Is Cessation-Related Weight Gain Temporary?

I recently blogged about the Rule of Thirds – the myth that only a third of smokers gain weight after quitting (with a third remaining the same and a third actually losing weight).  This would be nice if it were true but it simply is not.  The large majority of quitters gain weight.  Only a handful actually lose weight, and as I have suggested elsewhere, some of those who do may be suffering from loss of appetite associated with depression.

Another dubious claim floating around out there is that weight gain after quitting smoking is temporary, and that after an initial increase in weight, quitters will return to their pre-cessation weight with no special effort. This optimistic view – basically just a twist on misleading promises that anyone can quit without gaining weight – is propagated in a government pamphlet entitled Forever Free (http://www.smokefree.gov/pubs/FFree3.pdf).  Even then, the pamphlet waffles, asserting that “most [quitters] lose weight over time with no special action” but repeatedly suggesting otherwise in the text.

So far as I can tell, the idea that weight gained after quitting magically melts away originated with an MIT economist named Jonathan Gruber, who flatly stated, “There’s no evidence in the medical literature that quitting smoking will affect your weight over a long period of time.”  In fact, there is considerable evidence in both cross-sectional studies, including one from my own laboratory, and longitudinal studies showing that exsmokers weigh about the same as people who never smoked, even several years after quitting, and that both of these groups weigh more than current smokers.  These findings are consistent with the common-sensical inference that quitters on average revert to the weight they would have been had they never smoked.

What IS true is that the period of gaining weight is temporary.  When you stop smoking, your weight generally goes up by a few pounds, mostly within the first six months.  Although Americans typically put on weight as they age, little of the weight you gain beyond your six-month anniversary is likely to be attributable to the fact that you stopped smoking.

This is also not to say that you cannot avoid weight gain or even lose weight after quitting by aggressively modifying your dietary and exercise patterns.  Alternatively, you can accept a few extra pounds as your badge of success, knowing that those pounds are likely to land in all the right places as your body, no longer exposed to the anti-estrogenic effects of smoking, assumes a more “feminine” shape. And you can manage that weight gain so that you remain in the 5-10 pound category that will minimize the impact on your Body Mass Index and your wardrobe – a very achievable goal.

But why not tell a little white lie if it might encourage people to quit by making them more hopeful?  Is it really any worse than responding “Fine” when people casually ask how you are, even if you had a fight with your husband, the dog threw up on the rug, and you feel a cold coming on?

Anyone following this blog has heard my mantra that realistic expectations are the best path to life as a contented nonsmoker who is not plagued by craving for cigarettes or dissatisfaction with her body. I would rather see smokers directly addressing the task of managing weight gain after quitting than facing disappointment, a sense of personal failure, and relapse because they hoped that if they ignored it, it would just go away.

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