Vaping for Weight Loss? 5 FAQs

Alicia Ault

Disclosures

April 25, 2019

Yes, vaping to lose weight is a thing. And that is not surprising, for multiple reasons.

America is fighting the battle of the bulge, with half of us trying to lose weight in an average year. Smoking is one of many tactics used to shed pounds, and fear of weight gain can be a stumbling block to quitting.

Given the meteoric rise in sales of electronic nicotine delivery systems, which include e-cigarettes, vape pens, pods, and e-hookahs, it's not a shock that smokers, whether current, former, or never smokers, might use vaping as a weight loss strategy.

1. How common is vaping for weight loss?

Meghan Morean, PhD, Assistant Professor, Psychology, Oberlin College, Oberlin, Ohio
Credit: Rosen-Jones Photography

A perusal of the Internet finds users discussing how to vape the weight off. A product often mentioned is JUUL. "In my experience hitting the juul does wonders while dieting," said a user on one Reddit thread. "I've lost 20lbs and was able to stave off cravings by being a juul fiend."

Another Reddit user posted, "Same with me I've been using a Juul since about November and I've lost 30 pounds. It's pretty much gotten rid of my appetite and now instead of eating when I'm bored I just hit my Juul."

No nationally representative epidemiologic studies have been conducted to determine how many e-cigarette users are employing the device as part or all of a weight loss strategy, said Meghan Morean, PhD, a researcher on substance use from Oberlin College in Ohio.

In 2016, Morean and colleague Amelia Wedel surveyed 459 adult e-cigarette users who self-identified as wanting to lose or maintain weight.[1] About 14% of the respondents said they used vaping as a means of controlling their weight, and unlike in smoking studies, men were just as likely as women to say they used vaping as a weight loss method.

Weight control is probably not the primary reason for vaping in most cases, however, said Dr Morean, adding, "But there is a subset of folks who are definitely doing this."

Morean recently completed research, not yet published, looking at vaping motivation among adolescents, and found that a similar small number are vaping for appetite control.

The 2015 Youth Risk Behavior Surveillance survey, conducted among 9th to 12th graders, two thirds of whom were girls, found that almost half of teenage e-cigarette users were trying to lose weight.[2]

Smokers who use cigarettes to help with weight control are more likely to be current e-cigarette users. An online survey examined eating and weight-related reasons for smoking reported by participants. Smokers who reported that they smoked to suppress appetite and/or to prevent overeating were more likely to vape.[3]

Adults with self-reported eating disorders are also more likely to use vaping for weight loss, with one study concluding that it was because of the availability of sweet flavors and the fact that the behavior was easily concealed.[4]

2. Does it work?

Little has been published on the effectiveness of vaping for weight loss.

Vapers have anecdotally reported success with weight control, and some experts have suggested that it may be worth considering e-cigarettes as a potential weapon against obesity.

Marewa Glover, PhD, director of the Centre of Research Excellence: Indigenous Sovereignty & Smoking in Auckland, New Zealand, suggests that the effects of nicotine in vaping liquids, the changes in taste perception, and the act of vaping (which provides a behavioral and sensory replacement for food) might all promote weight loss.[5]

Nicotine is a well-characterized appetite suppressant, but the data on whether it helps control weight are mixed. It has been shown to chemically induce an increase in the metabolic rate and release hormones that suppress appetite. But it also increases insulin resistance, which leads to higher concentrations of visceral body fat.[6]

Morean suggests that e-cigarettes could fulfill the aims of a dieter in several ways: by mimicking the hand-to-mouth action of eating or, as noted by Reddit users, by filling a void. The nicotine is also likely a motivator. Morean found that adults with eating disorders "were more likely to be using higher concentrations of nicotine."

Vapers have already figured out the nicotine effect. In a YouTube video by DashVapes, an e-cigarette manufacturer, the narrator claims that nicotine "speeds up your metabolism and allows your body to burn more calories."

One vaper blogged that because of the ease of use, he had been vaping more often but said he was pleased with what he ascribed as the beneficial effect: "all this extra nicotine I am consuming is [a]ffecting my weight and seeing me lose the pounds."

The nicotine-containing pods sold by JUUL, which leads the market in sales, at $1 billion in 2018, have among the highest nicotine concentrations: 5% by weight, or the equivalent of a pack of cigarettes. JUUL's high nicotine concentrations are being copied by other manufacturers. One study found a total of 39 devices that offered nicotine concentrations equal to or higher than JUUL's.[7]

3. What role do flavors play?

Some vapers have said that the availability of sweet flavors helps them satisfy cravings they would normally indulge with food. That sets e-cigarettes apart from cigarettes.

