Weight change among patients engaged in medication treatment for opioid use disorder: a scoping review

ABSTRACT

Background: Medication treatment for opioid use disorder (MOUD) is an instrumental tool in combatting opioid use and overdose. Excess weight gain associated with MOUD initiation is a potential barrier that is not well understood.

Objectives: Conduct a scoping review of available studies investigating the effect of MOUD on weight.

Methods: Included studies consisted of adults taking any type of MOUD (e.g. methadone, buprenorphine/naloxone, naltrexone) with data on weight or body mass index for at least two time points. Evidence was synthesized using qualitative and descriptive approaches, and predictors of weight gain including demographics, comorbid substance use, and medication dose were examined.

Results: Twenty-one unique studies were identified. Most studies were uncontrolled cohort studies or retrospective chart reviews testing the association between methadone and weight gain (n = 16). Studies examining 6 months of methadone treatment reported weight gain ranging from 4.2 to 23.4 pounds. Women appear to gain more weight from methadone than men, while patients using cocaine may gain less. Racial and ethnic disparities were largely unexamined. Only three case reports and two nonrandomized studies examined the effects of either buprenorphine/naloxone or naltrexone, and potential associations with weight gain were not clear.

Conclusion: The use of methadone as an MOUD appears to be associated with mild to moderate weight gain. In contrast, there is little data supporting or refuting weight gain with buprenorphine/naloxone or naltrexone. Providers should discuss the potential risk for weight gain with patients as well as prevention and intervention methods for excess weight gain.

KEYWORDS:

• Medication treatment for opioid use disorder
• drug-related side effects
• obesity
• scoping review

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00952990.2023.2207720

Additional information

Funding

Dr. Masheb. Dr. Carr is supported by the Interprofessional Advanced Fellowship in Addiction Treatment. Dr. Masheb is supported by VA Health Services Research and Development Service (HSR&D) [grant number IIR 15-349]; and HSR&D Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center [grant number CIN 13-407].