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Hedonic eating behaviors and food preferences associated with medication-assisted treatment for opioid use disorder

Elizabeth McDonald, MS, FNP-BC, Jennifer Laurent, PhD, FNP-BC


Objective: To characterize hedonic eating behaviors such as sugar cravings, food preferences, and appetitive responsiveness for sweet and hyper-palatable foods, and to determine the prevalence of addictive like eating behaviors and food addiction (FA) in individuals receiving medication-assisted treatment (MAT) for opioid use disorder (OUD).

Design: Quasi-experimental.

Setting: Outpatient MAT center.

Participants: Nonpregnant adult patients undergoing MAT (n = 116) receiving either buprenorphine/naloxone or methadone for at least 6 months.

Main outcome measures: Hedonic eating, FA, and food craving.

Results: Of the aggregate sample, 13.3 percent met criteria for FA. More than onethird of all subjects endorsed consuming larger amounts of highly palatable food than intended, unsuccessful attempts to quit or cut down on eating such foods, and a great deal of time spent on consuming or recovering from consuming such foods. Both medication groups demonstrated greatest cravings for sweets and fast foods followed by carbohydrates and fats (p < 0.001). Similarly, subjects reported “giving in” most frequently to sweets and fast foods followed by carbohydrates then fats (p < 0.001). Greater appetitive responsiveness was noted in the presence of hyper-palatable foods. No group differences were found. Weight change was not associated with addictive like eating, food craving, or appetitive responsiveness.

Conclusions: Individuals receiving MAT exhibit preferences for sweet and fast foods that appear to be influenced by the proximity of such foods. FA was present. Collectively, such eating behaviors and food preferences may pose additional adverse health consequences and associated co-morbidities. This underlies the importance of comprehensive healthcare for patients with OUD, including nutrition education and evaluation of eating behaviors and food preferences.


hedonic eating, food addiction, food craving, medication-assisted treatment, opioid use disorder

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