Elsevier

Appetite

Volume 71, 1 December 2013, Pages 75-80
Appetite

Research report
The skinny on cocaine: Insights into eating behavior and body weight in cocaine-dependent men☆☆,☆☆

https://doi.org/10.1016/j.appet.2013.07.011Get rights and content
Under a Creative Commons license
open access

Highlights

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    Low body weight in cocaine users may not be due to the appetite suppressing effects of the drug.

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    Chronic cocaine users report higher levels of uncontrolled food intake than healthy volunteers.

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    Imbalance in fat intake and storage may explain the excessive weight gain during abstinence.

Abstract

There is a general assumption that weight loss associated with cocaine use reflects its appetite suppressing properties. We sought to determine whether this was justified by characterizing, in detail, alterations in dietary food intake and body composition in actively using cocaine-dependent individuals. We conducted a cross-sectional case-control comparison of 65 male volunteers from the local community, half of whom satisfied the DSM-IV-TR criteria for cocaine dependence (n = 35) while the other half had no personal or family history of a psychiatric disorder, including substance abuse (n = 30). Assessments were made of eating behavior and dietary food intake, estimation of body composition, and measurement of plasma leptin. Although cocaine users reported significantly higher levels of dietary fat and carbohydrates as well as patterns of uncontrolled eating, their fat mass was significantly reduced compared with their non-drug using peers. Levels of leptin were associated with fat mass, and with the duration of stimulant use. Tobacco smoking status or concomitant use of medication did not affect the significance of the results. Weight changes in cocaine users reflect fundamental perturbations in fat regulation. These are likely to be overlooked in clinical practice but may produce significant health problems when cocaine use is discontinued during recovery.

Keywords

Dietary food intake
Body weight
Fat regulation
Cocaine dependence
Anthropometry
Impulsivity–compulsivity

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Acknowledgements: The authors thank all participants for their contributions in this study, staff at the National Institute for Health Research (NIHR) Mental Health Research Network for their support with volunteer recruitment, and staff at the Wellcome Trust Clinical Research Facility at Addenbrooke’s Hospital for their help and support throughout the study. The authors also thank Keith Burling and Peter Barker at the NIHR Cambridge Biomedical Research Centre, Core Biochemical Assay Laboratory for performing the blood analysis. A special word of thanks goes to Heather Agyepong and Elisabeth Kent for their assistance with data collection, Laura Watson for her help with the anthropometric measurements, and Dr. Sadaf Farooqi for helpful discussion. We are grateful to the EPIC-Norfolk study team for support and the use of their software. This study was jointly sponsored by the Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge.

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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Copyright © 2013 The Authors. Published by Elsevier Ltd.