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WEIGHT LOSS: LINKING YO-YO DIETING AND HYPOTHYROIDISM

I took a trip to the university library and spent some time digging through medical periodicals on the subject of weight cycling, fully expecting to find reams of information on what happens to people who lose and regain weight over the course of a lifetime. The phenomenon is so common that I expected tons of research material, showing that the body actually begins to lose its ability to lose weight on any type of program because of reduced basal metabolic rate, which is governed by the thyroid gland. I already had a list of preconceived ideas about why this could happen:

  1. The body's own homeostatic capabilities begin to break down from overuse.
  2. Rebound dieters lose muscle tissue and gain fat during each cycle, depleting the amount of active tissue and making the body less metabolically active.
  3. Inadequate protein intake or micronutrient deficiencies from inadequate consumption (the typical diet program) seriously erode the ability of the thyroid, pituitary, or other organs of the endocrine system to function normally.
  4. The body's store of brown fat becomes incapable of burning calories efficiently, or the body loses its stores of brown fat because of frequent dieting.
  5. The body refuses to lose weight after a period of deprivation. It instinctively knows that weight cycling is a risk factor for death and believes it is safer to be heavy than to continue cycling, so it just shuts down all weight-loss capabilities to save its life!

My list of theories was long—unlike the materials I found at the library. Even though a great deal of research has been done on obesity and many different weight issues, little has been done on the phenomenon of weight cycling. And what little research I did find was inconclusive and contradictory.

Let's look at some "cycling facts" from the perspective of the research community. An article in the Journal of the American Medical Association (JAMA) declares:

There is no convincing evidence that weight cycling in humans has adverse effects on body composition, energy expenditure, risk factors for cardiovascular disease, or the effectiveness of future efforts at weight loss.

The currently available evidence regarding increased morbidity and mortality with variation in body weight is not sufficiently compelling to override the potential benefits of moderate weight loss in significantly obese patients. Therefore, obese individuals should not allow concerns about hazards of weight cycling to deter them from efforts of controlling their body weight…

Other researchers agree that cycling does not have an impact on subsequent efforts to lose weight, citing possible compliance issues or metabolic changes. But when they addressed the issue of compliance, they wrote that "where compliance was consistent, weight loss was still significantly less on a second diet compared with the first." Some authors conceded that certain individuals may be susceptible or there may be "critical periods of vulnerability" where cycling does, in fact, shut down further weight loss.

Conversely, an abstract from an article in Archives of Internal Medicine said:

Repeated bouts of weight loss and regain, known as weight cycling or yo-yo dieting, are highly prevalent, occur in males and females, and are common in both overweight and nonoverweight individuals. While there has been no consistent demonstration that, as was first thought, weight cycling makes subsequent weight loss more difficult or regain more rapid, it is possible that this does occur under some conditions or in particular individuals. There are stronger and more consistent links between body weight variability and negative health outcomes, particularly all-cause mortality and mortality from coronary heart disease. Weight cycling may also have negative psychological and behavioral consequences; studies have reported increased risk for psychopathology, life dissatisfaction, and binge eating. The bulk of epidemiologic research shows an association of weight variability with morbidity and mortality, although the mechanisms are not clear at present.

We may not know exactly why weight cyclers suffer from health challenges, not the least of which is the inability to succeed on subsequent weight-loss programs, but studies clearly indicate that extremely low-calorie diets that are deficient in protein and carbohydrates slow down the metabolic rate by suppressing thyroid function, making it harder and harder to maintain normal weight, and harder and harder to maintain a healthy body overall.

One author/clinician noted that if you're going to maintain your new weight level after following a restrictive diet, you must progressively keep dropping your calorie intake to accommodate your lowered metabolism (increased efficiency!) or you'll gain it all back. He also says that reduced weight comes along with side effects like hunger, cold intolerance, and just not feeling well. We've seen that these symptoms are typical of thyroid insufficiency.

Other medical journals say it "just ain't so!" They cite problems with the research.

Regardless of what the "experts" are saying, I still believe that when you significantly reduce the number of calories you eat on any type of a nutrient-restrictive diet, your basal metabolic rate drops and your body temperature decreases. I've seen it happen over and over again, as have other clinicians. You simply don't get as much heat production from burning those calories as you do on a higher-calorie diet. Your body becomes more efficient in converting that energy and storing it as cellular energy (fat tissue), and enzyme activity possibly diminishes. Both the thyroid and BAT are rendered helpless in the face of sluggish metabolism!

The good news is that a nutrient-dense, low-calorie diet may help prolong both your health and your life; in other words, you'll live slower but longer. The bad news is that if you ever start eating more calories, you body will label them "extra" and turn them into body fat, which is why the rebound effect in some people can be so powerful. You really do become an efficient fat-producing machine!

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