More Q&A: smoking and weight

By Alan Koenigsberg, M.D.

1. Are there medications that can help me stop smoking?

Yes. I have prescribed Chantix for some patients, or Zyban, which is also known as Wellbutrin, the generic of which is bupropion, and each has helped some patients with reducing cravings. There are also nicotine patches, as well as nicotine gums, which do not contain tar, the ingredient in cigarettes which is associated with lung cancer, and can be used to help reduce withdrawals from stopping cigarettes.

2. Any other suggestions to help with quitting smoking?

Yes. I have recommended that the person pick a time a few months out when they can commit to stop smoking. Then, go purchase cartons of cigarettes to last that long. Those will be the last cigarettes they ever smoke. Remove the lids from the cartons, place them sideways on a chair and watch as they take packs from the cartons, thinking about how cigarettes have kept them company and provided soothing; grieve the loss as they are watching the empty spaces grow larger and larger. It’s a difficult process, and one that has proved to work the majority of the time.

3. The holidays are here. Any suggestions for losing weight?

Sure. Don’t try to lose weight right now, but rather, work to not gain weight, and start the weight loss program when life is a bit less stressful.

Several basic thoughts:

*There are indeed several medications that can help reduce hunger and food cravings. I would start by discussing this with your family physician or internist, and decide if one of them may be appropriate for you.

*There are various forms of bariatric (weight loss) surgeries; again, begin by discussing this option with your primary care physician, and then perhaps with a bariatric surgeon. These procedures are indeed effective, and reserved for the more severely obese people.

*The recommendations I most often suggest are the following:

A. Plan on changing your way of eating permanently. Diets work for a while, and then stop working when you stop them. Realize that you are in this for the long run, like a marathon, and adjust accordingly. Nothing is permanently forbidden, and you need a plan that will work for decades. Enjoy your latkes, sour cream and apple sauce!

B. Portion control. Weight Watchers is an excellent example of this. We tend to eat far more food than is necessary, and don’t burn it off. It takes concentration and focus, not so much will power, to adjust how much food we prepare and eat. We can go out and order a regular portion of food, and take home half. This is a critical component of healthy eating.

C. Reduce the processed carbohydrates. ALL breads, cereals, pastas, pizzas, candies, chips, pretzels, stone-ground oatmeal, cookies, pancakes, waffles and so on are digested into simple sugars, which the body uses for fuel. However, most of us don’t swim laps eight hours each day, and the unused sugars are metabolized into fat molecules by the body, to store for later famines. If you pay attention to the amount of processed carbs, you will reduce the tendency to produce more fat.

D. Weight training is an important part of being healthy. We lose percentages of muscle by growing older, and one way to stave off that process is to lift weights, regardless of the age we are. A 6-foot barbell with a few 5- or 10-pound weights will get you through your entire life. Squats, military presses, bench presses, dead lifts and toe raises are all we need to maintain healthy muscle tone. Start with doing whatever you can, without the bar, and slowly increase the amount of weight.

Alan Koenigsberg, M.D., is a practicing psychiatrist and clinical professor of psychiatry at UTSW Medical School in Dallas.

Leave a Reply