Weight Cycling and the Yo-Yo Effect: A Modern Pattern Difficult to Break

The overweight and obesity issue is worldwide considered an epidemic and, consequently, a public
health problem. Defined as a person whose body mass index (BMI) >30 kg m2, the population with
obesity has grown exponentially since 1980, where in 2014 at least 13% worldwide experienced this
issue [15].

Weight is a difficult issue to understand—more so to intervene. Weight is a result of a myriad of genetic
and environmental factors [15]. In today’s western society, weight loss or maintenance can seem
countercultural due to positive energy balance being the norm and the prevalence of high caloric foods
(high energy intake) [6], and the commonality of a sedentary lifestyle (low energy expenditure) [15].
Successful weight loss is defined as a person who decreases >10% of their total weight and maintains it
for >1 year [6].

The person who loses and regains weight can do so one or several times in their lifetime: This repetitive pattern is known as weight cycling, or, more commonly, the yo-yo effect.

Weight Cycling and the Yo-Yo Effect

Weight cycling, firstly coined by Kelly D. Brownell (Yale University) as the “yo-yo effect” [15], refers to
“the cyclical loss and gain of weight, resembling the up-down motion of a yo-yo” [12].

Those who experience a constant yo-yo effect have been shown to suffer from cardiovascular risk factors, such as blood pressure, heart rate, sympathetic activity, and circulating levels of glucose, lipids and insulin” [12]. Likewise, metabolic detriment has been registered in the form of indirect impact, since weight cycling has been correlated with weight regain and this, in its effect, with metabolic syndrome symptoms [13]. Even immunological detriments have been registered, by the alteration of the intestinal barrier after long periods of yo-yo effect, increasing thus the permeability and allowing toxins to leak into extraintestinal tissues and circulations [14].

Successful effort of avoiding weight cycling in the first year after weight loss is crucial for long-term
weight maintenance [6]. Specifically, those who maintained their weight loss in the first two years were
50% less vulnerable to experience a yo-yo effect [7].

Intrinsic to weight cycling are the following traits, which have been observed to provoke a yo-yo effect in individuals:

• Impulsivity: Thos with higher impulsivity rates are more prone to weight cycling due to higher
  prevalence in restrictive-binge patterns [5]. Likewise, impulsivity has been linked with unhealthy
  food choices such as those high in fat, salt and sugar [4].
• Highly Restrictive Diets: Known as the restrictive-binge pattern, it has been shown time and
  again that those who partake in highly restrictive/hypocaloric diets tend to overindulge once either the desired weight is lost or can no longer withstand the restrictiveness [8]. Thus,restraint eaters often experience the yo-yo effect [4].
• Hyperprocessed Food Consumption: The habit of consuming highly palatable and energy dense foods, typically enriched in saturated fats, salts and processed sugars, may lead to weight gain regardless of weight loss attempts. If your diet after weight loss comprises these types of foods, you will more than likely experience a yo-yo effect [9].

Long Standing Weight Loss and Maintenance

Restricting one’s diet by periods of fasting has gained popularity in the last decades [1], and although
caloric restriction has been shown to contribute to weight loss [2], the risk of weight regain is high [3].
Moreover, as if weight cycling weren’t enough, this yo-yo effect caused by strict hypocaloric and posterior hypercaloric intake may also reinforce unhealthy eating patterns.

It has been shown that those who practice fasting periodically usually follow-up with unvoluntary weight
regain [3]. Simply speaking, this is due to a decrease followed by an increase in caloric intake. The
following have been shown to effectively prevent weight cycling and yo-yo effect:

• Adequate Diets: Although “dieting” can have a negative connotation, a tailored meal plan which
  combines low-fat/carb intake and resistance or interval training has shown to be effective in
  weight control and prevention of the yo-yo effect [6].
• Physical Activity: Exercise has been shown to protect against weight cycling and the yo-yo effect
  due to its effectiveness to produce a negative caloric balance, thus reducing weight, and a
  positive impact in cardiovascular fitness, insulin sensitivity glycemic control of type 2 diabetes,
  blood pressure and depression [11].
• Bariatric Procedures/Surgery: Among the many types of weight control treatments, bariatric
  procedures or surgery “is the only one efficient therapeutic strategy against obesity” [6]. These
  procedures have constantly proven to be the most effective way to lose and control weight [10].

