Opioids Massive weight gain on methadone - please help!

[Bomb319]

Hi,

I have been on methadone for close to a year (10.5 months or so). It's working extremely well; better than I ever thought it could or would. I have my life back for the most part, and am able to go out, work, and overall live life normally again. I have begun repairing my relationships with my family and friends. I am on quite a high dose (210 mg) but am a rapid metabolizer, and have found that below this level, I experience some withdrawal by the next morning.

Anyway, my ideal weight is about 165 lbs. I am 5'10.5" or so, and I weighed roughly 180 - 185 lbs just before going on methadone (but while still chronically using H and other opiates). I considered that to be a bit too much, and have experienced cycles of weight gain and loss in the past after quitting temporarily.

But this is different. This morning I weighed almost 230 pounds... 227 or so. I'm not eating excessively either - on the contrary, there are still days where I eat very little, although what I DO eat can end up being fairly calorie rich and sugary, as well as excessive - I can and have eaten ten bowls of cereal (raisin bran) a day, thinking it was healthy yet totaling nearly 500 cal per bowl.

Stopping the methadone at this point is not an option; I am not cured, I still use occasionally but MUCH less, and know I would relapse without it. I know that this is a common problem for people who are on maintenance. However I now am at a weight that I consider to be "scary" in that it's unprecedented, want a relationship at some point which this will impede, and am worried about my health - particularly after years of opiate injection including pills, smoking, cocaine, and coming from a family whose men have all died in their fifties of heart attacks.

What I need is a tried and true healthy yet sustainable diet (and/or method of eating) in which I'm satiated, yet start losing weight and preferably RAPIDLY. I'm not a "food addict" per se; I can and have restricted my caloric intake in the past and can control myself semi-long term when it comes to sugar and fat avoidance. Does anybody have any advice and personal experiences combined with low-calorie, yet filling and satisfying diets?? I'm really getting concerned that I won't be able to drop this weight if it keeps up like this. I REALLY don't want to take any other medications that are designed for weight loss unless I absolutely have to, although I've heard that testosterone injections can be effective, and quite rapidly (sexual side effects are present with me although they're not impossible to deal with; I usually have to wait until morning before dosing to get off in a reasonable amount of time though.) I have also had problems with excessive sweating and feeling hot, though this has diminished considerably as it's now winter. Could testosterone be somewhat of a magic bullet here, or would it carry its own side effects that make it undesirable to use mainly for weight loss?

Any and all advice is hugely appreciated; thanks.

 

[Bomb319]

err I see I wrote an apparent contradiction regarding the amount I eat; I meant to say that I CAN eat excessively, but never do it daily. I may have a day where I eat ten bowls of Raisin Bran, then eat bare minimum the next day, like a few pieces of toast and an apple for example.

 

[rhun]

This is a common side effect of methadone, usually due to the sugar cravings and eating less frequently because you feel "full." Have you gotten your testosterone checked? Really important for males on methadone.

Regarding your dose, I will say that regardless if metabolism your dose is just insanely high and my experience with methadone has been that higher doses DO cause problems (I've been to multiple clinics and have been on it myself as well as family and friends). In addition to it just not being good for you at such. high amount, maintaining at that dose will make getting off a process that could take years and could result in you staying on MMT for life.

If you taper, you may have some discomfort but your tolerance will adjust to accommodate a lower dose. Just like how on your current dose, your tolerance will adjust and you'll eventually raise your dose again. I know when I started methadone, I kept raising my dose even when I got to a high enough dose where I was no longer sick. Why? Well of course I was hoping to feel something. But mostly, I think it's because as opioid addicts we become overly sensitive to any kind of discomfort. We have so much fear built around withdrawal and we don't even want to deal with a runny nose if we can avoid it. Getting past this really helped me progress in recovery.

Anyway, if this is strictly about diet and you don't have a specific drug question I'm going to move this to Healthy Living. But I think the majority of your side effects would disappear or dramatically lessen if you reduced your dosage.

