History of weight cycling does not impede future weight loss or metabolic improvements in postmenopausal women



      Given that the repetitive loss and regain of body weight, termed weight cycling, is a prevalent phenomenon that has been associated with negative physiological and psychological outcomes, the purpose of this study was to investigate weight change and physiological outcomes in women with a lifetime history of weight cycling enrolled in a 12-month diet and/or exercise intervention.


      439 overweight, inactive, postmenopausal women were randomized to: i) dietary weight loss with a 10% weight loss goal (N=118); ii) moderate-to-vigorous intensity aerobic exercise for 45 min/day, 5 days/week (n=117); ii) both dietary weight loss and exercise (n=117); or iv) control (n=87). Women were categorized as non-, moderate- (≥3 losses of ≥4.5 kg), or severe-cyclers (≥3 losses of ≥9.1 kg). Trend tests and linear regression were used to compare adherence and changes in weight, body composition, blood pressure, insulin, C-peptide, glucose, insulin resistance (HOMA-IR), C-reactive protein, leptin, adiponectin, and interleukin-6 between cyclers and non-cyclers.


      Moderate (n=103) and severe (n=77) cyclers were heavier and had less favorable metabolic profiles than non-cyclers at baseline. There were, however, no significant differences in adherence to the lifestyle interventions. Weight-cyclers (combined) had a greater improvement in HOMA-IR compared to non-cyclers participating in the exercise only intervention (P=.03), but no differences were apparent in the other groups.


      A history of weight cycling does not impede successful participation in lifestyle interventions or alter the benefits of diet and/or exercise on body composition and metabolic outcomes.


      NEW (Nutrition and Exercise in Women), BMI (Body Mass Index), METs (Metabolic Equivalents), VO2max (Maximal Oxygen Uptake), DXA (Dual-energy X-ray Absorptiometry), MAP (Mean Arterial Pressure), CRP (C-Reactive Protein), CV (Coefficient of Variation), ELISA (Enzyme-linked immunosorbent assay), IL-6 (Interleukin-6), HOMA-IR (Homeostasis Model Assessment-Insulin Resistance), GEE (General Estimating Equation)


