Why is Weight Gain So Common After Rehab?

You may be one of the 65 percent of people who have gained weight after rehab. Almost 20 percent of individuals who have been able to fight their addiction to drugs or alcohol have found themselves becoming obese after rehab and many more struggle with an eating disorder, compulsive overeating or what is now being called “food addiction.”

Weight gain during recovery can be a significant source of personal suffering leading to relapse. It can also contribute to health consequences such as diabetes, heart disease and high blood pressure later in life.

Why do so many people struggle with weight gain during recovery? Here are six of the most common reasons:

  • Drug addiction and overeating have similar effects on the brain. Repeated use of drugs or repeated consumption of what are called “highly palatable” foods (processed with added sugars, salt and fat) activate the brain’s reward center, stimulating the release of the natural opioids and triggering the release of dopamine – making us feel good. This behavior may represent a “replacement” of food for the drug of choice. Substituting food for drugs or alcohol over time may lead to compulsive overeating and weight gain.

  • If you are in recovery from drugs or alcohol, you may have a reduction of dopamine receptors in the reward center of the brain that leads to lack of impulse control and trouble with emotional regulation. These brain changes don’t instantly improve when you stop using. In the absence of drugs for this reward mechanism, food becomes the next best thing.

  • Just as stress is known to be a significant risk factor for relapse from drug addiction, research has repeatedly shown stress to be a risk factor for overeating. For vulnerable individuals (with genetic risks for obesity), stress can lead to compulsive overeating and to obesity.


  • Few SUD treatment programs actively screen their incoming clients for eating disorders. It is not uncommon that when a person is in recovery from SUDs, their eating disorder may become more active.-Dr. Carolyn Coker Ross

  • Having a history of a substance use disorders (SUD) also puts you at higher risk for disordered eating and eating disorders. Few SUD treatment programs actively screen their incoming clients for eating disorders. It is not uncommon that when a person is in recovery from SUDs, their eating disorder may become more active. Almost 40 percent of women in treatment for SUD meet criteria for an eating disorder. Men in treatment also experience binge eating and weight gain, especially in the first six months and admit to using food to satisfy cravings for drugs or alcohol (Czarlinksi, et al., 2012; Cowan and Devine, 2008). If you are like the 24.8 percent of women and men diagnosed with binge eating disorder you may also have a substance use disorder (Grilo, et al. 2009).

  • Untreated depression or anxiety may also lead to overeating. Nutritional deficiencies that are associated with chronic drug or alcohol use can actually contribute to the development of substance-induced mood disorders as discussed below. Treatment for mood and anxiety disorders or for attention deficit disorder may lower the risk for overeating related to these common co-occurring disorders.

  • It’s not just the fact that 12-step meetings offer foods high in sugar and caffeine that leads to overeating. You may have noticed that you tend to crave specific foods high in sugar, fat or salt since you stopped using. These changes in taste preferences are supported by research and of course, have an ugly downside of weight gain.

Despite recent research about the importance of nutrition as part of recovery, it is still uncommon for treatment facilities to offer nutrition or lifestyle education. Although there is little research on this topic, Cowan and Devine (2012) were able to show that nutrition education and changes in diet offered to men in a residential treatment program improved eating habits and reduced weight gain during recovery. While it is important to put your recovery from drugs or alcohol first, there are steps you can take to improve your overall health and well-being.

Despite recent research about the importance of nutrition as part of recovery, it is still uncommon for treatment facilities to offer nutrition or lifestyle education.-Dr. Carolyn Coker Ross

Tips for Health and Wellness During Recovery:

  • Eat three meals and one snack a day. Make sure you eat protein at every meal and snack to increase your brain’s ability to make the feel good chemicals (neurotransmitters) like serotonin, dopamine and norepinephrine. Eating regularly throughout the day makes it less likely that you ‘ll binge eat at that late night AA meeting or when you get home from a stressful day at work. While it takes some planning, it is worth it to help your body heal from all it’s been through while you were using.

  • Be sure to include lots of vegetables and fruits in your diet. Eating these foods in their natural state (not juices) will give your brain the sugar boost it is craving in a way that doesn’t make you crash an hour later like donuts and other processed sweets do.

  • More Supplements with Doctor Approval 5-hydroxytryptophan (5-HTP) is the precursor to serotonin and can help with depression and with insomnia.

    Tyrosine is an amino acid that is the precursor for dopamine (your reward neurotransmitter).

    Taurine is an amino acid that helps with liver function and with anxiety.
  • Take supplements to replace nutrients that are usually missing or deficient in people with addiction. You can get most of these vitamins in a good multivitamin supplement. Recommendations include a B-Complex vitamin every day. The B- vitamins are needed to make the neurotransmitters discussed above. Vitamin D – take 2,000 to 5,000 IU daily to support mood and improve immune function. Omega 3 Fatty Acids help you think more clearly, make better decisions and have been associated with lower rates of depression and lower suicide attempts. Supplements also support your gut function. You may have noticed constipation or digestive problems when you were drinking or using drugs. Poor gut function is not just a nuisance, it can affect your mood and also your immune function. For gut function take: probiotics and the amino acid glutamate -1,000 mg daily.

  • Most important of all may be something most of us don’t pay much attention to – sleep! Most addicts struggle with sleep issues for over a year after they stop using. You can try 5-HTP as above or use Melatonin. But nothing is better than good sleep habits. Go to bed at the same time and get up at the same time. Form bedtime rituals – something you do that helps you relax before you go to sleep. This could be reading a relaxing book, listening to music or taking a long walk.

  • Don’t let spirituality only be about your higher power in AA meetings. Spend time in nature. Learn to meditate. Take a yoga class. Practice breathing exercises. All of these activities connect you with spirit, and a connection with spirit is the best way to improve your health and wellbeing.

Recovery is a special journey, but one that can’t be made without a healthy body, mind and spirit.




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