Dear DOCTOR Owen:
I have gained and lost weight many times. I have lost 75 pounds three times. I am afraid to lose weight again, as I have read that cycling weight can cause serious illness and is dangerous. What am I to do? I do not want to stay this heavy, or be heavier, forever.
Yo-yo Phobic
Dear “Phobic”:
Your concern originates from information that made headlines many years ago, suggesting a higher mortality rate among people who “cycle” large amounts of weight. The studies suggesting this were embraced by a media message: “See? Diets don’t work and are dangerous.” The implication was one of “doom” for everyone who is obese: “Damned if you do, damned if you don’t. So, why even try?” In addition, a deeper, subtler message was implied: “You are a failure. You will always be a failure. So, learn to accept the inevitable.”
This message has been incorporated as fact on TV talk shows and in commercial diet programs; this even is a belief of many physicians.
Unfortunately, as is often the case, the information scooped up by the media is incomplete, poorly acquired, preliminary, or “skimpy.” And, when related to controversial or popular subjects, early information is presented as “gospel truth.” Most well-trained scientists, including physicians, resist early data as fact. However, with intense public pressure, the judgments of even good scientists become blurred.
Subsequent data on this subject failed to support the widely publicized “news” but—not being controversial—have never made it into the general media. Hence, you have become “stuck” because you never had an opportunity to see the follow-up information.
Two items promoted as fact were:
- Weight cycling prevents future weight loss.
- Increased risk of death accompanies weight cycling.
The notion that suggests a “lowering” of metabolism by weight cycling has been refuted in many studies since the 1980s. People will lose weight at exactly the same rate by burning up the same number of calories each time. (I have personal experience with a firm of certified public accountant patients, who methodically try to disprove this fact with meticulous record-keeping, only to prove that the weight loss is the same each time.)
An article published by researchers from Pittsburgh in Archives of Internal Medicine, Vol. 155, 1416–1422, looked at cardiovascular risk in weight cyclers. Patients were divided into groups of Gainers, Stable, Large Cyclers, Small Cyclers, Partial Cyclers, Small Successes, and Large Successes. In summary, those who lost weight, and then maintained that loss, had reduced their cardiovascular risk. Every category of cyclers who re-gained weight showed no increased cardiovascular risk.
My suspicion about weight cycling risk relates to what people eat (high-fat diets) as they re-gain weight, concomitant illness such as diabetes, hypertension, high cholesterol, and cigarette addiction. These factors are most associated with risk of heart attack and stroke. With weight loss, there is clearly a reduction in disability and mortality.
The most impressive fact I have learned through the years is that persistence is the key to all success. I encourage you to lose your weight again. This time, however, get the notion out of your mind that the diet will “end”—because it will never “end.” Dieting is a conscious method of eating and exercising. You will never be able to ignore or unconsciously maintain that weight loss. You will need methods, motivation, support, and effort—forever. So, go for it!
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