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Here in the United States, there is a growing problem of people gaining too much weight. This isn’t because we now have more food available. There hasn’t been a famine in this country during the lifetime of anyone living here. And yet, last night on the Public Broadcasting System’s (PBS) news were seen the victims of opioid addiction all of whom were morbidly obese. Part of the pain these legal opioid users mentioned was their poverty. For me there was an obvious omission because the subject of obesity didn’t arise in the conversations but it was profoundly apparent.

If these people are eating far more calories than their bodies need for maintenance there must be something these people and the TV interviewers are missing. Does their addiction to opioids interfere with their body’s ability to sense when to quit eating or are they simply eating the wrong foods? Is there some way that simple question could be answered? For example, if they happened to have an identical twin who wasn’t on opioids but who ate the same foods, was that twin obese? Or alternatively, would an identical twin who was on opioids but ate one of the popular diets have a normal BMI (Body Mass Index) below 25?

It would be difficult to find twins with one twin on opioids and the other not on opioids but on a specific one of those diets and impossible for all of the diets. However, it would be relatively easy to follow for a week a largish number of opioid users and observe what they actually ate. Even a questionnaire, which is not a very good way for getting accurate results, would probably be adequate for demonstrating that these opioid users were eating poor diets. Perhaps the best intervention for them wouldn’t be trying to wean them off of opioids but help them to eat appropriate amounts of better quality foods.

American’s big problem is putting too much of the wrong stuff into their bodies.