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Key points
- Many women report using drugs in an effort to lose weight.
- A recent study of 1,533 women in drug treatment found that 57% were concerned about weight gain in recovery.
- Substance use treatment centers must address weight concerns as an integral part of recovery when present.
Body dissatisfaction and weight concern are rampant in the United States. Research suggests that almost half of American adolescents are dissatisfied with their body. By adulthood, it’s more common for women to be dissatisfied with the way they look than satisfied (National Eating Disorders Association)
<a href="https://healthylife7.com/why-keeping-weight-loss-ads-off-your-fyp-feels-impossible/” title=”Why keeping weight loss ads off your FYP feels impossible”>Weight Loss and Substance Use
In addition to being a key feature of many eating disorders,body image disturbanceand a desire to lose weight can motivate substance use—both legal and illegal—as women strive to attain a culturally valued low body weight (Robinson, Walter, Deane, & Larance, 2023). For example, in a nationally representative sample of more than 12,000 young adults in the US, losing weight was one of the most common motivations for non-medical use of stimulants for women (Drazdowski et al., 2020). Similarly, in a sample of 131 college students who used substances, 15.3 percent of women reported using drugs for weight control purposes; and those who did mostly used illicit stimulants known for their weight-loss and appetite-suppressing side effects (including amphetamine, cocaine and methamphetamine; Bruening et al., 2018).
In fact, women in treatment for substance use treatment often report weight-loss as a primary motivation to start and continue using drugs (Warren et al., 2013, 2026). In a recent study of 1,533 women in drug treatment centers in Nevada, my colleagues and I found that 12.3 percent had a lifetime eating disorder diagnosis and 21 percent reported symptoms of eating pathology without a formal diagnosis (Warren et al., 2026). Additionally, about 44 percent strongly agreed that they started using substances for weight loss purposes, and more than half were concerned about weight gain in recovery (57 percent). Strikingly, women who endorsed using substances for weight loss also reported significantly higher mean levels of body dissatisfaction, binge eating behavior, and general eating pathology than those who did not.
Implications for Drug Treatment
A 2026 advisory by the Substance Use and Mental Health Administration (SAMHSA, 2026) described the need for evidence-based care for people struggling with drug use, body image concerns, and eating disorder symptoms. Specifically, assessing how body image and weight concerns relate to substance use, treating overlapping symptoms simultaneously, and offering supplemental care in a supportive, nonjudgmental environment with experts who understand drug addiction as well as eating pathology is key to recovery success.
One evidence-based program for women in drug treatment is the Healthy Steps to Freedom (HSF; Lindsay et al., 2012, 2026) program. HSF is a 10- to 12-week supplemental program that provides participants in drug treatment information about weight, nutrition, physical activity, body image, and eating behavior. In a recent study of 607 adult women in drug treatment (Lindsay et al., 2026), participation in HSF improved healthy eating and physical activity while thin-ideal internalization, body dissatisfaction, and disordered eating symptoms significantly decreased. These findings suggest that programs like HSF can support women in drug treatment to address weight-related concerns related to nutrition, physical activity, body image, and eating pathology as they relate to substance use.
The Naked Truth
In Western cultural contexts, women have been using drugs—both legal and illegal—to lose weight for decades. In fact, research increasingly highlights the link between weight dissatisfaction, disordered eating behavior, and drug use. Given that over-the-counter and prescription drugs are increasingly used to treat obesity in an accessible and culturally sanctioned way, addressing body concerns in a culture that increasingly promotes drug use to manage weight is particularly timely
For anyone struggling with body image and substance use, the National Eating Disorder Associationwebsitehas a host of helpful tools and information on treatment options. To find a therapist near you, visitthe Psychology Today Therapy Directory
Copyright Cortney S. Warren, Ph.D., ABPP
Note: This content is only for informational and educational purposes and should not be considered therapy or any form of treatment. I cannot respond to personal requests for advice over the internet. Best on your continued journey
- What Is Addiction?
- Take our Addiction Test
- Find a therapist to overcome addiction