 

[Thomas29]

Nobody Really Knows why this happens could be water retention a Lot of factors make the causes different for all....,. I Am On it for almost 7 Months Roughly Now and have Noticed No Weight Gain. But Who Knows 5 Years From Now it just Might Wreak Havoc on My Body Hence I stayed Away From Methadone For the Longest Time I Could.

 

[Aidens]

I don't really know much about methadone use and maintenance but I do know quite a bit on health. I am a healthy build now when I used to be a chubby muscle less individual. In the last year I have changed this dramatically. It does seem that your eating habits seem inconsistent and unhealthy(ish). Are you working out or doing physical activity? It doesn't have to be pounding weights at the gym, it can be as simple and going for a jog, long bike or hike, swimming, push-ups, etc.

Healthy diet is key in losing weight, but it's not the only thing. Physical activity is also prime as I described. Just because you eat 5000 calories in one day does not mean you should eat less the next day to "balance it out". Your body doesn't work like that. It is constantly metabolizing and needs sustenance at all times. Also, the calories you do intake matters as well. 5000 calories of raisin bran is NOWHERE near as beneficial as 5000 calories of well balanced meals. Definitely look up diets that are balanced and whole. Even if you did eat bad one day, do NOT minimize eating the next, just make sure your intake is healthy. I have since changed my habits and stopped eating like I did, which I would say is near yours but I never minimized my intake the next day after eating bad.

I have great belief in you that you can make this change if you are willing, and with a proper workout routine and diet I think you can find a more suitable weight in time. What are your days like? Do you stay inside most of the time?

Doing physical activity is not only good for your body but your mind as well! It will make you more positive about yourself and in turn you will have a better outlook and feel productive. Personally it has even changed my drug habits since my mind hasn't been as scattered. I wish you good luck and hope you see progress.

 

[jeng1128]

I've been on methadone for three years. My highest dose being 180mgs(I kno it's a lot) and my lowest being 35(what I'm on now since I'm trying to get off it. Idt the actual methadone makes you gain weight but the side effects more so. When I was on 180 (im a small girl) I gained like 30#'s. I really feel like it was because A.it made me crave sweets so much (and I was never a sweet eater before) B. It made me tired which meant I definitely wasn't as active and C. I'm almost positive methadone lowers your metabolism.
As soon as I got to about 60mgs the weight just started coming off (thank god) and the lower I go the more weight I lose. I've always been really tiny so the weight gain was killing me. I was used to being 100#'s and I gained 50. It sucked. But now I'm down to 128(and I realize when I was 100#'s I was 22, and now I'm 30 so I was probably going to gain a little weight anyway. My goal weight is 115(I'm 5'4") so only 13 pounds but it's always those last pounds that are hardest.
I think your dose has a lot to do w it, so if you can go down. If that's not an option for you, you just have to be really dedicated to eating well and exercising. Even if it's just walking. You wouldn't believe just walking an hour/day how much it really does make a difference. Good luck!

 

[belfort]

i remember quickly putting on about 30 pounds when i went on methadone, as did many others at the clinic i went to..some put on over 50 pounds and looked terrible..i asked the nurses and they said it was due to it slowing the metabolism ddown...what i did was start working out harder and cutting down my food intake..even doing this it ws a slow process so i took a shortcut and started taking ephedrine 3 days a week..that helped a good deal..

 

[Canuckistani]

You can ask at doctor about Ditropan XL (Oxybutynin) to help battle the sweating. When I was on MMT I was given it and it worked for me. I went to MMT because no one would treat my chronic pain seriously so I took methadone from a friend to piss dirty and they accepted me. I eventually found a real doctor who took me seriously. I have been on Methadone for 7-8 years now for chronic pain.

