Weight Cycling Increases Risk of Multiple Cardiometabolic Diseases

Overview

This study analyzed electronic health records of over 1.4 million adults to assess how different weight trajectories impact the risk of 10 cardiometabolic diseases. Weight cycling was associated with significantly increased risks for obstructive sleep apnea, metabolic liver disease, type 2 diabetes, and heart failure compared to weight stability, independent of baseline BMI.

Background

Excess body weight is a major contributor to cardiometabolic diseases worldwide. Although modest weight loss can improve cardiometabolic health, maintaining weight loss is challenging, leading to frequent weight cycling—repeated loss and regain of weight. Weight cycling may worsen cardiometabolic risk beyond that caused by stable high body mass. Prior studies have linked weight cycling to hypertension, cardiovascular disease, and diabetes, but its relative impact compared to stable weight or consistent weight gain/loss remains unclear.

Data Highlights

Key Findings

• Weight cycling increased risk of obstructive sleep apnea by 28% compared to weight stability.
• Weight cycling was associated with a 28% higher risk of metabolic dysfunction-associated steatotic liver disease.
• Risk of type 2 diabetes was 23% higher in weight cyclers versus weight stable individuals.
• Weight cycling conferred a 54% increased risk of heart failure, greater than risks associated with weight gain or weight loss alone.
• The increased cardiometabolic risk from weight cycling was independent of baseline BMI, which was similar across weight trajectory groups.
• Weight cyclers were more likely to be prescribed medications for hypertension, dyslipidemia, and diabetes, indicating higher disease prevalence.

Clinical Implications

Clinicians should recognize weight cycling as a significant risk factor for multiple cardiometabolic diseases independent of baseline obesity. Emphasis should be placed on promoting weight stability or sustained weight loss rather than repeated cycles of loss and regain. Weight management strategies that support long-term maintenance may reduce the incidence of heart failure, diabetes, and other cardiometabolic conditions.

Conclusion

Weight cycling markedly increases the risk of several cardiometabolic diseases beyond that associated with stable high BMI or unidirectional weight changes. Preventing weight cycling through sustained weight management may be critical to reducing cardiometabolic disease burden.

References

1. Vanderbilt University Medical Center Study 1997-2020 -- The Influence of Weight Patterns on the Risk of Ten Different Cardiometabolic Disorders