Weight Loss Surgery in Tijuana, Mexico

At LIMARP, International Center of Excellence for Obesity, we offer an integrative bariatric program,
with a multidisciplinary approach, for the treatment of obesity. Our program includes a surgical
intervention —like a gastric sleeve, a gastric bypass or a duodenal switch—, or a non-surgical
intervention —like an intragastric balloon—, along with psychological counselling, nutritional guidance,
personalized fitness routines, and long-term follow-up.

For our patients traveling from abroad, we also offer accommodation in our next-door hotel, the
luxurious Grand Hotel Tijuana, and transportation to and fro the airport and the hotel.
Our clinic is one of the only centers in Mexico that have been certified as a Center of Excellence by the
Surgical Review Corporation. Our lead surgeon, Dr. Liza María Pompa González is certified as a Master
Surgeon and Surgeon of Excellence by the same organization, and she is the first female surgeon to be
awarded with this recognition.

Contact Us Today

Our team is ready to help you. At LIMARP, patients will always receive warm, sincere and professional
answers. For a free evaluation please call us at (619) 270 8823, fill out a contact form at
our website, or message through any of our social media pages.

References

• [1] Janaswamy, R. et al. (2022). A narrative review on intermittent fasting as an approachable measure for weight reduction and obesity management. Cureus, 14(10), 1-8.
• [2] Vasim, I. et al. (2022). Intermittent fasting and metabolic health. Nutrients, 14(3), 1-15.
• [3] Muhammad, H. F. L. et al. (2018). The yo-yo effect of Ramadan fasting on overweight/obese
  individuals in Indonesian: A prospective study.
• [4] Meesters, A. (2014). The relationship between impulsivity, weight concern and the yoyo-effect in healthy women. Maastricht Stud J Psych Neuros, 3, 9-21.
• [5] Pierce-Messick, Z. J. (2019). Impulsivity and limited access to palatable foods in rats [Master’s Degree Thesis, Wake Forest University].
  https://wakespace.lib.wfu.edu/bitstream/handle/10339/93935/PierceMessick_wfu_0248M_11323.pdf
• [6] Contreras, R. E. et al. (2019). Physiological and epigenetic features of yoyo dieting and weight
  control. Front Gen, 10(1015), 1-12.
• [7] Wing, R. R. et al. (2005). Long-term weight loss maintenance. Am J Clin Nutr, 82, 222S-225S.
• [8] Jiang, K. (2021). Review on binge eating disorder: Theories, influencing factors and treatments. AdvaSoci Scie Huma Rese, 561, 574-8.
• [9] Kistenmacher, A. (2018). Food addiction: A cost-effective treatment proposal within a developing country context [Master’s Degree Thesis, University of South Africa].
  https://uir.unisa.ac.za/bitstream/handle/10500/24503/dissertation_kistenmacher_a.pdf?sequence=1&isAllowed=y
• [10] Gulinac, M. et al. (2023). Long-term effectiveness, outcomes and complications of bariatric surgery.World J Clin Cases, 11(19), 4504-12.
• [11] Cox, C. E. (2017). Role of physical activity for weight loss and weight maintenance. Diabe Spectr,30(3), 157-60.
• [12] Rhee, E. J. (2017). Weight cycling and its cardiometabolic impact. J Obes Metab Syndr, 26(4), 237-42.
• [13] Ran-Chin, Y. et al. (2021). The effects of weight fluctuation on the components of metabolic
  syndrome: A 16-year prospective cohort study in South Korea. Arch Publ Health, 79(21), 1-9.
• [14] Li, W. et al. (2023). Weight cycling based on altered immune microenvironment as a result of
  metaflammation. Nutri & Metab, 20(1), 1-14.
• [13] Ran-Chin, Y. et al. (2021). The effects of weight fluctuation on the components of metabolic
  syndrome: A 16-year prospective cohort study in South Korea. Arch Publ Health, 79(21), 1-9.
• [15] Brownell, K. D. et al. (1991). The heterogenity of obesity: Fitting treatments to individuals. BehavThera, 22, 53-77.