Addiction switching: Quit smoking, but binge?

On this segment of “Today’s Health,” we look at the phenomenon of switching addictions. That’s when someone who is trying to give up one addiction picks up another to fill the void. Madelyn Fernstrom, a show contributor and director of the Weight Management Center at the University of Pittsburgh, was invited on “Today” to tell us why so many of us replace one bad habit with another.

Addictions come in many forms — alcoholism, smoking, overeating, etc. — but they have much in common. For instance, they can help addicts manage stress or give them a sense that they have control over their lives. So when someone manages to overcome one addiction, they often pick up another. Sometimes people are considered to have addictive personalities, but for most addicts drugs, cigarettes, or food are simply crutches to deal with stress and other issues.

Evidence suggests there are overlapping circuits in the brain that relate to pleasure seeking and relief from anxiety. Of course, we can’t use our biology as an excuse to say, “Well, it’s my personality and I have no control.” While there may be biological tendencies to have an addiction, you can overcome drinking, smoking and overeating, if you take a step back and get some personal insight into your behavior. And when you plan to give up one addiction, be prepared to make some lifestyle changes, so you don’t find yourself dealing with another addiction.

In fact, addicts worry about switching addictions. Many smokers are reluctant to quit, because they’re afraid that they’ll eat more and gain weight. And their fear is warranted. Many times smokers will find themselves substituting smoking—an oral behavior—with eating—another one. Smoking also stimulates metabolism. So even if you don’t eat more, you’ll put on extra pounds, if you don’t increase your physical activities. The best way to avoid gaining weight is to change your lifestyle one or two months before you expect to quit.

The first step to overcome any addiction is facing the fact that you have one and that you need a long-term strategy to deal with it. A support group, such as Alcoholics Anonymous or Overeaters Anonymous, can be helpful, if you’re comfortable in group settings. If not, some have success overcoming an addiction if they do it with someone else who is battling the same problem. But don’t pair up with someone with a different addiction. This can cause you to switch to the other person’s addictions. So smokers should pair up with smokers, for instance. If you don’t have someone with whom you can buddy up, you may need one-on-one counseling with a close friend, a family member, or even a therapist.

Of course, overeaters have a harder time kicking their addiction, because, in a sense, we are all food addicts — we have to eat. And you can’t simply stop eating to overcome your food addiction. Overeaters often need professional help to them identify the factors that lead to their addiction to food.

While there aren’t any prescription medications to help people with their food cravings, there are some to help addicts with their need for nicotine or alcohol. Buproprion, sold under the brand names Wellbutrin and Zyban, can help smokers and alcoholics with their cravings, and they can sometimes reduce their cravings for food. A newer smoking cessation prescription medication, Chantix, helps smokers combat the psychological dependence on cigarettes. If you’ve tried to stop smoking and have used nicotine gum, patches, and other over-the-counter anti-smoking aids, and nothing has worked, call your doctor. You may need a prescription drug to help you quit.

Smokers need to remember that smoking should be the first addiction to go. Then they can deal with overeating or other addictions later on. So stop smoking, even if it means that you gain 20 pounds. Here are fix tips for ex-smokers who don’t want to gain weight:

• Think before you eat
• Keep your mouth busy with low-calorie food and drinks
• Increase your daily physical activities
• Seek professional help, if needed

Madelyn Fernstrom is the director of the Weight Management Center at the University of Pittsburgh. For more information on the center, go to http://weightloss.upmc.com/.

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