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Metabolism - Clinical and Experimental
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Field A.E.
        • Byers T.
        • Hunter D.J.
        • Laird N.M.
        • Manson J.E.
        • Williamson D.F.
        • et al.
        Weight cycling, weight gain, and risk of hypertension in women.
        Am J Epidemiol. 1999; 150: 573-579
        • Kroke A.
        • Liese A.D.
        • Schulz M.
        • Bergmann M.M.
        • Klipstein-Grobusch K.
        • Hoffmann K.
        • et al.
        Recent weight changes and weight cycling as predictors of subsequent two year weight change in a middle-aged cohort.
        Int J Obes Relat Metab Disord. 2002; 26: 403-409
        • Parker E.D.
        • Folsom A.R.
        Intentional weight loss and incidence of obesity-related cancers: the Iowa Women's Health Study.
        Int J Obes Relat Metab Disord. 2003; 27: 1447-1452
        • Lahti-Koski M.
        • Mannisto S.
        • Pietinen P.
        • Vartiainen E.
        Prevalence of weight cycling and its relation to health indicators in Finland.
        Obes Res. 2005; 13: 333-341
        • Stevens V.L.
        • Jacobs E.J.
        • Sun J.
        • Patel A.V.
        • McCullough M.L.
        • Teras L.R.
        • et al.
        Weight cycling and mortality in a large prospective US study.
        Am J Epidemiol. 2012; 175: 785-792
      1. Weight cycling. National task force on the prevention and treatment of obesity.
        JAMA. 1994; 272: 1196-1202
        • French S.A.
        • Jeffery R.W.
        • Folsom A.R.
        • Williamson D.F.
        • Byers T.
        Relation of weight variability and intentionality of weight loss to disease history and health-related variables in a population-based sample of women aged 55–69 years.
        Am J Epidemiol. 1995; 142: 1306-1314
        • French S.A.
        • Folsom A.R.
        • Jeffery R.W.
        • Zheng W.
        • Mink P.J.
        • Baxter J.E.
        Weight variability and incident disease in older women: the Iowa Women's Health Study.
        Int J Obes Relat Metab Disord. 1997; 21: 217-223
        • Shade E.D.
        • Ulrich C.M.
        • Wener M.H.
        • Wood B.
        • Yasui Y.
        • Lacroix K.
        • et al.
        Frequent intentional weight loss is associated with lower natural killer cell cytotoxicity in postmenopausal women: possible long-term immune effects.
        J Am Diet Assoc. 2004; 104: 903-912
        • Foreyt J.P.
        • Brunner R.L.
        • Goodrick G.K.
        • Cutter G.
        • Brownell K.D.
        • St Jeor S.T.
        Psychological correlates of weight fluctuation..
        Int J Eat Disord. 1995; 17: 263-275
        • Strychar I.
        • Lavoie M.E.
        • Messier L.
        • Karelis A.D.
        • Doucet E.
        • Prud'homme D.
        • et al.
        Anthropometric, metabolic, psychosocial, and dietary characteristics of overweight/obese postmenopausal women with a history of weight cycling: a MONET (Montreal Ottawa New Emerging Team) study.
        J Am Diet Assoc. 2009; 109: 718-724
        • Smith D.E.
        • Wing R.R.
        Diminished weight loss and behavioral compliance during repeated diets in obese patients with type II diabetes.
        Health Psychol. 1991; 10: 378-383
        • Rodin J.
        • Radke-Sharpe N.
        • Rebuffe-Scrive M.
        • Greenwood M.R.
        Weight cycling and fat distribution.
        Int J Obes. 1990; 14: 303-310
        • Brownell K.D.
        • Rodin J.
        Medical, metabolic, and psychological effects of weight cycling.
        Arch Intern Med. 1994; 154: 1325-1330
        • Drewnowski A.
        • Holden-Wiltse J.
        Taste responses and food preferences in obese women: effects of weight cycling.
        Int J Obes Relat Metab Disord. 1992; 16: 639-648
        • Field A.E.
        • Malspeis S.
        • Willett W.C.
        Weight cycling and mortality among middle-aged or older women.
        Arch Intern Med. 2009; 169: 881-886
        • Field A.E.
        • Wing R.R.
        • Manson J.E.
        • Spiegelman D.L.
        • Willett W.C.
        Relationship of a large weight loss to long-term weight change among young and middle-aged US women.
        Int J Obes Relat Metab Disord. 2001; 25: 1113-1121
        • Korkeila M.
        • Rissanen A.
        • Kaprio J.
        • Sorensen T.I.
        • Koskenvuo M.
        Weight-loss attempts and risk of major weight gain: a prospective study in Finnish adults.
        Am J Clin Nutr. 1999; 70: 965-975
        • Wing R.R.
        • Hill J.O.
        Successful weight loss maintenance.
        Annu Rev Nutr. 2001; 21: 323-341
        • Turk M.W.
        • Yang K.
        • Hravnak M.
        • Sereika S.M.
        • Ewing L.J.
        • Burke L.E.
        Randomized clinical trials of weight loss maintenance: a review.
        J Cardiovasc Nurs. 2009; 24: 58-80
        • Foster-Schubert K.E.
        • Alfano C.M.
        • Duggan C.
        • Xiao L.
        • Campbell K.L.
        • Kong A.
        • et al.
        Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese postmenopausal women.
        Obesity. 2011; ([Epub ahead of print])
        • Knowler W.C.
        • Barrett-Connor E.
        • Fowler S.E.
        • Hamman R.F.
        • Lachin J.M.
        • Walker E.A.
        • et al.
        Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.
        N Engl J Med. 2002; 346: 393-403
        • Ryan D.H.
        • Espeland M.A.
