Yo-Yo Dieting Linked to Heart Disease Risk in Women

Researchers at Columbia University Irving Medical Center reported that women with a history of yo-yo dieting or weight cycling—a pattern in which weight loss is followed by subsequent weight gain—had more cardiovascular risk factors than those who maintained a consistent weight.

Preliminary data from the study were presented at the American Heart Association annual meeting in Houston, Texas.

Previous studies have focused mostly on men

Numerous studies have found that maintaining a healthy weight is one way to reduce the risk of heart disease and other chronic illnesses. But more than a third of post-menopausal women participating in a large national observational study reported that efforts to lose excess weight were stalled by a rapid return to their pre-diet weight, a pattern known as weight cycling. 

“Weight cycling is common, especially for individuals who are trying to improve their cardiovascular health,” says Brooke Aggarwal, EdD, MS, assistant professor of medical sciences at Columbia University Vagelos College of Physicians and Surgeons. “But it’s difficult to draw conclusions from previous studies, which focused mainly on white, middle-aged men with a history of heart disease, as some found an association between weight cycling and cardiovascular risk while others did not. They also failed to capture points in a woman’s life that are commonly associated with weight gain, such as pregnancy and menopause.”

Weight cycling implicated in poor heart health

In the current study, Aggarwal and her team included a more diverse group of 485 women between the ages of 20 and 76 with an average body mass index (BMI) of 26, which is considered overweight. 

The women reported the number of times, other than during pregnancy, they had lost and regained a minimum of 10 pounds within a year. The researchers then estimated each woman’s cardiovascular health using the American Heart Association’s Life’s Simple 7—a group of health behaviors and risk factors that offer a composite of heart health, including BMI, blood pressure, total cholesterol, glucose, physical activity, diet, and smoking. 

More than 70 percent of the women had at least one episode of weight cycling. Of these, 29 percent had poor cardiovascular health and were 82 percent less likely to have an optimal BMI. The more episodes of yo-yo dieting women reported, the worse they performed on Life’s Simple 7. 

The effects were similar for women before and after menopause but were stronger for those who had never been pregnant. 

“It’s possible that pregnancy may protect the heart in ways we don’t currently understand,” says Aggarwal. “However, there’s some evidence that weight cycling in younger women, before pregnancy, could set the stage for future cardiovascular risk.”

Brooke Aggarwal, EdD, MS (CUIMC)

What’s next

Additional studies are needed to determine exactly why weight cycling may have a negative impact on heart health in women. “Some studies have suggested that a reduction in lean muscle during weight loss is replaced by fat when the weight is regained. Another idea is that blood pressure, blood sugar, triglycerides, and other values inch higher each time weight is gained back,” Aggarwal says.


More info

Brooke Aggarwal, EdD, is a principal investigator of the Go Red for Women Strategically Focused Research Network at Columbia University Irving Medical Center.

The other researchers (all CUIMC) are Stephanie S. Byun, Natalie A. Bello, Ming Liao, and Nour Makarem.

The study participants were part of the American Heart Association’s Go Red for Women Strategically Focused Research Network at Columbia University Irving Medical Center.