Obesity and substance misuse: is there a relationship?

Area of Science:

• Behavioral Science
• Epidemiology
• Neuroscience

Background:

• The link between obesity and alcohol/drug misuse is complex, with varying findings across studies.
• Recent data indicate increased alcohol misuse rates among the obese since 1990.
• Drug misuse rates among the obese are comparable to the general population.

Purpose of the Study:

• To synthesize findings from site and epidemiological studies on obesity and substance misuse.
• To determine if obesity is a significant risk factor for alcohol and drug misuse.

Main Methods:

• Review of 19 site studies on alcohol misuse in obese populations.
• Analysis of 7 studies on drug misuse in obese populations.
• Examination of 5 large epidemiological studies, including National Comorbidity Survey Replication data.

Main Results:

• Alcohol misuse rates among the obese have doubled since 1990 (6.2% to 14.3%).
• Average drug misuse rate among the obese is 8.0%.
• Large epidemiological studies do not consistently support higher substance misuse risk in obese individuals, except for specific subgroups (e.g., those with Cluster B personality disorders).

Conclusions:

• Overall, obesity is not clearly linked to increased substance misuse risk compared to the general population.
• Potential explanations for observed associations include overlapping neurohormonal correlates.
• An alternative hypothesis suggests food and drugs compete for brain reward pathways, potentially making obesity protective against substance misuse.