If you are concerned about potential weight gain while taking Suboxone, it’s important to note that the study results are conflicting and each person’s experience in recovery is unique.
Some weight gain in recovery from opioid use disorder (OUD) is not uncommon, no matter what form of Medication for Addiction Treatment (MAT) is used. In most cases, the problem is a lack of healthy eating and exercise habits after the removal of a drug that can be an appetite suppressant.
If you are concerned about possible weight gain during opioid detox, talk to your doctor about your options.
What Is Suboxone?
Suboxone is a medication that combines two active drugs, buprenorphine and naloxone. It is prescribed for the purposes of treating OUD.[1] Buprenorphine helps to diminish cravings for the opioid of choice and limits withdrawal symptoms during the tapering process, while naloxone helps to protect against relapse.
Suboxone is available as an injection, tablet, sublingual tablet or sublingual film. Each form of the drug comes with its own potential benefits, risks and side effects.
Suboxone (Sublingual Film Strip)
Suboxone is taken by allowing the film strip to dissolve under the tongue. Possible side effects include the following:[2]
- Confusion
- Sleepiness and lack of coordination
- Blurred vision
- Slurred speech
- Dizziness
Zubsolv (Sublingual Tablet)
Zubsolv is taken as a tablet that is allowed to dissolve under the tongue. The possible side effects that may accompany its use include the following:[3]
- Sleepiness
- Dizziness
- Drop in blood pressure
- Headache
- Nausea or vomiting
- Liver problems
Subutex (Tablet)
Subutex has been discontinued. It was taken in the form of a pill and could trigger side effects, such as these:[4]
- Nausea and vomiting
- Constipation
- Insomnia
- Headache
Sublocade (injection)
Sublocade is a form of buprenorphine that is administered in the form of an injection. Some possible side effects may include the following:[5]
- Respiratory depression
- Injection site reactions
- Fatigue
- Constipation
- Headache
- Nausea and vomiting
Does Suboxone Cause Weight Gain?
Some studies show some weight gain in people taking medications like Suboxone that contain buprenorphine, while others show no change in weight. There are also some reports among Suboxone users that weight gain was an issue for them during early and ongoing recovery.
Ultimately, the medication seems to play less of a role in this change than other choices, such as nutrition and exercise levels. It is possible for people to take advantage of the benefits of the medication and maintain a healthy weight.
Examining the Evidence
In a study published in 2022 that looked into differences between men and women when it comes to weight gain during OUD treatment using medications, researchers found no significant weight gain after 12 weeks of treatment and that there was no difference between men and women.[7]
Another study compared the body weight of a group taking buprenorphine/naloxone before treatment and after four months of treatment and saw a mean weight gain of about 5 kilograms.[7]
The study that saw weight gain among users was correlative and not causative. That is, it didn’t show that the medication specifically caused weight gain since there was no tracking of their nutritional choices or exercise levels before and after treatment.
Factors Influencing Weight Changes
The truth is that weight gain is common in recovery, with or without medication. Some of the most common issues that impact weight changes in recovery include the following:
- Lifestyle: If life becomes more sedentary in recovery, it can cause metabolism to slow down and calorie burn to become less efficient.
- Diet: OUD often means poor nutrition, and many report losing a significant amount of weight during active opioid misuse. Therefore, when that misuse stops, returning to eating normally can mean weight gain. When eating choices are poor, the weight can pile on more quickly.
- Water weight: Eating foods that are high in sodium (which is common in processed foods and often easy for people in recovery) can lead to water retention. This can add up to a few extra pounds on the scale.
- Metabolism shift: Drug misuse alters metabolism, and stopping drug use can alter metabolism as well. Generally, people who lose weight during opioid misuse will gain it back in recovery.
- Other medications: If the person is diagnosed with co-occurring mental health disorders or physical issues and takes medication to manage the problem, these medications may lead to weight gain as well.
As compared to methadone, Suboxone was found to have a lesser impact on metabolic rate, triglycerides, HDL and blood pressure among other important health metrics.[8,9]
Weight Gain vs. Weight Loss on Suboxone
As with most things in recovery, there isn’t a way to predict how your weight might change in recovery.
Different Experiences
Everyone is unique in their OUD and in their experience during recovery. This truth extends to weight management during recovery as well.
Some people will experience weight changes, while others will not. If it is a concern, it is possible to work with your doctor, a nutritionist, or a trainer to address the issue.
Stress & Emotional Eating
It’s important to note that weight changes may not only have to do with medication and lifestyle choices but they can also be impacted by stress and emotional eating.
If emotional eating becomes an issue for you due to stress, you can try these steps:[10]
- Start taking yoga to find the connection between breath, body work and stress relief.