"You can't get a cupcake-flavored cigarette," noted Morean.

Vapers trade tips on what flavors of e-liquids or e-juices work best for weight loss. "Mr. Long Drag" promotes what he said are three flavors that have "been proven to keep someone's hunger in check": mint, cinnamon, and nuts.

The DashVapes video narrator said that some people with diabetes, rather than turn to candies and chocolate to relieve their sweet tooth, "have a vape of their favorite candy flavor."

On a vaping and weight loss thread on Reddit, one advocate claimed to have lost 50 pounds: "Basically anytime I would be boredom eating I'm vaping now."

Added another: "My weakness is pastries...muffins, cupcakes, cookies, I love them. So, I just found juices that satisfied those cravings."

But all of the talk is not backed up by scientific evidence, said Morean.

4. Are weight loss claims by manufacturers regulated?

The industry leader, JUUL, said it does not promote its device for weight loss.

"The JUUL system is a vapor product that is designed to provide a satisfying alternative to adult smokers," company spokeswoman Lindsay Andrews told Medscape. "It is not intended for weight loss or marketed as a weight loss device."

Gregory Conley, president of the American Vaping Association, which bills itself as "a non-profit advocating for sensible regulations of vaping products," said that vaping for weight loss might not be a bad idea.

"For existing adult smokers who are using potential weight gain as a justification for not making a quit attempt, smoke-free nicotine products are a smart choice," Conley told Medscape.

Many manufacturers openly promote their products for weight loss, and it is often difficult to tell whether the products contain nicotine; many appear to be nicotine-free. The website for "Twiggy Weight Loss Vapor E-Liquid" displays warnings required by the US Food and Drug Administration (FDA) that the product contains nicotine, but the product description says "Absolutely '0' Nicotine."

"Slim Faster" says its "organic vape juice" contains the "appetite suppressing properties of essential oils of orange, grapefruit, peppermint, lemon and bergamot" but has no nicotine warnings.

Some products specifically state that they do not contain nicotine, such as "Skinny Vapor," sold on eBay. "Nutrovape," sold on Amazon, purports to be an aromatherapy delivery system that is nicotine-free.

A study from the Tobacco Center of Regulatory Science for Vulnerable Populations[8] reports that a number of e-cigarette and vape companies are making unsubstantiated health claims for e-liquids and inhalation of various supplements. "Such claims seem premature given that there could be detrimental effects, particularly from long-term use," the authors write.

The FDA has the authority to regulate the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of electronic nicotine delivery systems, including e-liquids, flavorings, and all device components. If a product is marketed for therapeutic purposes, such as to quit smoking or for weight loss, it would be regulated as a medical product, which means the manufacturer would have to substantiate the claim through clinical studies.

E-cigarette makers may be taking a page from Big Tobacco by essentially skirting the rules, just as was the case with the combustible (or traditional) tobacco industry. That industry's long history of targeting women with subtle and not-so-subtle advertising that suggests smoking helps with weight loss is well documented.

So far, the FDA has not cracked down on weight loss promotions, but in March 2019, the agency sent warning letters to manufacturers that were not including the required nicotine warning. "This is an important public health warning and it's imperative that consumers are adequately informed of the presence of nicotine in tobacco products and understand the risks—especially kids," said FDA Commissioner Scott Gottlieb, MD, in a statement.

5. What should you tell patients?

The bottom line is that some adults and teenagers may be vaping, either nicotine or flavored liquids or supplements, in an attempt to maintain or lose weight.

Nicotine has been associated with cardiovascular toxicity, but much of the risk may be attributable to the oxidants and particulates that accompany combustible tobacco, rather than from nicotine itself.[6] Nicotine alone contributes to insulin resistance and the accumulation of visceral fat.

A landmark 2018 report from the National Academies of Sciences, Engineering, and Medicine found that e-cigarettes seemed to present less opportunity for harm than combustible cigarettes and could help adults quit. But it also warned that the devices seemed to entice youth to go on to smoking.[9]

The Academies warned that little is known about long-term health effects, and that the amounts of nicotine in devices are highly variable, which could have some bearing on health outcomes.

Morean recommends that clinicians screen all patients for e-cigarette use, especially those with eating disorders. "Doctors or other healthcare professionals should definitely be assessing vaping, period, which most don't," she said.

"If it's somebody who has really low body weight, or somebody who is really obese and has heart problems, they definitely shouldn't be trying to take in high quantities of nicotine for weight loss," Morean said. "They should be eating a heart-healthy diet and exercising."

Meghan Morean, PhD, has disclosed no relevant financial relationships.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....