Weight cycling and mortality among middle-aged or older women

Controversy exists about whether weight cycling increases morbidity and mortality.

To assess the independent association of weight cycling with mortality, we conducted a prospective study of 44 882 middle-aged or older women in the Nurses' Health Study who provided information on intentional weight losses between 1972 and 1992, survived until at least 1994, had a body mass index (calculated as weight in kilograms divided by height in meters squared) of at least 17, and had no history of cancer (other than nonmelanoma skin cancer) or heart disease. Women who reported they had intentionally lost at least 9.1 kg at least 3 times were classified as severe weight cyclers. Women who had intentionally lost at least 4.5 kg at least 3 times but did not meet the criteria for severe weight cycling were classified as mild weight cyclers. All-cause mortality and cardiovascular mortality were assessed.

Between 1972 and 1992, approximately 18.8% of the women were mild weight cyclers, and 8.0% were severe weight cyclers. During 12 years of follow-up, 2884 women died; of their deaths, 425 were due to cardiovascular events. Weight cyclers gained more weight during follow-up than noncyclers (P < .001). After adjusting for BMI at age 18 years, physical activity, smoking, postmenopausal hormone replacement therapy, alcohol intake, net weight change from age 18 years, and change in physical activity, there was no increase in risk of all-cause mortality among mild (relative risk [RR], 0.83; 95% confidence interval [CI], 0.75-0.93) or severe cyclers (RR, 0.89; 95% CI, 0.77-1.04). Similar results were observed for cardiovascular mortality and among women 70 years or younger.

Repeated intentional weight losses were not predictive of greater all-cause or cardiovascular mortality.