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Smoking cessation and weight gain.
Jonathan Foulds, PhD posted:
A number of people in this community have commented on their experiences of gaining weight when stopping smoking, so I thought it may be worth summarizing some of the scientific evidence on that topic. The U.S. Lung Health Study is an excellent source of data on this as it was a large study of a cohort of mainly middle age smokers, some of whom were helped to quit, and who were followed up thoroughly for over 5 years. In that study, smokers who did not quit smoking put on around 2 pounds over a year, and smokers who quit completely put on around 11 pounds over a year. After 5 years, those who continued to smoke had put on 3 or 4 pounds, and those who stayed smoke-free had gained an average of 17-18 pounds. One of the main findings of this study was that over a third of both men and women who quit smoking for 5 years, gained more than 22 pounds. About 60% of the weight gain occurs in the first year after quitting, and then the rest of the weight gain occurs more gradually over time. The weight gain in this study may have been slightly higher than normal as all of the participants had mildly impaired lung function at recruitment which may have affected the amount of exercise they took, and they also tended to be heavy smokers (about 25 cigarettes per day). The amount of weight gain tends to be proportional to the number of cigarettes smoked before quitting.
These numbers may be rather sobering for those in the process or considering quitting. Other studies suggest an average excess weight gain in the year after stopping smoking to be around 5 pounds (these studies including lighter smokers). So what can be done to reduce the weight gain? It is clear that using nicotine replacement or bupropion for smoking cessation will delay weight gain as long as the person takes these medications, but weight tends to increase afterwards. I do not recommend a strict calorie restriction diet while quitting smoking, but rather emphasize a move to a healthier balanced diet with munching on carrots and grapes rather than twinkies, and a steady increase in exercise to reduce weight gain.
This link summarizes the evidence on the relative effects of obesity and smoking on health.
O'Hara et al (1996) Early and late weight gain following smoking cessation in the Lung Health Study. American Journal of Epidemiology, 148: 821-830

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