My testosterone was so low from being on Methadone that it was less than what a teenage girl would have. I couldn't get erections, I couldn't have sex properly at all and I still last about 4 minutes and have to self-stimulate like 90% of the time. I've only had sex one time where I didn't have to jerk it to keep it up. Methadone does all sorts of shit to your hormones.

I think a change to your diet and having more activity would help with your weight. Stop drinking pop/soda if you drink it. I gained 2.5 lbs in a month drinking 2-3 pepsis a day.

I wish I could give more information. Good luck!

 

[crzydiamond]

I believe it is dose related. I'm on 80 mg and I gained like 40 lbs over the past year. Most of that came once I went over 60 mgs.

I have always (previously) had a fast metabolism. The only other time in my life I was this heavy was the previous time on methadone (was on for several years then off n completely clean for almost 9 yrs).

Last time when I got off the weight fell off. I expect the same this time. But it is frustrating. I eat small meals. I'm active. And I don't do much different than when I was clean without methadone (and 50 lbs lighter)

So I do believe methadone really slows your metabolism. And I believe the higher the dose the more one notices it. I think it's even more pronounced in people who are on more than they actually need. That was true for me

 

[SkagKush]

I've actually been loosing weight while on methadone. Prior to starting MMT I was drinking heavily, and eating poorly while sitting around.

I have lost about 15 LBS since sept, and am starting to get back to my normal weight. Just another 15 or 20 to go!

 

[Über-o-Mazdā]

Hi.
Wish you're all well.

I wanted to share my experience about Methadone and weight.


I lost 100 pounds in a couple of months while having been on a dose of 320 (when the weight-loss started) to 400 (when it ended) of Methadone per day.
It was years ago; I wasn't wise. I hadn't done any research into what a SANE and SAFE dosage was. I wasn't even a fast metabolizer. I wasn't on any maintenance program. It just helped me stay away from the urge of constantly seeking all sorts of combinations of drugs (mostly downers) to be mildly satisfied and still thirsty with an avarice for euphoria.



So,
-I exercised. You should have a favorite sport, something u enjoy. Mine had always been boxing; but, I generally recommend it since it might prove indirectly therapeutic to some!
-I used a wide variety of different fiber supplements. I used and saturated them properly to avoid obstructions, especially on sth like Methadone. I also used tons of natural fiber sources as well as some laxitives to counteract the constipation that was made worse by small food intake.
-I drank proper amount of water in timely manner. When I drank to much, I tried to also use electrolytes, etc.
-I monitored my sugar intake

The rest is normal diet stuff.
-Count calories if you're not gonna be obsessive about it (or at least have an understanding of the relationship between calorie, activity and weight)
-Eat properly

I just wanted to say it can be done. I know how hard it is not to eat - and enjoy eating - on Methadone.


I don't wish to discuss why I think I was able to do it and why I believe everybody can. When all the pharmacological and biological variables are dealt with or taken into account, the main discussion borders on philosophical/motivational. And, unfortunately, when some concepts are used, overused or misused, they become clichés, or we develop tolerance to them and might need to change the ROA! When this unwanted thing happens, words lose their potency, even if they are correct and truthful... so, just have a really deep understanding of every facet of your self. It'll help keep the inner fire goining.


Though I rarely use quotations, "Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness, that most frightens us."

 

[packjamNL]

I crave sugar from methadone, I did not know that it came from methadone, but I read it here, I sprint on my bike @ 19:50, ten minutes before they close, to the nearest supermarket and buy me a roll of chocolate cookies and devour them like crazy, bad sugar is not good man

 

[Über-o-Mazdā]

I crave sugar from methadone, I did not know that it came from methadone, but I read it here, I sprint on my bike @ 19:50, ten minutes before they close, to the nearest supermarket and buy me a roll of chocolate cookies and devour them like crazy, bad sugar is not good man

Exactly. There was a period all I took was simple sugary substances with carbohydrates. I would fry some sort of puffy Persian bread and would dip in a mixture of caramel sauce and whipped creame. It insanely impacts your sugar cravings. It's really bad, really unhealthy...

