Diabetes Health Team discusses yo-yo dieting and its consequences on health.
Case study
Ms Kritika Khatri (name changed) began her diet at a very young age. She followed an irregular diet pattern for nearly 10 years. Every time she resumed her normal diet pattern, she would put on more weight than what she had reduced. Her body weight fluctuated every time she would stop and begin her diet. By the age of 21, Ms Khatri was diagnosed of polycystic ovarian syndrome (PCOS), had developed insulin resistance and was on the onset of Diabetes. Ms Khatri understood that her interpretation of ‘lifestyle changes’ in successful weight loss was not appropriate. But she was determined to get her health back to normal. Her diagnosis acted as an eye- opener and led her to understand the importance of conscious eating over
starving oneself. She started taking a balanced diet. Earlier she would consume aerated drinks even when she quit other foods. She stopped continuing the same now. But her task didn’t finish here. She still had to lose 40 kgs of weight that she had gained all this long.
During her diagnosis, Ms Khatri shut herself from the outside world. She rejected her social life and avoided going in public due to her guilt. Ms Khatri wholeheartedly wanted to turn her situation around. She had set targets to lose her body weight. She would religiously work out every day and after achieving her target, she would gift herself a pair of clothing that is a size lesser than before. Eventually she gained her confidence back, stepped out into the public and joined a support group where she was encouraged in her attempt to get fit. Slowly with medical help, her health was
brought back to normal. She says she was never so happy than now.
What is yo-yo dieting?
Remember the classic toy yo-yo and how that little thing moved in and out of your hand when flicked. Every time the toy is flicked with more pressure, it comes back with more speed. Now replace each aspect of that activity with any typical dieting pattern. Consider the toy as your body weight and your hand control as dieting pattern. So, whenever you flick your hand, that is, when you diet, the yo-yo, meaning your body, loses weight. When you pull in your hand which signifies resuming your normal diet, the yo-yo resumes its original position. This causes your body to regain its lost weight. Higher the pressure exerted while flicking the hand, the faster the yo-yo bounces back.
What is implied here is that every time you diet, your body regains more than what it loses when normal diet is resumed. This fluctuation in a person’s body weight due to stop-and-go dieting is called yo-yo dieting. Yo-yo dieting, also called as weight cycling, is the fluctuation seen in a person’s body weight due to changes in daily diet. In this, the person’s body weight reduces when there is a cut down in the intake of calories but increases immediately when normal diet is resumed. Most research studies on yo-yo dieting have one thing in common that both obese and non-obese people would often indulge in yo-yo dieting.
When a person diets, carbohydrates and other vital nutrients entering the body is lowered. The body interprets it as a period of ‘famine’ and lowers its need of calorie intake. When normal diet is resumed, the body starts storing as much calories as it
can to sustain itself during the next period of ‘famine’. The effect is that we tend to eat more foods rich in carbohydrates and fat as they make us feel full. This overindulgence leads to weight gain.
Risks of yo-yo dieting
Obesity is an increasing cause of concern in India and the world. A research undertaken at the University of California had shown that two-third of people who had reduced their weight by dieting, subsequently gained more than before. A number of research studies have shown that obese people who tend to yo-yo diet are at an increased risk of Type 2 Diabetes and heart disease. Some risks that pose a danger to the heart health are:
Heart problems in women
Major case studies have established that 66 per cent women who follow yo-yo diet are susceptible to Coronary Heart Disease (CHD) and Sudden Cardiac Death (SCD) than those who do not, even when their body weight falls under the recommended
limit. Yo-yo dieting severely affects the electrolyte levels and leads to an imbalance in minerals and fluids. The imbalance can lead to heart failure.
Elevated blood pressure and heart rate
Changes in diet affect heart functioning. Research studies have shown that increased blood pressure levels can lead to organ damage. When obese people diet their blood pressure decreases. But when they resume their normal diet pattern, after successful weight loss, they put on more weight than before. This elevates blood
pressure and causes the heart to have to pump harder. To a lesser degree, this has also been seen in non-obese people. Elevated heart rate makes the heart vulnerable to
heart disease and even heart attacks.
Hampered kidney functioning
Research studies have shown that yo-yo dieting can impact kidney functioning. Repeated weight cycles affect the glomerular filtration rate of the kidneys (the first stage filtration in the kidneys). The glomerular filtration rate is managed by food intake. Any decrease or increase in the food intake affects the kidney functioning typically within 24 hours. Increased kidney functioning during weight gain increases the lipid levels and in the long run, this increased pressure affects the kidney health, leading to poor management of blood pressure.
Insulin resistance
During dieting, the body interprets it as ‘famine’ and lowers its secretion of insulin. As a result, there is a lesser consumption of blood glucose and lowered release of energy. When the body goes back to the normal diet pattern, the individual tends to overeat and there is an increased amount of blood glucose in the body. This requires the pancreas to release more insulin to manage the increased glucose levels. The insulin secreted in this process loses its potential to absorb the elevated glucose levels. This leads to a high quantity but poor quality of insulin secretion in the body (hyperinsulinaemia).
Another aspect of the condition is when the body fails to produce enough insulin to process the increased levels of glucose in the bloodstream after the period of dieting. This results in the development of insulin resistance.
Affected Lipid profile
When the body goes back to normal diet pattern, it tends to consume more of fat and carbohydrate-based foods. This leads
to an imbalance in the lipid levels caused by high LDL (bad cholesterol) and low HDL (good cholesterol). When there is an excess deposition of bad cholesterol in the arteries of the heart, the body is highly at a risk of heart disease.
An imbalance in the lipid levels can lead to many health conditions such as Diabetes, hypertension, obesity, lowered thyroid production (hypothyroidism), polycystic ovary syndrome (PCOS) and Cushing’s syndrome (deposition of fat in the midsection of the body due to high levels of cortisol hormone).
Situational yo-yo dieting
Is it always due to obesity or dissatisfaction with their appearance that people yo-yo diet? No. There is certainly more to yo-yo dieting that we should not ignore. People, especially those in a profession where physical appearance makes a huge impact, had been noted to follow yo-yo diet for a significant time. Professionals such as actors and models have to undergo yo-yo dieting due to professional necessity which often costs them their health. Many of them eventually develop Type 2 Diabetes, polycystic ovary syndrome, hypertension and heart diseases.
A significant percentage of population living in economically challenged countries or who have to face a prolonged shortage of food are forced to undergo the pattern due to shortage of supplies and calamities such as draught and famine. Socio-economic constraints such as unstable government, war and unrest force the country to undergo periodic starvation. In such cases the lipid levels, blood sugar and blood pressure levels fluctuate significantly.
Comeback from yo-yo dieting
Understanding the pros and cons of yo-yo dieting is the first step towards bringing a change in the habit. Knowing their body and what is good for them is important for people to come back from the trend that body has adapted. Body weight can fluctuate due to a number of reasons levels of carbohydrate intake, consistent travel, stress, electrolytes fluctuation, etc. In order to reduce body fat:
- Set realistic weight loss goals for a time frame which are possible for you to
- Do not starve yourself. Instead start taking small meals at regular intervals to avoid overeating.
- Monitor your weight every month to know if you are gaining excess weight.
- Seek advice from your dietician and physiotherapist to plan the right diet and exercise regime that suits you.
- Do not be a rebel and force your body to perform what is not possible or
After all, no battle can be won without a sound body and a sound mind!