        • Foster G.D.
        • Haffner S.M.
        • Hubbard V.S.
        • Johnson K.C.
        • et al.
        Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes.
        Control Clin Trials. 2003; 24: 610-628
        • Ainsworth B.E.
        • Haskell W.L.
        • Whitt M.C.
        • Irwin M.L.
        • Swartz A.M.
        • Strath S.J.
        • et al.
        Compendium of physical activities: an update of activity codes and MET intensities.
        Med Sci Sports Exerc. 2000; 32: S498-S504
        • Hooper L.E.
        • Foster-Schubert K.E.
        • Weigle D.S.
        • Sorensen B.
        • McTiernan A.
        • Ulrich C.M.
        Frequent intentional weight loss is associated with higher ghrelin and lower glucose and androgen levels in p[ostmenopusal women.
        Nutr Res. 2010; 30: 163-170
        • Van Wye G.
        • Dubin J.A.
        • Blair S.N.
        • Di Pietro L.
        Weight cycling and 6-year weight change in healthy adults: the aerobics center longitudinal study.
        Obesity. 2007; 15: 731-739
        • Field A.E.
        • Manson J.E.
        • Taylor C.B.
        • Willett W.C.
        • Colditz G.A.
        Association of weight change, weight control practices, and weight cycling among women in the Nurses' Health Study II.
        Int J Obes Relat Metab Disord. 2004; 28: 1134-1142
        • Patterson R.E.
        • Kristal A.R.
        • Tinker L.F.
        • Carter R.A.
        • Bolton M.P.
        • Agurs-Collins T.
        Measurement characteristics of the Women's Health Initiative food frequency questionnaire.
        Ann Epidemiol. 1999; 9: 178-187
        • Taylor H.L.
        • Jacobs Jr., D.R.
        • Schucker B.
        • Knudsen J.
        • Leon A.S.
        • Debacker G.
        A questionnaire for the assessment of leisure time physical activities.
        J Chronic Dis. 1978; 31: 741-755
        • Pate R.
        • Blair S.
        • Durstine J.
        Guidelines for exercise testing and prescription. Lea & Febinger, Philadelphia, Pa1991: 70-72
        • Matthews D.R.
        • Hosker J.P.
        • Rudenski A.S.
        • Naylor B.A.
        • Treacher D.F.
        • Turner R.C.
        Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.
        Diabetologia. 1985; 28: 412-419
        • Bonora E.
        • Targher G.
        • Alberiche M.
        • Bonadonna R.C.
        • Saggiani F.
        • Zenere M.B.
        • et al.
        Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity.
        Diabetes Care. 2000; 23: 57-63
        • Zeger S.L.
        • Liang K.Y.
        Longitudinal data analysis for discrete and continuous outcomes.
        Biometrics. 1986; 42: 121-130
        • Houmard J.A.
        • Tanner C.J.
        • Slentz C.A.
        • Duscha B.D.
        • McCartney J.S.
        • Kraus W.E.
        Effect of the volume and intensity of exercise training on insulin sensitivity.
        J Appl Physiol. 2004; 96: 101-106
        • Davidson L.E.
        • Hudson R.
        • Kilpatrick K.
        • Kuk J.L.
        • McMillan K.
        • Janiszewski P.M.
        • et al.
        Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial.
        Arch Intern Med. 2009; 169: 122-131
        • Beavers K.M.
        • Lyles M.F.
        • Davis C.C.
        • Wang X.
        • Beavers D.P.
        • Nicklas B.J.
        Is lost lean mass from intentional weight loss recovered during weight regain in postmenopausal women?.
        Am J Clin Nutr. 2011; 94: 767-774
        • Savage J.S.
        • Birch L.L.
        Patterns of weight control strategies predict differences in women's 4-year weight gain.
        Obesity (Silver Spring). 2010; 18: 513-520
        • Provencher V.
        • Drapeau V.
        • Tremblay A.
        • Despres J.P.
        • Bouchard C.
        • Lemieux S.
        Eating behaviours, dietary profile and body composition according to dieting history in men and women of the Quebec Family Study.
        Br J Nutr. 2004; 91: 997-1004
        • Morton G.J.
        • Cummings D.E.
        • Baskin D.G.
        • Barsh G.S.
        • Schwartz M.W.
        Central nervous system control of food intake and body weight.
        Nature. 2006; 443: 289-295
        • Sumithran P.
        • Prendergast L.A.
        • Delbridge E.
        • Purcell K.
        • Shulkes A.
        • Kriketos A.
        • et al.
        Long-term persistence of hormonal adaptations to weight loss.
        N Engl J Med. 2011; 365: 1597-1604
        • French S.A.
        • Folsom A.R.
        • Jeffery R.W.
        • Williamson D.F.
        Prospective study of intentionality of weight loss and mortality in older women: the Iowa Women's Health Study.
        Am J Epidemiol. 1999; 149: 504-514
        • Ogden C.L.
        • Fryar C.D.
        • Carroll M.D.
        • Flegal K.M.
        Mean body weight, height, and body mass index, United States 1960–2002.
        Adv Data. 2004; 347: 1-17
        • Bish C.L.
        • Blanck H.M.
        • Serdula M.K.
        • Marcus M.
        • Kohl III, H.W.
        • Khan L.K.
        Diet and physical activity behaviors among Americans trying to lose weight: 2000 Behavioral Risk Factor Surveillance System.
        Obes Res. 2005; 13: 596-607
        • Field A.E.
        • Manson J.E.
        • Laird N.
        • Williamson D.F.
        • Willett W.C.
        • Colditz G.A.
        Weight cycling and the risk of developing type 2 diabetes among adult women in the United States.
        Obes Res. 2004; 12: 267-274