In a recent podcast episode, actor Josh Peck, most known for his role in Nickelodeon’s "Drake & Josh," discussed the pressure of growing up with fame as a “morbidly obese” teenager and the role that played in his past drug and alcohol addiction.
Losing weight, Peck assumed, would fix his problems. The realization that it didn’t tipped him over the edge. Drugs and alcohol helped cushion his fall when food no longer could.
“At 17 I lost all this weight...I thought, ‘I'm at the finish line, I did it, now I don't have to worry about anything,’” Peck said on an Oct. 20 episode of "Cancelled with Tana Mongeau." “But I was just still plagued with the same thoughts and things that had always messed with me my whole life.”
What followed was a four-year journey of “being a total cliché,” Peck said, as he tried to catch up on the partying he felt his career stole from him. At 21 years old, Peck sought treatment and became sober.
His story, some listeners pointed out, details a phenomenon shared by many people that occurs after significant weight loss called “cross addiction” or “addiction transfer”: when one addiction, often food, is swapped for another, like drugs and alcohol, after losing weight. Peck declined USA TODAY's request for comment.
Research has found that people can develop addictions after significant weight loss to other things too, such as gambling, shopping, exercise, skin picking and the internet — all of which serves as an emotional escape from the overwhelming lifestyle changes tied to weight loss.
The trade off is mostly associated with people who undergo weight loss surgery, such as gastric bypass or sleeve gastrectomy, because the procedures lead to a dramatically reduced food intake and body weight over a relatively short period of time. However, experts say it can happen after natural weight loss too, and potentially after weight loss via medications like Ozempic, although that remains to be seen.
“Anytime people endure a major change in their body, there's a psychological change that corresponds to that and it's not always the positive one that people imagine it's going to be,” said Alexis Conason, a licensed psychologist and certified eating disorder specialist who has studied addiction transfer. “When we lose a lot of weight, it sometimes happens very quickly and often in a way that feels outside of people's control.”
Similar to Peck’s experience, many people assume that a slimmer body is the answer to their problems. But without treating the underlying cause behind an existing addiction, some run the risk of replacing it with another potentially more dangerous one.
“They’ll put all their eggs in that basket and feel hopeful while having unrealistic expectations of what life is going to be like afterwards,” Conason said.
It can be jarring for society’s perception of a person to suddenly change, consequences of which can trickle into personal relationships. Oftentimes, people’s bodies change faster than their body image can adjust, which can lead to body dysmorphia. Peck described his experience as having “the same head [on] a different body," a sentiment he also shared in his memoir "Happy People Are Annoying" that released last year.
“It can be a disconcerting experience to see yourself one way and then have the world respond to you in a different way,” Conason said.
In some cases, people don’t lose the weight they wanted to or regain the weight they lost over time, which can be difficult to cope with, especially for people who undergo surgery and feel like it’s their final opportunity to lose weight. “When surgery doesn’t help, people can be more prone to depression and hopelessness,” Conason said, “and are oftentimes given very little support on how to deal with it.”
The result can be substituting food with a different coping mechanism to soften the blow of these challenges.
Drugs and alcohol, for example, have been shown to trigger similar reward responses in the brain as food, which helps explain why some people become addicted to substances when they can no longer receive satisfaction from their diet.
Research also shows that intoxication happens more quickly and with less alcohol following weight loss surgery, increasing risks of alcohol addiction, said Dr. Julio Teixeira, a bariatric surgeon with Northwell Health who has published research on addiction transfer. Because tolerance is reduced, people may experience the rewarding aspects of alcohol use sooner and more frequently, which could lead to a greater desire for more.
Addiction transfer after significant weight loss can happen even to those with no prior history of addiction, whether it’s to food, drugs, alcohol or another substance or behavior.
In a small 2022 study of 97 patients who had a sleeve gastrectomy, researchers found that 1 in 5 “non-high risk drinkers” (a total of 84 people) developed an alcohol problem one year after their procedure.
That said, a history of addiction is generally associated with increased risks of addiction transfer after weight loss. The prevalence of food addiction prior to weight loss surgery ranges from about 14% to 58%, according to multiple studies.
The medical community has yet to recognize food addiction as a disorder in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the standard classification of mental disorders used by mental health professionals.
Conason agrees that the concept of food addiction is controversial and is “really only seen in the context of dieting and restricting food intake — the more people try to restrict their food, the more out of control they feel around food.”
This debate has made it difficult for researchers to understand and communicate the risk factors for addiction transfer after weight loss.
The best way to avoid the phenomenon altogether, Conason said, is to work with a mental health professional, preferably one who’s trained to treat addictions and food-related disorders, before, during and after your weight loss journey.
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