How to Quit Smoking Without Gaining (Much) Weight

Will you gain weight if you quit smoking? Probably. Four out of five quitters gain some weight—4 to 10 pounds each, on average. The good news, however, is that quitters usually do get back to a normal weight, especially when the focus is on stopping smoking first.

Should you put off quitting in order to keep off unhealthy extra pounds? Nope. The science is unequivocal: "There’s no question that any weight gain is preferable to continuing to smoke," says Kenneth A. Perkins, Ph.D., professor of psychiatry at the University of Pittsburgh. Emily Rubin, R.D., of the Digestive Disease Institute at Thomas Jefferson University Hospital in Philadelphia, agrees. "You’d have to gain 100 pounds to have the same health risks that a pack-a-day cigarette habit would give you," she says.

Why do quitters usually gain weight?

Smokers develop a lifestyle that revolves around smoking rather than eating or exercising. But it’s also true that smoking helps you keep your weight down (if at great cost to your heart and other organs, not to mention your appearance and smell). As a smoker, your body gets used to these facts:

• Smoking burns calories. Smoking elevates your heart rate and increases your metabolism; when you quit, you burn about 100 fewer calories a day. After quitting, it can take weeks or even months for your metabolism to rebound.
• Smoking suppresses hunger. Nicotine causes the liver to release glycogen, which raises your blood-sugar level slightly and suppresses appetite. Until your metabolism adjusts, expect to gain about a pound a week.

• Smoking makes you feel good. Nicotine increases the levels of dopamine (a chemical associated with pleasure) in the brain. High-calorie treats, such as candy and cookies, produce much the same effect, so after quitting, you may be tempted to replace cigarettes with food. Alcohol boosts dopamine levels as well, and studies show that alcohol use tends to increase after quitting. This mechanism may explain why bupropion (Zyban), an antidepressant that works on the brain’s dopamine system, has shown to be helpful for smoking cessation.
• Smoking gives you something to do with your mouth and hands. Eating does the same—and makes you feel less deprived by your decision to quit.
• Smoking dulls your taste buds. After you quit, food begins to taste and smell better, so you may find yourself wanting to eat more.
• Smoking is reliable when other things are not. People use both cigarettes and food as a way to deal with boredom or stress, as a reward, or as a crutch in social situations.

Don’t think about your weight so much

Experts recommend focusing on the quitting process first and getting to the matter of your weight later on. "If you’re dieting while you’re trying to quit, there’s too much deprivation going on," says Perkins. Obsessing about keeping weight off while attempting to quit may even be counterproductive—on both fronts.

This dynamic is especially common for women, for whom weight gain can be such a tricky issue. (In addition to weight issues, research shows a range of other sex-based smoking differences.)

In a 2001 study, 219 women who wanted to quit—but were concerned about gaining weight—were divided into three groups. One group received cognitive-behavioral therapy (CBT) designed to help them accept a modest weight gain in exchange for the benefits of quitting smoking. Another group was given weight-control counseling and daily calorie goals. A third group (the control group) received counseling sessions in which they discussed their interpersonal relationships. A year later, 21 percent of the CBT group had successfully quit smoking, compared with 13 percent of the weight-control group and 9 percent of the control group. On average, the members of the CBT group also gained less weight than the other groups.

"Sometimes folks—particularly women—gain more, paradoxically, when they are concerned about weight gain, depending on how they approach the issue of quitting and weight," says Michele Levine, Ph.D., assistant professor of psychiatry and psychology at the University of Pittsburgh School of Medicine.