The Risks Associated with Weight Cycling

The start of the New Year signifies trying to uphold health-related New Year’s Resolutions for many Americans. According to a recent survey, the top 3 New Year’s Resolution categories for 2019 include: dieting or eating healthier, exercising more, and losing weight.1Unfortunately these resolutions, as well as the means to achieving such resolutions, are frequently not sustainable and ultimately result in less than 10% of people staying committed for more than 1 month.2Extreme actions to lose weight may not only be difficult to maintain, but research also demonstrates that body weight swings may increase an individual’s risk for cardiometabolic disease and mortality.3-6

 

Weight Cycling

Weight cycling, otherwise coined “yo-yo dieting”, incorporates a pattern of repeated periods of weight loss and regain.3A universally accepted definition of weight cycling is not available, and so there are significant differences in the amount of weight loss and weight regained to be considered weight cycling across scientific studies. However, a complete weight cycle is often defined as a 5-lb. or more weight loss from the highest recorded weight, and then a 5-lb. or more weight regain.4

 

Proposed Mechanisms for the Negative Impacts of Weight Cycling

        The mechanism behind why weight cycling shows an association with morbidity and mortality has not yet been proven, but two of the hypothesized mechanisms include:

  • Repeated overshoot: Once an individual loses weight, the body typically reduces the amount of energy expenditure while increasing hunger. Fluctuations in energy balance during weight cycling can lead to cardiovascular risk factors (blood pressure, heart rate, sympathetic activity) increasing above normal values during the periods of weight regain. This increases the amount of stress placed on the cardiovascular and metabolic systems, and may contribute to the higher prevalence rates of hypertension and dyslipidemia in individuals who weight cycle.3
  • Altered repartitioning of fat and lean mass: During the weight regain period of weight cycling, studies have found that body fat distribution may be altered in individuals who weight cycle. One study suggested there might be an association between a history of weight cycling and abdominal obesity. Another found a preferential regain of lean mass in the limbs compared to the trunk. Each of these results proposes weight cycling could have an impact on cardiometabolic health outcomes.3

 

Psychological Impact

        Repeated episodes of weight loss and regain may be detrimental to emotional well-being. The results of studies looking at the psychological impact of weight cycling are mixed, but some studies have found a link between weight cycling and increased self-reported measures of psychological distress, life dissatisfaction, reduced levels of self-efficacy, and lower quality of life.7,8

 

National Institute of Health Recommendations

According to the National Institution of Health, the goal for everyone should be to achieve a healthy body weight.9Although losing weight is often a goal of many New Year’s Resolutions, maintaining a healthy, stable body weight may be more important according to the research. People who are not overweight or obese, and do not have health problems related to weight, should maintain a stable weight. People who are overweight or obese should try to achieve weight loss at modest, gradual rate.9As a result, the potential drawbacks associated with weight cycling should not be a reason to avoid weight loss in individuals who are overweight or obese. Approaches to weight loss incorporating lifestyle changes that can be maintained long-term to prevent weight cycling are recommended.

 

 

References:

  1. Economy, P. Resolutions for success and happiness in 2019. Inc.com. https://www.inc.com/peter-economy/10-top-new-years-resolutions-for-success-happiness-in-2019.html. Published January 1, 2019. Accessed January 3, 2019.
  2. Cupples, K. New years diet resolutions are out, healthy habits are in. johnsoncitypress.com. https://www.johnsoncitypress.com/Food-Drink/2019/01/02/div-class-libPageBodyLinebreak-New-Year-s-diet-resolutions-are-out-healthy-habits-are-in-br-div-div-class-libPageBodyLinebreak-div. Published January 2, 2019. Accessed January 3, 2019.
  3. Rhee E-J. Weight Cycling and Its Cardiometabolic Impact. J Obes & Metab Syndr. 2017;26(4):237-242. doi:10.7570/jomes.2017.26.4.237
  4. Delahanty LM, Pan Q, Jablonski KA, et al. Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program. Diabetes Care. 2014;37(10):2738-2745. doi:10.2337/dc14-0018
  5. Oh TJ, Moon JH, Choi SH, et al. Body-weight fluctuation and incident diabetes mellitus, cardiovascular disease, and mortality: a 16-year prospective cohort study. J Clin Endocrinol & Metab. November 2018. doi:10.1210/jc.2018-01239
  6. Delahanty LM, Pan Q, Jablonski KA, et al. Effects of Weight Loss, Weight Cycling, and Weight Loss Maintenance on Diabetes Incidence and Change in Cardiometabolic Traits in the Diabetes Prevention Program. Diabetes Care. 2014;37(10):2738-2745. doi:10.2337/dc14-0018
  7. Foster GD, Sarwer DB, Wadden Ta. Psychological effect of weight cycling in obese persons: a review and research agenda. Obes Res. 1997 Sep;5(5) 474-88.
  8. Mannucci E, Petroni ML, Villanova N, et al; QUOVADIS Study Group. Clinical and psychological correlates of health-related quality of life in obese patients. Health Qual Life Outcomes. 2010 Aug 23;8:90.
  9. NIH Pubication No. 01-3901. Published May 2008. Accessed January 4, 2019.