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Eating Right Can Make – or Break – Your Recovery

When Stacey reached the one-year recovery mark, she was overjoyed with the progress she had made in all areas of her new, sober life – except for one. She was now more than fifty pounds heavier than she was a year ago.

Gaining weight is common in recovery because many substance users eat poorly and are often malnourished. Nutrition studies suggest that food and drugs may compete for overlapping reward mechanisms in the brain. So many people in early recovery may engage in “rebound eating” of non-nutritional foods high in sugar and caffeine to stimulate reward chemicals in the brain. Such substitutions, while arguably better than drugs, cause unhealthy swings in blood sugar levels and may lead to excessive weight gain.

Reinstating proper nutrition is important in recovery to help reverse some of the metabolic and nervous system damage caused by substance use. The key is to introduce proper nutrition while avoiding unhealthy “rebound eating”.

How Substances Affect Nutrition and Health

According to the National Institutes of Health, substances harm the body by affecting metabolism, organ function and mental well-being. Brain chemicals (neurotransmitters) may become depleted or malfunction; hypoglycemia (low blood sugar) can trigger anxiety, fatigue and depression; and digestive problems can occur, leading to poor absorption and deficiencies in key nutrients, vitamins and minerals.

Some commonly used substances and their resulting health-related symptoms include:


  • Diarrhea
  • Nausea
  • Vomiting

These conditions can result in an imbalance of electrolytes (sodium, potassium, chloride), which are essential for proper function of cells and organs. In addition, loss of fluids from diarrhea or vomiting poses a risk for dehydration, which is common during recovery.


  • Diabetes
  • High blood pressure
  • Liver damage
  • Hypoglycemia

Alcohol damages two major organs involved in metabolism and nutrition: the liver and the pancreas. The liver is responsible for removing harmful toxins from the body and the pancreas regulates blood sugar and fat absorption. Damage to these two organs causes an imbalance of fluids, protein, and electrolytes within the body.

Stimulants (Cocaine, Methamphetamine)

  • Reduced appetite
  • Weight loss
  • Memory problems

With prolonged use, memory problems may become permanent.


  • Mood disturbances
  • Thinking/problem-solving difficulties
  • Impaired memory

Brain changes are more severe for long-term, early-onset and heavy users, resulting in average loss of eight IQ points from ages 13 to 38, according to an NIH study, updated in 2015.

Such problems can be avoided or corrected with proper nutrition education and improved eating habits. A Journal of the American Dietetic Association study (2004: 104; 604-610) reported that comprehensive nutrition education provided as part of a recovery program significantly improved 3-month sobriety success rates.

The Link Between Poor Nutrition and Cravings

An unbalanced diet that is high in fat, sugar and caffeine and low in complex carbohydrates and protein can lead to low blood sugar and dehydration which often triggers anxiety, irritability, and low energy levels, and these in turn, are triggers for cravings. Increasing one’s intake of sugar, sweets and caffeine in an attempt to increase energy levels and improve mood can lead to long-term nutritional problems that derail recovery efforts rather than aid them.

How Proper Nutrition Can Assist Recovery

Proper nutrition can reverse nutritional deficiencies and reduce disease risk. Increased consumption of nutrient-dense foods such as fruits, vegetables, whole grains and fish are the basics of a healthful diet. These foods help aid the return of healthy neurotransmitter activity, reduce harmful inflammation and cell damage and increase absorption of essential amino acids, vitamins and minerals.

The Role of Carbohydrates

A nutritionally balanced diet with the correct amount of healthy carbohydrates, which are the body’s main source of energy, can aid brain function, provide blood sugar stabilization and ward off neurotransmitter disruption. Carbohydrates are also important for the production of serotonin, which stabilizes mood, aids sleep and curbs cravings.

The Role of Amino Acids and Vitamins

Amino acids are the building blocks of proteins and they are also the substances from which neurotransmitters, or brain chemicals, are formed. According to the NIH, the most common nutritional deficiencies seen in patients with mental disorders are of omega–3 fatty acids, B vitamins, and amino acids.

According to the NIH, the most common nutritional deficiencies seen in patients with mental disorders are of omega–3 fatty acids, B vitamins, and amino acids.-Rita MiliosSince dopamine, the “reward” neurotransmitter, is made from the amino acid tyrosine and serotonin, a neurotransmitter that regulates mood and appetite, is made from the amino acid tryptophan, a lack of either of these amino acids in the diet can cause disruption in the regulation of the brain chemicals that affect mood and cravings for drugs or alcohol.

Omega-3 fatty acids, found in foods like walnuts, flaxseed oil and fish or krill oil, are important for normal metabolism. They aid neurotransmitter function and decrease inflammation. Supplements containing omega-3 fatty acids are sometimes recommended during recovery to assist in reducing depression or anxiety symptoms.

In addition, studies have found that vitamins B6 and B12 are effective in treating symptoms of depression.

“Recovery Friendly” Nutrition and Diet Options

Nutrition expert David Wiss, RDN, founder of the Nutrition in Recovery program, suggests that those in recovery eat several small meals throughout the day to prevent spikes and drops in blood sugar. He suggests following the plan of “never hungry, never full” in relation to food consumption.

Another approach, Medical Nutritional Therapy, was introduced in the late 90’s as a protocol of the American Dietetic Association. It suggests that those in recovery from substance abuse focus on the reversal of malnutrition and the management of blood sugar levels by increasing consumption of nutrient-dense foods (fruits, vegetables, whole grains, fish) and increasing consumption of antioxidant-rich foods (blueberries, grapes, nuts dark vegetables).

Below are more general guidelines for a “recovery friendly” diet and nutrition program:

  • Follow a meal and snack schedule (ex: 3 small meals and 3 snacks per day). Eating at regularly scheduled intervals will reduce cravings and help with blood sugar balance.
  • Aim for a balanced diet of 25% protein, 45% complex carbohydrates, 30% healthy fats.
  • Eat enough fruits and vegetables. USDA recommendation: 3-5 vegetable servings, 2-4 fruit servings per day.
  • Drink sufficient amounts of water and other healthy fluids. Eight to ten ounces per day of water and other fluids combined is recommended by the National Institute of Medicine.
  • Use vitamin and mineral supplements when needed. (But nutrients from food are more easily metabolized and used by the body.)
  • Snack smarter. Choose lower-fat, lower sugar snacks (ex: choose popcorn over potato chips, fruit over baked goods and yogurt over ice cream).

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