Methadone weight gain is not a myth. Working as a counselor at a methadone clinic I saw patients gain up to 50 pounds in 4 months. I also saw many patients who didn’t experience methadone weight gain. There were commonalities in the patients who gained a large amount of weight.
There were also commonalities in the ones who didn’t. In this article I will provide you with a list of these similarities. I will also teach you the absolute best strategies for avoiding methadone weight gain.
Furthermore, this will include a plan for losing unwanted methadone weight gain you might have already accumulated.
So the question is “does methadone cause weight gain?” And the answer is “yes…….and no.” I’ll get to the reason for this a little later. First, I believe it’s important to share some of my patients’ experiences with methadone weight gain.
Methadone Weight Gain Stories
I can recall many accounts of patients who gained weight on methadone. Both male and female patients were at risk. From my observation, and also from speaking with the patients, females appeared to experience more methadone weight gain than males.
They were also much more psychologically devastated by it. The men who I saw gain the most weight usually put on 5-20 pounds after being on methadone for 2-6 months. Many of them stated they didn’t mind the extra weight.
There was one patient, however, that ended up gaining over 40 pounds in less than a year. He was already overweight when he started treatment, and had the classic endomorph body type. He went through a severe depression as a result of the methadone weight gain. He almost lost his girlfriend of several years in fact.
The women on methadone seemed to have a harder time. The ones who I saw gain the most weight usually put on 10-50 pounds. Unfortunately, they didn’t hide the new weight as well as the men did. It also appeared to impact their lives negatively much, much more.
One female patient gained 50 pounds in 4 months. She came into treatment as a slender opiate abuser wanting to get clean. She experienced methadone weight gain faster than anyone else I know about.
It completely destroyed her self-confidence. It eventually led her to getting off methadone through another method.
I ran into her a few months later and she stated that not only was she sober, but she had also lost nearly all the weight she had gained on methadone, except for about 10 pounds.
These are the two most drastic cases mentioned above. They are by no means the norm or what one should expect.
I will add that a lot of patients, both male and female, didn’t gain an ounce. Some even lost weight! To effectively teach you how to avoid methadone weight gain, I will start by providing you with my clinical observations.
My Clinical Observations
Patients who Experienced Methadone Weight Gain
I found certain patterns in the patients that experienced methadone weight gain. I also noticed many similarities in the patients who didn’t gain weight.
The majority of patients who experienced significant weight gain:
- Were on 80 mg and above, with the most significant weight gain occurring over 100 mg.
- Had massive cravings for sweets and junk food, and gave in to these cravings on a regular basis.
- Were female, though many males gained a lot of weight as well.
- Didn’t get much exercise, if any.
- Didn’t eat enough fruits and vegetables.
From my clinical observation, the biggest factor determining who would experience methadone weight gain was the amount of methadone medication they were taking. Many times I heard patients say they wished they would have stopped at 70 mg.
Due to the ease of getting a dose increase, it’s extremely common for patients to take more methadone than is needed. They accomplish this by telling the doctor they are still experiencing cravings and/or withdrawal symptoms on their current dose. Patients frequently bend the truth to get more methadone. This came back to haunt many patients who experienced methadone weight gain. The short-term euphoria from a dose-increase isn’t worth the weight gain and other side effects.
Patients who Avoided Methadone Weight Gain
Here are the main similarities of the patients who didn’t gain weight, only put on a few pounds, or lost weight:
- They were on less than 80 mg, with around 40-50 mg being the most optimal dose for not putting on weight.
- They didn’t experience horrible cravings for sweets, although they still tended to have cravings nonetheless.
- They ate less calories and healthier foods than the patients who experienced methadone weight gain.
As I mentioned earlier, the single most important factor is the amount of methadone medication the patient was taking. Also, patients that tended to be thin and small-boned entering treatment had a much easier time avoiding methadone weight gain. Patients that tended to be less thin and bigger boned had a much harder time avoiding the unwanted weight.
Why does Methadone Cause Weight Gain?
First off, I want to explain the difference between methadone weight gain and regular weight gain from getting sober. It’s extremely common for people who quit abusing opioids to put on some weight. This is often due to them consuming more daily calories than they did while they were in active addiction.
I remember my experience with weight gain when I quit using heroin. I’m 6’2″ and got down to about 155 pounds by the end of my addiction. After I stopped my opioid abuse I got up to about 180 pounds within 2 months. I even have a fast metabolism and still gained 25 pounds. This was after only using 40 mg of methadone for 8 days straight to quit heroin once and for all. It’s important to note that my resting, normal weight is right around 180 pounds. My body simply balanced out.
If you gain weight on methadone, it’s important to ascertain whether it’s “healthy weight gain”, meaning it brings you back to your optimum weight. However, if you are one of the patients who goes well beyond this point into the 30-60 pound increase range, you should analyze whether or not the methadone could be affecting you, as well as any other medications you’re currently taking, prescribed or not.
Methadone can cause weight gain due to the following side-effects:
- It has the ability to slow your metabolism down.
- It can cause water retention.
- It can give you massive cravings for foods that are high in sugar and fat, which can indirectly lead to weight gain.
- It can be constipating, and without adequate daily elimination of wastes this can result in weight gain.
It’s also important to remember that the more you increase your dose, the more these factors listed above come into play. For instance, let’s say a woman on 40mg has minimal sugar cravings and no weight gain whatsoever. She has a sister who is her identical twin. Her twin decides to keep going all the way up to 140 mg. She ends up gaining 30 pounds in a few months and her self-esteem is ruined due to her negative view about her new body image.
