So, in addition to information about the practice, I thought I would post medical news and notices on this site. Basically, it will be a medical weblog as well as a practice home page. Let me know if you like the idea (for practice news, scroll down).
I see on the UPI wire that the ongoing Lung Health Study at the University of Minnesota has finally proven what a lot of my patients have been telling me for years: you gain a lot of weight when you quit smoking…
It’s conventional wisdom that many who quit smoking may gain 5 to 15 pounds, but a U.S. study finds many smokers who quit gain about 20 pounds…
Eisenberg and Quinn re-analyzed data from the Lung Health Study, in which 5,887 American smokers were randomly assigned to either a smoking cessation program or usual care and then followed for five years. The authors of the 1998 study had estimated that quitters gained nearly 12 pounds.
However, the researchers used a complex statistical method that allowed them to compare “apples to apples” in the two groups, and they found that average weight gain was actually 21 pounds.
I find that this is a serious obstacle to quitting for many of my patients – especially now, with a health campaign underway to educate the public on the dangers of obesity. Cosmetic issues aside, patients are not sure which is worse – smoking, or the weight gain associated with quitting.
The answer is: smoking is far worse. There’s hardly an organ system in the body that’s not affected by smoking. In addition to lung cancer and heart attack, smoking greatly increases the risk of stroke, emphysema, cancer of the mouth, stomach, kidney and bladder, cataracts… you name it. If you want to see an illuminating little graphic on the dangers of smoking, click here. Even if you do gain twenty pounds when you quit smoking, you’ll live longer with the twenty pounds than you would with the cigarettes.
Still, I usually counsel patients to think of quitting smoking as one part of a bigger effort to improve their health through lifestyle change. If, in addition to quitting, you begin exercising (or increase your exercise) and make healthy food choices, you’ll minimize weight gain, improve your cardiovascular health, and also have more fun.
The Lung Health Study data should increase the interest in topiramate as an aid to smoking cessation. Topiramate is an anti-epileptic medicine that, in addition to preventing seizures, has some other interesting properties. It inhibits the release of dopamine in the mesocortocolimbic area of the brain – the part thought to be responsible for addictive behaviors. In other words, it helps to block one chemical pathway for addiction.
Topiramate has been used successfully to treat alcoholism. One study showed that it also reduced smoking in alcoholics; and in another, published last month, six out of thirteen non-alcoholic smokers quit cigarettes after being given topiramate. So, early data suggest that topiramate is effective in helping people to quite smoking.
A very common side effect of topiramate treatment is: weight loss. I saw a very dramatic case of a young woman with epilepsy who lost thirty pounds in a couple of months after being started on topiramate. I worked her up for cancer before figuring out it was the medicine that caused it.
Topiramate is being studied as a therapeutic drug for obesity. Subjects lose, on the average, eight to ten percent of body weight over two months, and maintain it over a three year period with continued treatment.
This would make topiramate an appealing drug to aid in smoking cessation, since it could blunt the weight gain associated with quitting.
It’s definitely not ready for prime time yet. The studies are preliminary, and topiramate has some significant side effects that could limit its use. The FDA has not approved it for this indication. But keep your eye on it. It may turn out to be a good adjunct to behavioral measures in smokers who want to quit and are afraid of weight gain.
Post a Comment