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Does Methadone Maintenance Cause Weight Gain?

Published on December 2, 2020
Methadone Maintenance Cause Weight Gain Man stepping onto a scale to check his weight

Medication-assisted treatment (MAT) is one of the most effective ways to lower the rising death toll caused by opioid addiction and overdoses. 

The following are approved medications to be used in opioid addiction treatment:

  • methadone
  • buprenorphine
  • Suboxone (buprenorphine and naloxone)

One of the most common concerns with methadone maintenance treatment is weight gain. Weight gain can be dangerous if it isn’t managed because it can lead to serious health complications.

How Does Methadone Work?

Methadone is an opioid agonist that activates receptors in the central nervous system, the same receptors as other opioids like heroin, morphine, and oxycodone. When methadone attaches to these receptors, it alleviates withdrawal and drug cravings.

However, methadone is slower acting and does not produce pleasurable effects if you are opioid dependent and take maintenance level doses. 

Does Methadone Cause Weight Gain?

All opioid medications share common side effects such as sedation, dizziness, and headache. However, many individuals experience weight gain as one of the side effects of methadone. 

According to the National Library of Medicine, a study of 96 individuals on methadone treatment reported changes in body weight as the biggest complaint. 

Studies also show an average of 10 lbs of weight gain during the first six months of treatment and 17.8 lbs in about two years of treatment. 

Body Mass Index (BMI)

One of the ways medical professionals can determine if someone is at a healthy weight is by using the body mass index formula. Your BMI is calculated by dividing your weight in kilograms by the square of your height in meters. 

The Centers for Disease Control (CDC) provide a calculator online for adults and children, which will tell you if you are in a healthy range. 

Individuals on methadone generally experience at least a 5% increase in their BMI while being on methadone. Females typically gain significantly more body fat than males, almost three times the amount. 

Factors Associated With Weight Gain

Individuals who suffer from opioid dependence or opioid use disorder (addiction) may live unhealthy lifestyles. 

In active addiction, your main focus is obtaining and using your drug. 

Healthy diets, exercise, relationships, and responsibilities are often neglected. Many individuals enter treatment with significant weight loss. 

Lifestyle Changes

A common characteristic of someone in detox and early treatment is being underweight and malnourished. There is a possibility that some of the weight gain on methadone treatment can be assumed comes from a change in diet and lifestyle. 

You and your health care providers can determine if your weight changes are healthy or becoming problematic.

Sugar Cravings

Chemical reactions in the brain can account for the sugar cravings and preference for carbohydrates. The opioid receptors that methadone attaches to are associated with increased preference for sweet foods when they’re activated. 

An increased sugar intake can lead to numerous health issues including:

  • obesity
  • diabetes
  • insulin resistance 

Water Retention

Methadone is also associated with edema, which is swelling from excess fluids being trapped in the body. Water retention from methadone use can be treated by drinking plenty of fluids, exercising, and reducing salt intake. 

Physical Activity Levels

Your methadone clinic will determine the dose that is best for you and your situation. It should be enough to prevent withdrawal symptoms but not enough to produce a high. 

Even though it doesn’t produce pleasurable effects, it can cause extreme sedation which may limit activity levels in those on high doses. If you are craving sugary foods and not exercising or moving enough, it could impact your weight. 

How To Manage A Healthy Lifestyle 

Substance abuse can cause serious consequences to your overall health. Most people stay on methadone treatment for years because it allows them to live a healthy lifestyle. 

Methadone treatment is linked with:

  • reduced criminal activity
  • eliminates the need for illicit drug use
  • lower rates of death and overdose
  • improved relationships
  • improved physical and mental health

Gaining weight on methadone is a manageable side effect and should not be a reason to stop your treatment program. Always discuss any concerns with your doctor but in most cases, the benefits of methadone outweigh the risks. 

The following are ways to stay healthy if you are on methadone:

  • drink plenty of water
  • eat plenty of whole grains, which contain fiber and can help you stay full and diminish sugar cravings
  • exercise regularly, such as taking walks, which can increase dopamine in your brain and help you cope with early recovery

Most importantly, you should keep open communication with your treatment center and doctors about any concerns you may have about weight gain while taking methadone. 

Please contact Ark Behavioral Health if you would like more information about other treatment options.

Written by Ark Behavioral Health Editorial Team
This page does not provide medical advice.

Centers for Disease Control & Prevention (CDC) - Body Mass Index (BMI)
National Library of Medicine - Increases in body mass index following initiation of methadone treatment
National Library of Medicine: MedlinePlus - Substance use recovery and diet
PubMed - Weight gain and edema on methadone maintenance therapy

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