 15, people struggling with alcohol or drug addiction have been known to gain 15 to 20 pounds or more in the early months of recovery.
Beyond concerns about physical health and self-image, poor dietary habits also have been linked with a greater risk of relapse. Is weight gain an inevitable part of getting sober?
Your Body on Drugs
Drug abuse poses a dual threat to the body. First, the substance itself impairs the body’s ability to fight off illness, filter toxins, build and repair organ tissue, convert food into energy, and otherwise function normally. Second, drug abuse goes hand in hand with problematic lifestyle changes, such as poor dietary choices, lack of exercise and irregular eating patterns. There are unique nutritional considerations for each class of drugs:
- Alcohol: Heavy drinkers tend to replace nutritious food with the empty calories of alcohol, deriving as much as 50 percent of their daily calorie intake from alcohol. This results in nutritional deficiencies (namely thiamine, vitamin B6 and folic acid), which can cause anemia and dysfunction in the nervous system. Even if a heavy drinker eats “real” food, alcohol interferes with the body’s ability to break down and metabolize nutrients. Alcohol also impairs the ability of the liver and pancreas to remove toxins from the body, absorb fat and regulate blood sugar. These problems make it imperative for alcoholics to be tested for iron, protein and electrolyte imbalances and, in women, osteoporosis.
- Opiates: A common side effect of opiate abuse (heroin, morphine, prescription painkillers) is constipation. During withdrawal, recovering addicts may experience nausea and diarrhea, which can lead to malnutrition and electrolyte imbalances.
- Stimulants: People taking stimulant drugs (cocaine, methamphetamine, ADHD medications) experience suppressed appetite and may go without eating for extended periods of time. When they arrive in treatment, they are often severely malnourished and dehydrated.
- Marijuana: People who abuse marijuana are at risk of the opposite problem: an increase in appetite that may result in weight gain.
Reversing the Damage
While some experts believe that a dietary overhaul should be secondary to the daunting process of getting sober, I believe a healthy lifestyle is part of recovery.-Carolyn RossWhile some experts believe that a dietary overhaul should be secondary to the daunting process of getting sober, I believe a healthy lifestyle is part of recovery. They are not two separate issues; rather, they are part of one overarching goal to address the underlying issues preventing recovering addicts from having fulfilling, sober lives.
Because each individual is affected in different ways depending on their drug(s) of choice, it’s important to talk with a registered dietitian or nutritionist for specific recommendations. But for most people in early recovery, the following are important steps toward healing:
- Choose whole grains. Many people in early recovery (especially from alcoholism) stock their kitchens with salty, sugary, fatty processed foods. In part, this is because their bodies have grown accustomed to, and thus crave, simple carbohydrates. Especially for alcoholics, a sugar high or low can trigger powerful alcohol cravings. Replace simple, processed carbs, which further burden the liver, with whole grains that are rich in antioxidants and fiber. They’ll keep you satisfied and energized, and can also help combat constipation and other digestive issues.
- Beware of cross addiction. In some cases, people in recovery from drug or alcohol addiction gain weight because of cross addiction to food, especially sugar. The brain craves a dopamine release to feel normal, whether it comes from drugs or food or other compulsive behaviors. Instead of using food to fuel the body, it becomes a replacement coping strategy when their primary strategy (drugs) is no longer available.
- Pack in the protein. Without adequate nutrition, the body breaks down muscle tissue to meet its nutritional needs, which slows metabolism, causes the body to store calories as fat, and makes it harder to maintain a healthy weight after getting sober. This is why it’s important to eat plenty of readily digestible lean protein, such as chicken, beans and fish. Protein helps us produce the feel-good brain chemical dopamine (the same neurotransmitter that becomes dysregulated in addiction).
- Eat regularly and moderately. To the brain, cravings for food – often brought on by blood sugar highs and lows – can be indistinguishable from cravings for drugs, increasing the risk of relapse. Eating regular meals throughout the day stabilizes blood sugar levels, reducing fatigue and mood swings and boosting energy. It also teaches the body that nutritious food is not scarce and thus it doesn’t need to store fat, allowing a healthy metabolism to be restored.
- Cut back on caffeine. Another way to minimize mood swings and combat the insomnia and anxiety people experience in early recovery is to cut back on caffeine (a stimulant that can make it difficult to fight cravings).
- Consider supplements. Drugs flood the brain with dopamine and other mood-boosting chemicals, causing it to stop producing its own. Amino acids – the building blocks of protein – are precursors to these feel-good brain chemicals, now in short supply in the brain. Strategic supplementation with amino acids (such as phenylalanine, which becomes tyrosine and is then converted to dopamine) and certain vitamins and minerals (for example, B vitamins, zinc and omega-3 fatty acids) can help restore normal function to the brain. For those recovering from drugs that heavily tax the digestive system, such as opiates, probiotics may help restore gut health. For more on supplements, see my website.
Protein helps us produce the feel-good brain chemical dopamine (the same neurotransmitter that becomes dysregulated in addiction).-Carolyn Ross
Strategic supplementation with amino acids (such as phenylalanine, which becomes tyrosine and is then converted to dopamine) ... can help restore normal function to the brain.-Carolyn Ross
Some of the physical damage caused by drug abuse can be reversed or at least mitigated. This is where nutrition education and counseling play a vital role in addiction recovery, markedly improving outcomes. Change what you eat, change how you think and feel – that’s good for you and good for your recovery.
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