Methamphetamine Use for Weight Control: A Grounded Theory Analysis of Online Narratives

Methamphetamine (MA) use is associated with significant physical, psychological and social harms. Although appetite suppression and weight loss are well-known effects of MA, weight control remains an underexamined motivation for use. This study aimed to develop a theoretical understanding of how individuals initiate and sustain MA use for the explicit purpose of weight management.

Using a constructivist grounded theory approach, we analysed publicly available online narratives posted to an anti-methamphetamine website between 2009 and 2013. Narratives were purposively sampled from a larger corpus of submissions if they explicitly referenced MA use to lose weight, suppress appetite or maintain thinness. Data were analysed using iterative coding, constant comparison and theoretical integration.

Analysis suggested several recurring processes and narrative patterns through which participants described weight-motivated MA use: (i) longstanding body dissatisfaction and disordered eating vulnerabilities; (ii) social exposure to MA through peers or family members who normalised its weight-loss effects; (iii) risk-reward appraisals in which weight concerns outweighed perceived danger; and (iv) reinforcement through rapid weight loss, perceived control and identity affirmation, often followed by shame and regret over time.

Findings highlight how sociocultural thinness ideals, social networks and emotional regulation processes converge to make MA use appear rational and necessary for some individuals. Prevention and treatment efforts should address body image distress, peer normalisation of stimulant use for weight control and shame-based barriers to recovery.