This is a complicated matter. Some patients simply do not stop using illicit opioids on low or even moderate doses. I frequently had patients that were on anywhere from 100-150 mg that stated a high dose was the only way they could stay clean. In these cases I am a proponent for high doses. I’ve literally seen this approach save peoples lives, families and careers.
It’s when the high doses cause unwanted methadone weight gain or other side-effects that it begins to be a problem. Two female patients immediately come to my mind.
Their situations were almost identical. They both were about 5’3″. They were thin when they entered treatment. At about 70-80mg they had gained about 10 pounds each, bringing them back to their optimal body weight. They kept getting cravings so they went up to well over 100mg. Within a few short months they both had gained around 50 pounds. They were absolutely crushed.
On the one hand they were happy to be free of addiction and cravings, on the other hand they were depressed about their new body. It pained me greatly to watch this happen. I will also mention that they frequently told me how much cookies, donuts and other junk they ate due to the bad cravings for sweets.
One even stated that she would wake up in the middle of the night on a regular basis and go to the kitchen to eat a big plate of cookies before going back to bed…….without forgetting to wash it all down with a big glass of milk!
I could totally relate with her due to my previous addiction to Valium and other benzos. Those pills made me constantly crave frappacinnos, pizza, cookies, milk, bacon cheeseburgers with fries……you name it! Food cravings are hard to resist. Food is a powerful drug and should be taken seriously
If you’re suffering from methadone weight gain, there is a chance you could have Opioid-Induced Endocrinopathy. Below is a quote from the article Opioid-Induced Endocrinopathy, written in The Journal of the American Osteopathic Association:
Concern has grown regarding the adverse consequences of opioid treatment, which range from fatigue and depression to sexual dysfunction. Opioid-induced endocrinopathy is one of the most common yet least often diagnosed consequences of prolonged opioid therapy. Sustained-action opioids used on a daily basis for more than a month have a number of adverse effects on human endocrine function.”
I highly recommend reading the entire article. It’s extremely complex, and you’d probably have to be a doctor to understand it completely, but you should be able to get the general idea nonetheless.
Common symptoms of Opioid-Induced Endocrinopathy include:
- Decreased libido
- Weight gain
- Decreased muscle mass
- Erectile dysfunction
- Menstrual irregularities
- Vasomotor instability
Note: If you’re experiencing any of these symptoms on sustained action opioids such as Suboxone, Methadone, time-released Rx opiates etc., you can talk to your doctor about getting checked for opioid-induced endocrinopathy. They will run some tests which include, but are not limited to, measuring your testosterone and other hormone levels.
Currently, the most prescribed treatment for Opioid-Induced Endocrinopathy is:
- Males – Testosterone supplementation
- Females – DHEA supplementation
*Also, rotation to a different opioid is sometimes beneficial, particularly for women.
How to Avoid Methadone Weight Gain
There are several things you can do to decrease your chances of gaining unhealthy weight while starting methadone treatment.
I have arranged them in order of importance for your convenience:
- Have your doctor examine you for Opioid-Induced Endocrinopathy.
- Keep your dose below 80 mg (as long as it’s enough to stabilize you physically and mentally), keeping in mind that 40-50 almost always prevents massive weight gain.
- Eat plenty of fresh fruits, veggies, beans and other foods that are high in fiber; this can help you go to the bathroom on a daily basis and stay at a healthy weight.
- Consider taking the recommended supplements at the end of this article; they are effective at reducing constipation and sugar cravings.
- Eliminate high calorie junk food as much as possible; if you enjoy an occasional treat it’s fine, just don’t eat them at 3 am!
- Get plenty of moderate exercise; even something as simple as going on a 30 minute brisk walk a few times a week will help.
How to get rid of Methadone Weight Gain
Perhaps you’ve already experienced methadone weight gain and are looking for a way to lose the weight. I would suggest using all the strategies I mentioned above for starters. If you are on a high dose and think you can stay clean, you might consider talking to your doctor and counselor (if you attend a clinic) about decreasing your medication.
Developing a strategic tapering schedule could be a good start towards losing unwanted methadone weight gain. If you decide to taper, check out my article Tapering Methadone: Tips for Success. It should really help you devise a taper protocol. It will also teach you other things you can do in your life to have a much easier time tapering methadone.
Finally, don’t stress about your weight! I know this is easier said than done, but stress can cause weight gain. Exercise can help reduce stress, increase metabolism and reduce sugar cravings, which all promote weight loss. Be sure to get adequate exercise while trying to get rid of methadone weight gain.
There are many factors at play which can cause unwanted weight gain while undergoing methadone treatment. By implementing the strategies listed above you should be able to eliminate or significantly reduce the amount of weight you gain while taking methadone. Along with implementing these strategies, there are some highly effective natural supplements that can help you along the way:
- Good Belly Big-Shot 50 – This is the most powerful probiotic supplement available, containing 50 billion live active cultures of beneficial intestinal bacteria per serving. It helps counteract methadone’s constipating affect.
- L-Glutamine – An amino acid that can help to reduce sugar cravings.
- Vitadone or Nutridone – These are multivitamin supplements that are specifically created for people on methadone. I had patients tell me it helped with methadone side effects like sweating, low energy and sugar cravings.
*Remember to always consult with your physician before starting any new supplements.
Now you have all the information you need on methadone weight gain. Please feel free to leave a comment if you need any questions answered.