Smoking and Disordered Eating

Patients with eating disorders can be very creative about finding ways to lose weight, including excessive exercise and dietary restriction, not to mention cigarette smoking. A study at Yale recently examined the relationships between cigarette smoking for weight control and eating disorder symptoms in a community sample of adult female smokers.

Marney A. White reported that 107 adult female smokers (drawn from an original sample of 1141 male and female participants) completed a battery of questionnaires, including the Eating Disorder Examination-Questionnaire (EDE-Q) (Comprehensive Psychiatry 2012; 53:403). The key areas measured included weight-control smoking, including smoking to prevent overeating, smoking to undo the effects of overeating, and smoking to feel less hungry. Women who used these measures were then compared (on the EDE-Q) with women who denied using such behaviors and scores and frequency of binge eating and purging.

The results of this community survey showed that a significant proportion of the adult female smokers participating in the study reported smoking cigarettes for weight control, More than half of the participants reported smoking more when dieting (55.1%; n=59) or smoking to suppress hunger (54.2%; n=58). Forty-three percent (n=46) reported smoking more after overeating and 43% (n=46) reported smoking to prevent overeating. More than a fourth of the women endorsed smoking more to undo the effects of overeating than for the stimulation from nicotine; that is, they turned to smoking as a means to control their weight.

The authors suggest that clinicians treating patients with eating disorders monitor and address smoking with these patients because they may be using smoking to compensate for overeating and/or to help them restrict their food intake.