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. 2013 Dec;71:75-80.
doi: 10.1016/j.appet.2013.07.011. Epub 2013 Aug 3.

The Skinny on Cocaine: Insights Into Eating Behavior and Body Weight in Cocaine-Dependent Men

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The Skinny on Cocaine: Insights Into Eating Behavior and Body Weight in Cocaine-Dependent Men

Karen D Ersche et al. Appetite. .
Free PMC article


There is a general assumption that weight loss associated with cocaine use reflects its appetite suppressing properties. We sought to determine whether this was justified by characterizing, in detail, alterations in dietary food intake and body composition in actively using cocaine-dependent individuals. We conducted a cross-sectional case-control comparison of 65 male volunteers from the local community, half of whom satisfied the DSM-IV-TR criteria for cocaine dependence (n=35) while the other half had no personal or family history of a psychiatric disorder, including substance abuse (n=30). Assessments were made of eating behavior and dietary food intake, estimation of body composition, and measurement of plasma leptin. Although cocaine users reported significantly higher levels of dietary fat and carbohydrates as well as patterns of uncontrolled eating, their fat mass was significantly reduced compared with their non-drug using peers. Levels of leptin were associated with fat mass, and with the duration of stimulant use. Tobacco smoking status or concomitant use of medication did not affect the significance of the results. Weight changes in cocaine users reflect fundamental perturbations in fat regulation. These are likely to be overlooked in clinical practice but may produce significant health problems when cocaine use is discontinued during recovery.

Keywords: Anthropometry; Body weight; Cocaine dependence; Dietary food intake; Fat regulation; Impulsivity–compulsivity.


Fig. 1
Fig. 1
Correlations between eating behavior, as measured by the Three-Factor Eating Questionnaire (TFEQ) and personality traits of impulsivity and compulsivity, as measured by the Barratt Impulsiveness Scale (BIS-11) and the Obsessive–Compulsive Inventory (OCI-R). (a and b) impulsive personality traits are significantly associated with uncontrolled eating in healthy men, but not in cocaine-dependent men. (c and d) compulsive personality traits are associated with deliberate restriction of food intake to influence body weight in cocaine-dependent men but this relationship is not seen in healthy men.

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