Recent weight changes and weight cycling as predictors of subsequent two year weight change in a middle-aged cohort

Abstract

Objective: To evaluate the influence of recent weight changes (weight gain, loss and cycling) on subsequent weight changes. Design: Prospective cohort study with 2 y of follow-up. Data analysis with a polytomous logistic regression model. Subjects: A total of 18 001 non-smoking subjects, 6689 men and 11 312 women, from the general population. Measurements: Body height and weight measurements and interview data on lifestyle habits and medical history at baseline. For follow-up, self-administered questionnaires for assessment of body weight and incident diseases. Results: Recent changes in body weight, that is weight gain, weight loss and weight cycling, were significant predictors of subsequent weight changes in both men and women after controlling for age, baseline BMI and several lifestyle and behavioural characteristics as potential confounding factors. Weight cycling before baseline was the strongest predictor of subsequent large weight gain ( ! 2 kg) with an odds ratio (OR) of 4.84 (95% confidence interval (CI) 3.34 -7.02) in men. In women, prior weight loss was the strongest predictor of subsequent large weight gain (OR 4.77; 95% CI 3.63 -6.03), followed by weight cycling (OR 3.02; 95% CI 2.15 -4.25). Conclusion: These data indicate the need for thorough weight history assessment to identify those who are most likely to gain weight. Effective weight control before the development of obesity or after intentional weight loss due to obesity should be a primary goal in the management of obesity.

Associations of short-term weight changes and weight cycling with incidence of essential hypertension in the EPIC-Potsdam Study

“…As we have previously shown, in this population, previous weight loss was a very strong predictor for subsequent weight gain. 26 Consequently, the increased odds for developing hypertension among obese individuals with 2-year short-term weight loss prior to recruitment may, at least in part, be attributable to subsequent weight gain. In this case, individuals with 2-year short-term weight loss were in fact weight cyclers, who have been shown to be at an increased risk for hypertension.…”

Weight cycling of athletes and subsequent weight gain in middleage

“…The long-term effects of periodic dieting and weight regain on long-term weight development are still controversial. [1][2][3] We therefore studied long-term weight changes in a unique population of former world-class elite athletes, including a group of men who had been active in sports with weight classes that have been linked to periodic weight reduction and regain practices. As our interest was in the development of overweight and obesity, we focused on changes in body weight in middle age.…”

Challenges in the study of causation of obesity

“…With the measurement techniques available for both EI and energy expenditure (physical activity in particular) and for body-weight changes, it has so far not been possible to convincingly detect initiating differences in EI or energy expenditure and subsequent changes in body weight (9)(10)(11)(12)(13)(14)(15)(16) . A major fundamental problem in such studies is that body weight tends to fluctuate; increases tend to be followed by decreases in body weight (as in the overfeeding studies) and decreases tend to be followed by increases in body weight (as in the weight-loss studies) (9,11) . To avoid bias for this reason, studies starting at any specific point in time will therefore have to take into account the possible effects of the preceding changes in weight on the determinants of subsequent changes in body weight.…”

“…Many studies (including the author's studies) have sought evidence for the role of food intake and physical activity in weight gain and obesity development by investigating the correlations between these exposures taken separately through a broad range of levels at one point in time and the subsequent change in body weight (9)(10)(11)(12)(13)(14)(15)(16) . For such studies to be valid as tests of the role of these exposures in weight gain, a number of assumptions must be made that are not likely to be fulfilled.…”