Consequences of smoking for body weight, body fat distribution, and insulin resistance

Am J Clin Nutr. 2008 Apr;87(4):801-9. doi: 10.1093/ajcn/87.4.801.


Our aim was to critically evaluate the relations among smoking, body weight, body fat distribution, and insulin resistance as reported in the literature. In the short term, nicotine increases energy expenditure and could reduce appetite, which may explain why smokers tend to have lower body weight than do nonsmokers and why smoking cessation is frequently followed by weight gain. In contrast, heavy smokers tend to have greater body weight than do light smokers or nonsmokers, which likely reflects a clustering of risky behaviors (eg, low degree of physical activity, poor diet, and smoking) that is conducive to weight gain. Other factors, such as weight cycling, could also be involved. In addition, smoking increases insulin resistance and is associated with central fat accumulation. As a result, smoking increases the risk of metabolic syndrome and diabetes, and these factors increase risk of cardiovascular disease. In the context of the worldwide obesity epidemic and a high prevalence of smoking, the greater risk of (central) obesity and insulin resistance among smokers is a matter of major concern.

Publication types

  • Review

MeSH terms

  • Appetite Regulation / drug effects
  • Body Composition / drug effects
  • Body Fat Distribution*
  • Body Weight / drug effects*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Dose-Response Relationship, Drug
  • Energy Metabolism / drug effects
  • Humans
  • Insulin Resistance*
  • Nicotine / adverse effects
  • Nicotine / pharmacology*
  • Obesity / complications
  • Risk Factors
  • Risk-Taking
  • Smoking* / adverse effects


  • Nicotine