How Malnutrition Can Effect Mental Health in Addiction Recovery

Woman on the beach struggling with addiction

According to the National Council on Alcoholism and Drug Dependence, alcohol is “very rich in energy, packing 7 calories per gram. But unlike pure sugar, or fat, the calories are void of nutrients. The more calories an individual consumes in alcohol, the less likely it is that they will eat enough food to obtain adequate nutrients.” Chronic alcohol abuse displaces calories from essential nutrients within the body and interferes with the body’s metabolism, which can cause damage to the liver, digestive system, and various organs.

Impact of Alcohol on Nutrition and Appetite

Many studies look at the effects of malnutrition and alcohol. Alcohol affects a person’s central nervous system, which in turn effects appetite and nutrition. When alcohol is initially ingested an increase in euphoria and energy occur, but alcohol is a depressant drug, which leaves the user feeling sleepy, drowsy, and depressed.

In heavy drinking or chronic use, individuals will fill daily calorie needs with alcohol rather than food. When food is consumed, typically the user, tends to choose foods heavily based on carbohydrates due to the fact that alcohol is an addictive carbohydrate. Alcohol increases the cravings for further carbs, salts, and sugars.

Chronic uses also tend to choose low nutrient foods which causes the body struggle to absorb, which can in turn lead to malnutrition. Malnutrition can cause short and long term effects to a person’s immune system, such as, malfunctioning of organs, and decline in physical health and appearance.

Symptoms of malnutrition can include fatigue, dizziness, weight loss, and decreased immune response. It can lead to long term effects such as impaired mental functioning, physical disability, various chronic illness, and death.

Woman struggling with alcoholismAccording to the National Institute on Alcohol Abuse and Alcoholism, alcohol “inhibits the breakdown of nutrients into usable molecules by decreeing secretion of digestive enzymes from the pancreas…..alcohol impairs nutrient absorption by damaging he cells lining the stomach and intestines, and disabling transport of some nutrients into the blood.”

Malnutrition can also lead to decreased liver storage of Vitamin A, Vitamin B1, B2, Vitamin C, and Folic Acid, as well as increase excretion of nutrients such as fat. Adversely, some substances can suppress appetite and disrupt metabolic and neuroendocrine regulation. Other substances can lead to an increase in appetite and weight gain.

Consequences of Malnutrition on Mental Health

Malnutrition by way of addictions can affect a person’s mental health by its toxic effect on the brain chemistry. This can leave the addict feeling depressed, agitated, and unstable early in the recovery process. Nutrition, proper or not, effects the body and mind.

Carbohydrates are the body’s main source of energy. Without it the brain cannot function properly and blood sugar becomes unstable. This can disrupt serotonin, which can increase anxiety, feelings of frustration, depression, sleep disturbances, and intense cravings. Insulin helps glucose enter cells.

This can help with the release of important vitamins folic acid, and vitamins B6 and B12. Deficiencies in these vitamins can lead to depression, fatigue, poor attention, and altered sleep. Amino Acids aid in protein which strengthens neurotransmitters.

When this is low it decreases dopamine which affects mood, aggression, and the reward center of the brain. Dietary fat affects inflammation and cell membrane integrity, and limiting this fat influences mood, which can lead to increased depressive symptoms.

Working With a Dietitian

Individualized meal plans coupled with educational programs that are geared toward healthy, balanced eating, have been found to significantly improve sobriety rates. Medical nutrition therapy (MNT) can offer nutrition education by learning how substance abuse damages the body, increasing mood and reducing stress, reducing cravings and withdrawal effects, and encourage self-care routines.

Mental health issues such an anxiety, irritability and low mood can be triggers for cravings. These symptoms can result from low blood sugar, dehydration, and unbalanced diet. Increase relapse may occur during this time due to malnutrition’s effect on cravings.

A meal plan that is focused on high complex carbohydrates, moderate protein, low fat and sugar are recommended to help maintain recovery. Often times when recovery starts, addicts find it difficult to differentiate between hunger and cravings as well report increased sweet cravings. This is linked to fulfilling the pleasure/reward part of the brain to get the same response as dopamine.

Binge eating may also occur in recovering addicts. 50% of substance users have a comorbid eating disorder. During detox weight gain can occur due to the fact that many addicts turn to food to replace the substance. Due to decreased substance, and biochemical changes, appetite increases.

Friends discussing substance abuseDifferent substance abuse can lead to various physical and mental health concerns. Alcohol can lead to malnutrition by impacting the digestion and absorption of essential nutrients. It interferes with protein metabolism and can lead to low albumin levels, increased fluid in abdomen, reduced blood clotting, and decreased urea production. Liver damage can result.

Opioids, used for pain management, can cause slowed body movements, sedation, slow digestion and constipation. Stimulant abuse can lead to decreased appetite and weight loss. It can cause insomnia, paranoia, anxiety, and memory problems. Marijuana abuse impairs memory, attention, judgment, and balance. It can cause increased appetite and weight gain.

In conclusion, malnutrition can happen with many substances, and cause physical and mental health issues. In recovery it is imperative to have a dietician on the treatment team to ensure holistic treatment for recovery.

Community Discussion – Share your thoughts here!

What nutritional effects do you see with substance use?

Image of Libby Lyons and familyAbout the Author: Libby Lyons, MSW, LCSW, CEDS, is a Certified Eating Disorder Specialist (CEDS) who works with individuals and families in the area of eating disorders. Mrs. Lyons works in the metropolitan St. Louis area and has been practicing in the field for 11 years. Libby is also trained in Family Based Therapy (FBT) to work with children-young adults to treat eating disorders. Mrs. Lyons has prior experience working with the United States Air Force, Saint Louis University, Operating Officer of a Private Practice, and currently works with both Saint Louis Behavioral Medicine Institute within their Eating Disorders Program and Fontbonne University


[1]: Salz, Alyssa. Substance Abuse and Nutrition. Today’s Dietician. 2014
[2]: Retrieved from 2016
[3]: Retrieved from 2016


The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 21, 2016
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About Jacquelyn Ekern, MS, LPC

Jacquelyn Ekern founded Addiction Hope in January, 2013, after experiencing years of inquiries for addiction help by visitors to our well regarded sister site, Eating Disorder Hope. Many of the eating disorder sufferers that contact Eating Disorder Hope also had a co-occurring issue of addiction to alcohol, drugs, and process addictions.