 

[packjamNL]

Exactly. There was a period all I took was simple sugary substances with carbohydrates. I would fry some sort of puffy Persian bread and would dip in a mixture of caramel sauce and whipped creame. It insanely impacts your sugar cravings. It's really bad, really unhealthy...

Well I am on MD (70mg.atm) for 30 years now I did 40 mg. for years too, but lately this sugar craving started, I didn't know where it came from, but it makes you tired, at 6pm I am done, and that is since I got the two jabs or since I eat a lot of sugar, I never ate sugar not even as a kid never never but now since 6months or so yeah craving it @7pm

 

[somnilicious]

Well I am on MD (70mg.atm) for 30 years now I did 40 mg. for years too, but lately this sugar craving started, I didn't know where it came from, but it makes you tired, at 6pm I am done, and that is since I got the two jabs or since I eat a lot of sugar, I never ate sugar not even as a kid never never but now since 6months or so yeah craving it @7pm

I probably drank 2.5 liters of creme Soda a day on methadone. I'm still trying to lose my methadone weight from this last time. At least I got some fat to burn when I start trying to put on muscle. All the other times I would get clean and workout I'd be rail thin while hitting the gym and trying to get gains by shoveling in more calories than I burned.

 

[Über-o-Mazdā]

Well I am on MD (70mg.atm) for 30 years now I did 40 mg. for years too, but lately this sugar craving started, I didn't know where it came from, but it makes you tired, at 6pm I am done, and that is since I got the two jabs or since I eat a lot of sugar, I never ate sugar not even as a kid never never but now since 6months or so yeah craving it @7pm

Wow... The late-onset sugar craving is a mystery to me too! And, it does really make you tired. It messes with the stability of your energy levels. Of it's sudden, maybe check some other factors too. Moderate usage of a PROPER low-calorie sugar replacement might be a good complementary method. And the whole thing with consuming a consistent amount of protein might also do the work. But, I still vividly remember the joy of a full sugary meal followed by a couple of cigarettes while on Methadone. So, that's that.

 

[4meSM]

Methadone is associated with metabolic syndrome and insulin resistance. And higher doses have worse outcomes. Here's a recent paper :

Metabolic and Addiction Indices in Patients on Opioid Agonist Medication-Assisted Treatment: A Comparison of Buprenorphine and Methadone - Scientific Reports

Metabolic hormones stabilize brain reward and motivational circuits, whereas excessive opioid consumption counteracts this effect and may impair metabolic function. Here we addressed the role of metabolic processes in the course of the agonist medication-assisted treatment for opioid use...

www.nature.com

"Our data are consistent with the proposition that variations in the methadone exposure adversely affects triglycerides, HDL, blood pressure, insulin sensitivity and MetS as a whole..."
But also
"Metabolically impaired people actually have a greater severity of opioid addiction and are thus receiving a higher dose and a longer duration of the methadone therapy."

 

[Über-o-Mazdā]

Methadone is associated with metabolic syndrome and insulin resistance. And higher doses have worse outcomes. Here's a recent paper :

Metabolic and Addiction Indices in Patients on Opioid Agonist Medication-Assisted Treatment: A Comparison of Buprenorphine and Methadone - Scientific Reports

Metabolic hormones stabilize brain reward and motivational circuits, whereas excessive opioid consumption counteracts this effect and may impair metabolic function. Here we addressed the role of metabolic processes in the course of the agonist medication-assisted treatment for opioid use...

www.nature.com

"Our data are consistent with the proposition that variations in the methadone exposure adversely affects triglycerides, HDL, blood pressure, insulin sensitivity and MetS as a whole..."
But also
"Metabolically impaired people actually have a greater severity of opioid addiction and are thus receiving a higher dose and a longer duration of the methadone therapy."

Exactly the info that was needed