Obesity and substance misuse: is there a relationship?

The relationship between obesity and alcohol/drug misuse has been examined through both site studies and large epidemiological studies. In reviewing 19 site studies that have examined alcohol misuse among the obese, in comparison with rates before 1990, rates since 1990 have doubled (6.2% to 14.3%). Of the 7 studies that have examined drug misuse among the obese, rates average 8.0%. Given the potential limitations of varying study populations, methodologies, and prevalence assessments, these rates closely reflect those in the general population, according to data from the National Comorbidity Survey Replication study. As for the findings from 5 large epidemiological studies, Overall, findings do not clearly support the contention that obese individuals are at a higher risk for substance misuse, although specific sub-populations of the obese may be (e.g., those with Cluster B personality disorders). If there is an association between some obese populations and substance abuse, this may be accounted for by overlapping neurohormonal correlates. However, some authorities contend that food and drugs compete for the same reward pathways in the brain, suggesting that obesity may actually be protective against substance misuse.