Smoking cessation and weight gain

Smoking cessation clearly improves health, but is accompanied by increased appetite and weight gain in the majority of quitters. This issue is clinically relevant, since fear of weight gain prevents many smokers from even trying to quit. If they do try, males who gain weight are at increased risk for early relapse. Weight gain is associated with adverse metabolic consequences, which might reverse some of the favourable health effects of quitting. Findings on appetite-regulating hormones suggest that altered endocrine feedback in former smokers might cause appetite dysregulation and possibly alter reward sensitivity, thereby affecting relapse risk. However, these phenomena are poorly described and their underlying mechanisms remain unknown, which precludes targeted treatment strategies. This study investigates the effects of smoking cessation on neural mechanisms associated with appetite and the secretion of appetite-regulating hormones. The objective of this study is to explore whether smoking cessation alters the hormonal and metabolic central nervous feedback and whether those processes predict future weight gain. Central nervous mechanisms of appetite and food reward will be studied in a group of 30 smokers and a control group of 30 never-smokers using functional magnetic resonance imaging. Neural processing of food-related stimuli will be measured before and after dextrose administration. For this purpose, an oral glucose tolerance test (OGTT) is administered inside the MR scanner. Measures of glucose, insulin, cortisol, leptin, and ghrelin are obtained at continuous time points throughout the experiment. In order to investigate alterations of neural and hormonal parameters due to smoking cessation, smokers will be examined twice, once while smoking normally and a second time after two weeks of abstinence from smoking. Weight is determined three and six months after quitting.

Researchers:
Ricarda Kling
Andrea Kobiella
Lena Krebs
Maximilian Pilhatsch
Hannah Scheuing
Michael N. Smolka

Collaborations:
Ulrich S. Zimmermann, Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Germany

Funding:
DFG Grant # SM80/5-1