- Engage in meditation to lower stress levels.
- Talk to a therapist about the challenges you face in recovery.
- Make sure to get enough sleep each night, as a lack of sleep has been shown to contribute to increased calorie intake and weight gain.
Weight Loss as a Side Effect
Many people don’t gain weight while on Suboxone but instead find that they lose weight in recovery. Again, this may not have much to do with the medication itself and more to do with personal factors, such as metabolism, eating choices and exercise level.
For some, weight loss occurs when they switch from methadone to Suboxone. Methadone has been shown to have negative effects on weight, triglycerides, blood pressure and more, and it comes with increased regulations that can hamper independence in recovery.[8] When people switch to Suboxone, they often see a positive change in all these issues, including weight management. Nevertheless, after trying both medications, some people prefer Suboxone and others prefer Methadone for their recovery. Work with your doctor to find the right medication for you.
Managing Your Weight While on Suboxone
Here are some tips to help you manage your weight while using Suboxone:
Tips for Maintaining Healthy Weight
Managing a healthy weight is a great project for recovery because it helps you to feel better physically and mentally, which can make it easier to avoid relapse. Some ways to do this include the following:
- Get restorative sleep each night, so you have energy without turning to sugary foods.
- Create a workout regimen that suits your interests, schedule and personality.
- Work with a trainer if you need accountability in your exercise regimen.
- Learn how to eat healthfully, emphasizing produce and lean protein and minimizing processed foods and sugar.
Additionally, investing time and energy into building a community in recovery can help you to stay sober and also help you establish healthy habits as you all support each other in rebuilding a balanced life.
Consultation With a Healthcare Provider
If you find that you are gaining weight rapidly, are unable to lose weight despite actively trying, or experience extreme fatigue, joint pain, or heart health issues due to obesity, consult with your healthcare provider for personalized guidance on your path forward.
Prioritizing Recovery
There is no definitive link between MAT and weight gain. Other factors likely play a greater role in weight changes in recovery.
If weight management is a concern in recovery, make healthy lifestyle changes, build a community of support, and work with your healthcare provider to create an actionable plan that takes into consideration all your unique needs.
The most important thing is to prioritize your recovery from OUD. If you are engaging in active opioid misuse, your health is at risk. With the help of Suboxone, you can effectively manage your OUD and build healthy lifestyle habits in recovery. Reach out for help today.
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Buprenorphine. Substance Abuse and Mental Health Services Administration. Published 2023. Accessed January 25, 2024. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/buprenorphine
- Patient information for SUBOXONE® (buprenorphine and naloxone) sublingual film (CIII). Indivior. Accessed January 25, 2024. https://www.suboxone.com/
- Zubsolv | ZUBSOLV® (buprenorphine and naloxone) sublingual tablets. Orexo. Accessed January 25, 2024. https://www.zubsolv.com/
- CIII highlights of prescribing information Subutex. Federal Drug Administration. Accessed January 25, 2024. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020732s018lbl.pdf
- SUBLOCADE® (buprenorphine extended-release) injection. Indivior. Accessed January 25, 2024. https://www.sublocadehcp.com/
- Manza P, Kroll D, McPherson KL, et al. Sex differences in weight gain during medication-based treatment for opioid use disorder: A meta-analysis and retrospective analysis of clinical trial data. Drug and Alcohol Dependence. 2022;238:109575. https://doi.org/10.1016/j.drugalcdep.2022.109575
- Baykara S, Alban K. The effects of buprenorphine/naloxone maintenance treatment on sexual dysfunction, sleep and weight in opioid use disorder patients. Psychiatry Research. 2019;272:450-453. https://doi.org/10.1016/j.psychres.2018.12.153
- Elman I, Howard M, Borodovsky JT, et al. Metabolic and addiction indices in patients on opioid agonist medication-assisted treatment: A comparison of buprenorphine and methadone. Scientific Reports. 2020;10(1). https://doi.org/10.1038/s41598-020-62556-0
- Schlienz NJ, Huhn AS, Speed TJ, Sweeney MM, Antoine DG. Double jeopardy: a review of weight gain and weight management strategies for psychotropic medication prescribing during methadone maintenance treatment. International Review of Psychiatry. 2018;30(5):147-154. https://doi.org/10.1080/09540261.2018.1509843
- Salamon M. Snooze more, eat less? Sleep deprivation may hamper weight control – Harvard Health. Harvard Health Publishing. Published April 4, 2022. Accessed January 25, 2024. https://www.health.harvard.edu/blog/snooze-more-eat-less-sleep-deprivation-may-hamper-weight-control-202204042718
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