Journal de recherche et de thérapie en toxicomanie

Abstrait

Eating Behaviors, Body Composition and Risk of Relapse among Persons withdrawing from Substance Abuse: A 3-months Follow-up Study

Maaike Kruseman, André Berchtold, Carmen Sangin, Yasser Khazaal, Rita Manghi, Michel Piccard-Kossovsky, Jean-Michel Gaspoz and Barbara Broers

Objective: To describe eating behaviors and body composition before, during and after substance abuse withdrawal, and to assess if these factors were related with withdrawal outcome.

Methods: This was a three month follow-up study examining eating behaviors (measured by validated questionnaires and interview), substance use (assessed with Addiction Severity Index) anthropometry (weight, height and bioimpedance for body composition), medical conditions and psycho-social environment (recorded from medical files and Addiction Severity Index) of 117 patients enrolling in a detoxification program at the University Hospitals, Geneva, Switzerland. Characteristics at baseline and after one month were compared according to patients’ outcome. Variables showing a significant association with relapse were entered in a multivariate logistic regression

Results: Most patients were men (84, 71%), and detoxified from alcohol (95, 81%). Relapse rates were 27% after 1 month and 45% after 3 months. Eating disorders were rare but 19% scored high on shape concern scale, 35% experienced nibbling, 20% compulsive night eating and 14% binge episodes, 24% displayed lower than normal fat-free mass and 40% had higher than normal fat mass. Bivariate analysis showed that low nutritional status (low BMI, or low fat mass or low fat free mass), was associated with a decreased risk of relapse. Withdrawal from drugs, higher tobacco consumption and higher severity index for legal area were associated with relapse. These determinants showed no effect on outcome in a multivariate analysis.

Conclusion: Problematic eating behaviors were common in this group, whereas eating disorders were rare. Relapse rate was high. No variable was related with relapse at multivariate level. As in general population, overweight and high fat mass were common among persons abusing substances. BMI was a poor indicator of their nutritional status. Our study suggests attention should be given to patients’ eating behaviors, weight and shape preoccupation during substance withdrawal and follow-up.