Assessing the relationship between body mass index and substance craving among patients with substance use disorders

The aim of this study was to assess body mass index (BMI) category as a predictor of substance craving in people with substance use disorder (SUD) participating in 5 clinical trials.

BMI was categorized into 4 groups: underweight, healthy weight, overweight, and obesity. Craving assessments were harmonized to calculate comparable craving scores for each participant across trials. General linear mixed effects regression models were fit to final craving score where BMI was considered a main effect and clinical trials as a random effect while also controlling for demographic and clinical characteristics of the participants.

1,418 participants were included in the final sample. Participants were primarily male (68.97%), and mean age was 39.73 years (SD: 11.38). Obesity (β = 0.59; p = 0.73) and overweight (β = 1.65; p = 0.29) were not significantly associated with final craving score while controlling for covariates. Baseline depression, age, and concomitant SUD medications were significantly associated with final craving score.

Although results indicate participants with obesity and SUD do not experience significantly higher craving for substances, more research is needed to uncover how this varies across different patient populations. Future studies should seek to include more comprehensive measures of obesity and eating behaviors to assess how these may impact substance craving and other SUD treatment outcomes. Level of Evidence Level III (Evidence obtained from well-designed cohort or case-control analytic studies).