Being overweight and obese is becoming increasingly more common among Americans — one third of adult Americans are now considered obese. Public health officials are concerned that this increased weight profile predicts an increase in overweight-associated diseases like diabetes and high blood pressure (hypertension). Both of these conditions are serious risk factors for heart disease, the leading cause of death in the United States.

In addition to the increasing weight problem, the fact that many Americans have gained, lost and regained weight repeatedly has led researchers to suggest that this so-called “weight-cycling” itself contributes to associated health risks. This possibility has led some to suggest that overweight people not be counseled to lose weight, since many attempts to maintain weight loss are unsuccessful and result in repeated episodes of such “weight cycling.”

An investigation published in the Sept. 15 issue of the American Journal of Epidemiology, however, does not support this concept. Researchers at the Brigham and Women’s Hospital in Boston examined the extent and patterns of weight gain by more than 46,000 women enrolled in the Nurses’ Health Study.

Subjects of the study were between 33 and 51 years old at the beginning of the investigation in 1989. They completed questionnaires about their medical histories, health-related behaviors, and life-styles and were asked to complete follow-up questionnaires two, four and five years later.

The investigators focused on the nurses’ intentional repeated weight loss of at least 10 pounds. Women who lost 20 or more pounds at least three times during the four-year period were considered severe weight cyclers; while those who lost and regained between 10 and 19 pounds were considered mild weight cyclers.

Neither group of weight cyclers had a significantly increased risk of developing hypertension, compared to non-cyclers, when other health-related factors such as smoking, initial body weight and weight gain during the study were taken into account. Importantly, the investigators confirmed that excessive body weight as well as additional weight gain were each significantly associated with an increased risk of developing hypertension.

Commenting on what we may be able to learn from this study, Dr. Alison E. Field, lead investigator, stated, “Of course the ideal would be for women to try to maintain a healthy weight. However, for women for whom it is not possible to lose weight, it would be better to maintain current weight (even if they are overweight) rather than gain weight over time.”

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