Are Your Pain Meds Causing Weight Gain?

Woman on scale

By Dr. Peter Abaci

Managing chronic pain on a daily basis can be challenging enough, but on top of that many patients with chronic pain are often faced with dealing with other significant chronic diseases at the same time. In fact, I have had countless patients over the years tell me that they developed medical problems like hypertension and diabetes only after their injuries occurred, and many report weight gains of 15-20 pounds after the onset of their pain problem. There can often be a strong association between typical pain disorders like arthritis, back pain, or fibromyalgia, with the occurrence of other common chronic health problems like diabetes, hypertension, heart disease, and obesity.

There are likely many reasons for this connection, including the body’s stress response to ongoing pain as well as pain related inactivity, but one potential factor that has gotten little attention is the use of common opioid-based pain medications like hydrocodone, oxycodone, and morphine. In fact research studies have found that medications that act on the body’s opiate receptors can have a sizeable effect on the metabolic state of the human body, leading to changes in things like body weight and potentially increasing the risk for cardiac problems and diabetes.

Consider these eye-opening results from a 2010 review looking at studies done on the relationship between opioid use and glucose activity:

  • Chronic opioid use is associated with increased dietary sugar consumption. Studies indicate that patients on opioids prefer to get more of their calories from sugary foods and less from whole grains, fruits and vegetables. The mechanism creating this sweet-tooth phenomenon is still unclear but it seems to show up in both humans and animal test subjects.
  • Long-term opioid use is linked to weight gain. This may potentially be a byproduct of eating more sugary foods as well as what appears to be a tendency toward increased food intake stimulated by opioids over time. Studies have shown that when patients go on a maintenance regimen of methadone that their body mass indexes increase and their rates of obesity rise.
  • Activating opiate receptors increases levels of insulin in the bloodstream raising concerns that opioid-based medications may be a risk factor for developing diabetes. In fact, researchers have found compelling evidence that chronic narcotic use leads to the same types of changes seen with non-insulin dependent diabetes mellitus. One of the explanations for this being considered has to do with the slowing down of the movement of the intestines created by activation of opiate receptors.
  • Eating sugary sweet foods has been shown to reduce pain symptoms in multiple studies, making dietary education to avoid weight gain an important part of pain management.
  • Opiate receptor blocking drugs, like naloxone and naltrexone, have been shown to blunt the urge to eat more sugar and high caloric foods.

Putting all of this together, it raises concerns that the ongoing reliance on opioid-based painkillers poses a risk for developing other significant chronic diseases including diabetes, obesity, and cardiovascular disease. If you have chronic pain and find yourself struggling with a decline in health, including changes in blood pressure, body weight, and sugar regulation, then talk to your doctor about the potential role some of your treatments may play, including the long-term use of opioid-based pain killers.