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They were recruited within the local community either upon referral from health care professionals, probation officers, advertisements or by word-of-mouth. Sixty-five male volunteers participated in this study. We predicted that changes in dietary food intake are reflected in alterations of body composition. We hypothesized that chronic cocaine use is associated with changes in eating patterns, specifically with regard to the consumption of fat and carbohydrates that had been observed in cocaine-treated animals. We measured circulating levels of leptin, body composition and self-reported eating habits in a sample of cocaine-dependent men and compared them to matched healthy non-drug using male volunteers. In the current study, we characterized key patterns of eating behavior and weight change in cocaine dependence. This is an important consideration given that by far the most substantial health burden arising from drug addiction lies not in the direct effects of drug intoxication but in the secondary effects on physical health. Given that the significant weight gain following cocaine abstinence is not only a source of major personal suffering but also has profound implications for health and recovery, we suggest that there is a pressing need for a more detailed understanding of the effects of cocaine on dietary intake and body composition. Similar observations have also been noted in humans: regular cocaine users report eating fewer balanced meals than non-using peers, with an expressed preference for fatty foods, but no corresponding weight gain ( Castro, Newcomb, & Cadish, 1987). Paradoxically, the weight gain generally associated with increased caloric density and fat intake is, however, not seen in cocaine-treated animals ( Bane et al., 1993). Research in experimental animals indicates that cocaine’s anorexic effects are relatively transient ( Balopole, Hansult, & Dorph, 1979), with intake of food delayed but not actually reduced ( Cooper & Vanderhoek, 1993), and followed by a compensatory increase in the consumption of fat and carbohydrates ( Bane, Mccoy, Stump, & Avery, 1993). However, we argue that a more nuanced view is needed, one that acknowledges a major disturbance in eating behaviors and metabolism accompanying cocaine use.
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As a consequence, community treatment services try to address drug users’ weight problems with educational interventions promoting healthy eating ( Cowan & Devine, 2012). Many clinical interventions are therefore shaped by the belief that eating habits and weight-related problems are not an issue during cocaine use ( VanBuskirk & Potenza, 2010), but rather occur in abstinent users to restore the weight that they previously lost due to a cocaine-induced suppression of appetite ( Vanbuskirk & Potenza, 2010). This view is supported by observations that problematic weight gain may rapidly emerge on cessation of regular cocaine use ( Cowan & Devine, 2008), a distressing phenomenon that can lead to relapse. There is a wide belief that cocaine use suppresses appetite, thereby reducing body weight ( Cochrane, Malcolm, & Brewerton, 1998). These are likely to be overlooked in clinical practice but may produce significant health problems when cocaine use is discontinued during recovery. Weight changes in cocaine users reflect fundamental perturbations in fat regulation. Tobacco smoking status or concomitant use of medication did not affect the significance of the results. Levels of leptin were associated with fat mass, and with the duration of stimulant use. 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. Assessments were made of eating behavior and dietary food intake, estimation of body composition, and measurement of plasma leptin. 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). 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. There is a general assumption that weight loss associated with cocaine use reflects its appetite suppressing properties.