Yo-Yo Dieting and Diabetes: How Repeated Weight Loss and Gain Affects Blood Sugar
Losing weight can help reduce insulin resistance, but yo-yo dieting could have the opposite effect, increasing your risk for diabetes or contributing to disease progression.
By Stephanie Bucklin
Medically Reviewed by Kelly Kennedy, RD
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For those people who have been diagnosed with or are at risk for type 2 diabetes, losing weight can lead to big benefits, from improved self-esteem and more energy, to increased insulin sensitivity. But regaining lost weight — a phenomenon clinically referred to as weight cycling, or conversationally as “yo-yo dieting” — can cause potentially serious health outcomes, especially in the case of diabetes, research suggests.
Yo-Yo Dieting: How It May Affect Your Heart and Blood Sugar
With popular diets on the rise, many people with type 2 diabetes are attempting them, but one-third to two-thirds of the overall weight that is lost on these plans is generally regained within one year, suggests a review published in February 2015 in the journal Obesity Reviews. In fact, at least one-third of people actually gain back more weight than they lost.
Not only can this result be emotionally frustrating, but it also can lead to physical health complications for certain individuals. For example, a study published in November 2019 in the journal Circulation suggested weight cycling in post-menopausal women may increase their risk for sudden cardiac death and death from coronary heart disease.
Yo-yo dieting can also harm the health of people with type 2 diabetes, says Reshmi Srinath, MD, an endocrinologist and an assistant professor of medicine at Mount Sinai in New York City. “Weight cycling can contribute not only to raising the blood sugar, but also to the risk for complications,” like eye disease and neuropathy, says Dr. Srinath.
How Yo-Yo Dieting May Impact Your Risk for Type 2 Diabetes
If your genetics, body weight, or past personal health history leave you at a greater risk for prediabetes and type 2 diabetes, you may also want to be mindful of losing then regaining weight, studies suggest. According to a study published in February 2015 in the journal Diabetologia, participants who had an average yearly weight loss of more than about 2.5 pounds, followed by net weight regain (or vice versa) had a higher risk for diabetes.
Although this study noted that weight cycling wasn’t a strong independent risk factor for the disease, other research seems to support this conclusion. For instance, an observational study published in October 2014 in the journal Diabetes Care found that people who experienced weight cycling in the National Institutes of Health’s Diabetes Prevention Program had a greater risk for type 2 diabetes than those who lost weight and kept it off.
A study published in July 2019 in the journal BMJ found that, two years after an initial diabetes diagnosis, either weight loss or maintaining weight without it fluctuating was associated with better blood sugar control. Meanwhile, major variability in weight was associated with poorer survival and increased risks to heart health. That’s crucial, considering the Centers for Disease Control and Prevention (CDC) estimates people with type 2 diabetes are two times as likely to die from heart disease compared with people who do not have diabetes.
Why Can Regaining Weight You Lost Have These Effects?
There are two primary reasons why yo-yo dieting may have this effect on blood sugar levels, heart health, diabetes risk, and the like:
A Loss of Lean Body Mass If you lose weight rapidly, such as on a fad diet, you’re more likely to lose muscle, says Viola F. Holmes, RD, CDE, education and outreach manager at the Virginia Center for Diabetes Prevention and Education at the University of Virginia in Charlottesville. With lost muscle, your metabolism also slows down, making it harder to maintain weight loss, she explains — possibly contributing to that cycle of losing and regaining.
Maintaining muscle is important when it comes to managing your risk of type 2 diabetes: According to a study published in June 2012 inThe Journal of Clinical Endocrinology & Metabolism, a higher muscle mass is associated with better insulin sensitivity and a lower risk for both prediabetes and type 2 diabetes.
An Increase in Stress Hormones Your body’s level of stress hormones, like cortisol, may increase when you crash diet, messing with the physiology of your body, Holmes says. In turn, when we’re stressed, we don’t usually sleep as well, which can lead to poorer food choices and an increased risk of unhealthy abdominal fat, Srinath says.
This abdominal fat has been linked to a number of negative health effects, including high cholesterol and insulin resistance, according to Harvard Medical School. A study published in December 2012 in the journal Diabetic Medicine put the link between stress and type 2 diabetes more starkly: After following over 7,000 middle-aged men for 35 years, researchers concluded that self-reported stress was a long-term predictor of type 2 diabetes, even after adjusting for things like body mass index (BMI) and other risk factors for type 2 diabetes.
3 Possible Reasons Why You Regained the Weight You Lost
There a few different reasons why you may be struggling with yo-yo dieting:
1. You’re using a restrictive fad diet to lose weight quickly.These plans commonly lead to weight fluctuation, Holmes says. It’s not uncommon for people on a fad diet to lose weight quickly when they restrict several foods or food groups, and then gain it back when they discover it isn't a realistic way to eat long term. Sometimes women are more prone to these fluctuations, given the societal pressure on women to be thin and their tendency to try popular diets, she adds.
2. You’re setting unrealistic goals.Similarly, if you approach dieting as an all-or-nothing battle, you may be more prone to weight cycling. “It’s really how an individual starts the process,” Holmes says. If someone tries to go to the gym every day for two hours a day, and it’s not realistic for that person, it may put them on the path to weight cycling, she explains. Instead, consider your schedule and goals to come up with a weight-loss plan that works for you and is maintainable over time.
2. Your body has a "set point" it gravitates toward.It’s possible that your body naturally gravitates towards a set weight point unique to your individual genetics, and when you start losing weight, your metabolism slows as your body fights to get back to that set point, Srinath explains. “It definitely can be reset, but because of that, people do yo-yo back and forth,” she adds.
Follow These 3 Tips to Help You Lose Weight and Keep It Off
So how can you avoid weight cycling, and lose weight in a natural, sustainable way? The experts offered these tips:
1. Approach weight loss with a combination of healthy eating and physical exercise. Holmes says neither crash diets nor intense exercise are sustainable in the long term — you need a balance of each. And exercising is crucial: It can actually help you reset your starting point by ramping up your metabolism, Srinath adds, noting that a mix of cardio and resistance training is best. The at least 30 minutes of moderate exercise a day for at least five days a week (150 minutes per week) or 75 minutes per week of vigorous activity, she notes.
Just be sure to talk to your medical team before trying a new activity with diabetes, as individuals with diabetes may be more prone to injury and needs to take certain precautions when exercising. That is especially true for people with poorly controlled blood sugar.
2. Make realistic changes.Realize your diet is not about a quick fix, but about identifying sustainable dietary habits that meet your desires and needs, Holmes says. Making healthy changes that you can continue for years to come is the best way to get your weight to a healthy range and keep it there.
3. Get help from a professional if you need it.Finding a registered dietitian who is also a certified diabetes educator (CDE) can help you come up with a responsible plan that suits your lifestyle, Holmes says.
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