Weight CyclingA Health Risk

The term 'weight cycling' is used in the fields of nutrition and obesity research to refer to losses and subsequent regains of body weight typically occurring in association with weight loss dieting. Interest in this phenomenon was initially based on the observation that conventional weight loss programs are often unsuccessful in the long term. Dieting recidivism thus sets the stage for weight cycling, popularly referred to as yo-yo dieting, whereby dieters undergo multiple cycles of weight loss and regain in pursuit of their ideal body weights.

There seems to be little disagreement that weight cycling is one of the most difficult therapeutic aspects in the management of obesity. The majority of obese subjects seeking treatment have previously experienced cycles of weight loss and regain. Examples of weight cycling in two case studies are shown in Figure 1. These examples illustrate several phenomena that are important when considering weight cycling in humans: Weight losses and subsequent regains frequently occur in conjunction with intentional weight loss dieting; however, weight changes vary in magnitude and important fluctuations may be missed if weight measurements are taken at infrequent time intervals. Moreover, these two cases

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Figure 1 Monthly body weights (average of daily weights) of two female subjects, self-monitored over time. Reproduced with permission from Black DR, Pack DJ, and Hovell MF (1991) A time-series analysis of longitudinal weight changes in two adult women. International Journal of Obesity 15: 623-633.

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Figure 1 Monthly body weights (average of daily weights) of two female subjects, self-monitored over time. Reproduced with permission from Black DR, Pack DJ, and Hovell MF (1991) A time-series analysis of longitudinal weight changes in two adult women. International Journal of Obesity 15: 623-633.

illustrate the common observation that intentional weight losses are frequently followed by regains in excess of the original body weight, and that true weight stability may be difficult to achieve.

Dieting to control body weight is not confined to overweight individuals but has been widely reported even among men and women who have never been overweight. As described by Jeffery in 1984, 72.5 and 43.7% of surveyed women and men, respectively, had dieted to lose weight; even among women who had never been overweight, the majority reported having been on weight loss diets. Although it is traditionally assumed that adherence to weight reduction diets is beneficial to health, the high rates of dieting and weight loss recidivism, among the nonobese as well as the obese, have naturally created concern regarding potential negative health consequences. However, weight cycling can be intentional or unintentional, and the most recent generation of research on weight cycling has focused on intentional weight loss as the risk factor of relevance to the weight cycling debate.

In this article, some of the main points of this debate are highlighted. The first epidemiological studies suggesting health implications of weight cycling were reviewed in 1992, at which time the majority of available observational evidence indicated adverse consequences. Subsequently, this topic became a source of considerable controversy, and a number of investigators continued to examine this issue, focusing on possible effects of weight cycling on metabolism, chronic disease, and mental health. This article also provides an overview of knowledge in this area, together with some methodological controversies surrounding existing research on weight cycling.

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