September 8, 2008

Weight Gain Follows Smoking Cessation

By Michael Roizen, MD, and Mehmet Oz, MD

Question: I quit smoking for two years, but in the process I gained 30 pounds - and I hate it. I've started smoking again in hopes I can lose the weight. I know it's not good for me. I'm 61, a little under 5 feet tall, weigh 138 pounds and hate how I look. Can you help me? - Janet, Sonora, Calif.

Answer: We wish we could have worked with you from the beginning. On our "YOU Can Quit" plan, the key to success is substituting an activity like walking for smoking.

You won't gain weight, and you will successfully stay off cigarettes. Of the more than 700 patients Dr. Mike has helped, the women average NO weight gain over six weeks, while men gain about 2 pounds. (The range has been minus 10 to plus 30 pounds.)

Basically, after walking for 30 days, 30 minutes a day, every day, and calling a buddy before or afterward for support, you then quit (with medications).

Talk to your physician about starting bupropion, 100 mg twice a day, and on day 30, adding a 21 or 22 mg nicotine patch (assuming a pack-a-day habit). Fifteen to 30 days later, start weight training for 20 minutes three times per week.

Throughout, avoid simple sugars or syrups; saturated fats or trans fats; and any grains that aren't 100 percent whole grains. (For complete plan specifics, check the YOU Docs section at

Good luck on the weight loss and the smoking cessation. E-mail us again in three weeks to let us know of your progress.

Question: What is with the body mass index scale? I am definitely NOT obese, but my BMI says I am. I'm 5 feet, 10 inches tall with an athletic build and have always been large compared with the average woman. My weight is 206. The least I've ever weighed was 160, and people thought I was sick.

This is completely unmotivating because my BMI just won't go down to where the chart says it should be.

Isn't there a better way to measure whether I'm healthy? - Robin, St. Michael, Minn.

Answer: BMI can be inaccurate for someone who is very muscular.

For example, when Michael Jordan was at his basketball-star prime, his BMI placed him in the obese category.

A better measure is your waist size - the distance around it at your belly button measured while you suck in. For a woman, the ideal is 32.5 inches or less; more than 37 inches, you start to age greatly (and health risks go up). For a man, the ideal is 35 inches or less; more than 40 inches and the same troubles start.

Question: Do I need a sports drink during my workout? I'm afraid they might contain lots of sugar and make me gain, not lose, weight. - Yvette, New York

Answer: You only need sports drinks if you exercise hard for more than 60 minutes. They rehydrate your body faster than water after long periods of exercise, because they contain minerals called electrolytes (some of the same ones that are already in your body) that hasten the absorption of water.

But if you drink them regularly or after short workouts, you'll end up in exactly the situation you're concerned about: consuming more calories than you burn off. A great sports drink for short workouts: Water.

To submit questions and find ways to grow younger and healthier, go to, the docs'online home.

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