Sex and Gender Differences in Weight-Related Biopsychosocial Factors Among Adults Receiving Buprenorphine for Opioid Use Disorder.

Introduction: Medication for opioid use disorder (MOUD) is the most efficacious treatment for opioid use disorder (OUD). MOUD uptake and continuation may be impacted by health concerns, including weight gain, and social factors, such as food insecurity, that vary between men and women. This study aimed to describe sex and gender differences in body mass index (BMI) and weight-related demographic, psychosocial, and clinical characteristics among adults receiving buprenorphine for OUD.

Methods: This secondary analysis used data from a cross-sectional survey and prospective medical record review study among adults (n = 77 female, n = 66 male) engaged in outpatient treatment receiving buprenorphine for OUD. Survey items assessed weight-related demographic and psychosocial variables. Clinical factors were collected via chart abstraction. Comparisons between male and female participants were made using χ², Mann Whitney U, and t-tests.

Results: Most participants were non-Latinx, Black (69.9%), with a mean age of 43.3 ± 12.3 years. Among females, 2.6% had a BMI <18.5 kg/m², 32.5% had a BMI from 18.5 kg/m² to <25 kg/m², 35.1% had a BMI from 25 kg/m² to <30, and 29.9% had a BMI of 30 kg/m² or higher. Among males, 1.5% had a BMI <18.5 kg/m², 43.9% had a BMI from 18.5 kg/m² to <25 kg/m², 36.4% had a BMI from 25 kg/m² to <30, and 18.2% had a BMI of 30 kg/m² or higher. Females had a higher median BMI than males (27.4 kg/m² [IQR: 23.3-32.1] vs 25.5 kg/m² [IQR: 22.2-29.4], P = .041). Females were more likely than males to be unemployed, receive nutrition-based public assistance, and be prescribed psychotropic medication.

Conclusions: Females had a greater BMI than males and experienced more weight-related social and clinical vulnerabilities. Understanding weight-related sex and gender differences in this population is important for informing multidisciplinary treatment approaches that promote MOUD uptake and continuation and center overall health in people with OUD.