A hookah, also known as a water pipe or shisha, is a device used to smoke flavored tobacco through a water basin before inhalation. This practice has seen a surge in popularity globally, particularly among young adults. The social nature and sweet flavors often create a misconception that it is a less harmful alternative to traditional smoking. This article explores the biological and behavioral factors connecting regular hookah use to changes in body weight.
Chemical Effects on Metabolism and Appetite
Hookah use involves the absorption of compounds that influence the body’s energy regulation systems. Shisha tobacco contains nicotine, which is recognized for its ability to increase metabolic rate and temporarily suppress appetite. Nicotine triggers a release of catecholamines, elevating heart rate and increasing energy expenditure, similar to cigarette smoking. However, the nicotine content in shisha tobacco is often lower than in cigarettes, and the delivery method is slow and diffuse throughout a long session.
A more significant chemical factor is the massive exposure to carbon monoxide (CO), which comes primarily from the charcoal used to heat the shisha. A single hour-long hookah session exposes a user to significantly higher levels of CO than a cigarette. Carbon monoxide binds to hemoglobin, forming carboxyhemoglobin, which reduces the blood’s capacity to transport oxygen. This reduced oxygen availability decreases overall metabolic efficiency, negatively impacting energy expenditure and potentially contributing to weight gain.
The Hidden Calories in the Hookah Session
The behavioral context of a hookah session introduces substantial hidden calories. Hookah use is a prolonged, sedentary activity, with typical sessions lasting one hour or more. This extended period of physical inactivity decreases the body’s daily energy expenditure compared to more active pastimes.
This relaxed, social environment encourages the consumption of high-calorie food and beverages. Patrons frequently pair their session with sugary drinks like sodas, sweetened teas, or fruit juices, which contribute significant empty calories. Furthermore, many shisha tobacco blends are flavored with ingredients like molasses, glycerin, and high-sugar fruit pulp, which introduces a small caloric load. The combination of prolonged sitting and the unconscious consumption of dense calories creates a significant energy surplus.
Does Hookah Lead to the Weight Loss Seen in Cigarette Smoking?
The association between traditional cigarette smoking and lower body weight stems from the potent, acute metabolic boost and appetite suppression provided by high-dose nicotine absorption. Cigarettes deliver a quick, concentrated burst of nicotine, which is more effective at temporarily increasing the basal metabolic rate. Hookah smoking, in contrast, involves a slow, drawn-out exposure to nicotine over a much longer period.
This difference in delivery profile means the metabolic stimulant effect of hookah is often too mild and gradual to counteract the large caloric intake associated with the session. Studies have found a strong correlation between regular hookah use and a higher risk of obesity. The behavioral factors, such as the sedentary nature of the activity and the accompanying calorie consumption, far outweigh any minor metabolic lift the nicotine might provide. The net effect on body weight is often the opposite of that observed in many cigarette smokers.
Broader Health Concerns Beyond Weight Fluctuation
Weight changes represent only one aspect of the overall health risks associated with hookah use. The practice involves inhaling high concentrations of toxic substances, including tar, heavy metals, and carcinogens. Hookah smoke causes significant strain on the cardiovascular system, leading to temporary increases in heart rate and blood pressure.
Long-term use is associated with a greater risk of developing heart disease and various respiratory illnesses, including lung cancer and obstructive lung disease. The high levels of carbon monoxide inhaled can also lead to acute carbon monoxide poisoning, causing symptoms like dizziness and nausea. Furthermore, sharing a single mouthpiece carries a risk of transmitting infectious diseases, such as herpes and tuberculosis.