Clinical Science| Volume 62, ISSUE 1, P127-136, January 2013

Download started.


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