The deadly consequences of yo-yo dieting

…and how to break the lethal cycle, once and for all

Another holiday season is upon us. And in case you haven’t noticed, visions of sugar plums aren’t exactly dancing in my head. 

Why should they be? It might be the most wonderful time of year for some people. But as far as I’m concerned, it’s Halloween all over again—that’s how scary the next couple of months are. Because the impact they can (and often do) have on your health is nothing short of devastating. 

You may think I’m being dramatic. But the average American will gain 8 to 10 pounds between now and the new year. 

No big deal, you might say. I can drop those eight pounds by April.  

And maybe you can. But it will still come at a price. Because a see-sawing scale doesn’t just wreak havoc on your metabolism… it can also double your risk of heart attack, stroke, diabetes, and death.

It only takes eight pounds

A new study made headlines after appearing in the New England Journal of Medicine recently. Researchers followed over 9,500 participants with coronary artery disease (CAD) for nearly five years. And their findings linked weight fluctuations to higher risk of both death and cardiovascular events, independent of any other factors.¹ 

Not by a small amount, either. Among people with the highest weight variations, risk of a heart-related event was 85 percent higher. Risk of death was 124 percent higher. And risk of heart attack or stroke was 117 percent and 136 percent higher, respectively.

And the weight fluctuations weren’t as big as you might expect. 

The highest risk group in this study saw the scales tip just over 8 pounds. A change that—I repeat—doubled the risk of heart attack, stroke, and death. And, as I mentioned above, it’s the same amount of weight most people can expect to gain over the holiday period. 

Unsurprisingly, there were also increased odds of developing diabetes among those whose weight varied the most—which is a compelling reason to avoid fluctuations all by itself. 

If all of this isn’t a strong argument against yo-yo dieting, I don’t know what is. Yes, I realize that even the most diligent weight watcher will fluctuate up and down by a few pounds. But this research makes pretty clear that the pendulum doesn’t have to swing far to cause very real—and very serious—problems for your health. 

And it doesn’t require you to have pre-existing heart problems, either. While this particular study looked at patients with CAD, plenty of research shows that even yo-yo dieters without cardiovascular disease are at risk. 

Vicious effects of rollercoaster weight cycling

Inflammation is believed to be the root cause of the medical issues associated with yo-yo dieting.² And ultimately, this is a risk that affects all “chronic dieters,” regardless of their disease status. 

More specifically, researchers think that repeated loss and regain of body weight, also known as “weight cycling,” actively changes the metabolic activity of your fat stores by depriving adipose tissue of oxygen. This deprivation triggers a hormone and immune-mediated inflammatory cascade above and beyond what we see with obesity alone.

To put it in more simple terms, that means chronic yo-yo dieting may actually be worse than simply gaining weight and never losing it.  

That might explain why studies show that weight cycling increases cardiovascular risk—not to mention risk of death by any cause—even among healthy weight men and women.³⁻⁴

Bottom line? It doesn’t matter whether you’re in good health or ill. And it doesn’t matter whether your weight is fluctuating by 10 pounds or 100 pounds. No one is immune to the deadly side effects of yo-yo dieting. 

And it’s time to start taking them seriously by putting an end to the “see-saw effect” you see on the scale, once and for all.

Start by changing your “spare tire”

The most crucial takeaway from this is obvious—once you lose weight, do whatever you can to keep it off (within a healthy means, of course). And that challenge doesn’t just start once you reach your goal weight. It’s something you need to be mindful of every single day. 

I know it may be frustrating when you set out to lose, say, 50 pounds, only to wind up stuck at the 10-pound mark. But you need to stick with the program anyway, because any weight loss is helpful. 

And I don’t need to tell you that taking it off is a lot harder than gaining it. So don’t lose any progress you’ve already made. 

Plus, there’s one goal that’s even more important than a specific target weight anyway… dealing with the dreaded “spare tire.” 

A lot of people think of their muffin top as a vanity issue. But in reality, there’s much more to it than that. In fact, extra belly fat is one of the primary risk factors for all of the deadly diseases mentioned above.

You see, belly fat is metabolically distinct from normal adipose (fat) tissue. Simply put, it’s a boiling cauldron of inflammation. Which means that losing your spare tire is a critical step toward correcting dangerous metabolic imbalances—and breaking the yo-yo dieting cycle for good. 

Putting out the fire once and for all

My A-List Diet hinges on inflammation control—something that sets it apart from other low-carb, high-protein diets out there. The specific strategies are outlined in more detail in my book (which is available via Amazon or—but for now, here are six quick ways to get the jump on this silent killer.

1. Eat antioxidants and polyphenols. These compounds mop up free radicals—rogue molecules that trigger inflammation and leave a path of destruction behind them. 

You need your body to deal with free radicals before they have a chance to overwhelm your system. And the phytochemicals in fruits and veggies—like broccoli, kale, collards, and berries—are essential to this duty. 

2. Choose the right fats. Omega-6 fats—from refined vegetable oils, salad dressings, chips, and pasta—promote inflammation and fat storage. Omega-3 fats—from foods like fish oil, cold-water fish, chia seeds, and walnuts—are anti-inflammatory. 

3. Add spices. Turmeric, garlic, cinnamon, cayenne pepper, ginger… practically every spice you can think of carries research-supported benefits against inflammation. You simply can’t use too many.

4. Exercise. Not too little, not too much. The science of exercise is probably moving faster than the science of nutrition. And at least for now, moderation is still king. Break a sweat for 30 minutes a day. 

And whatever you do, avoid too much sitting, another risk factor for inflammation and disease in itself.  

5. De-stress. The stress hormone cortisol is like gasoline on a fire. You need to keep your levels of this hormone under control. 

Whether you opt for yoga, meditation, or just something simple like listening to music or reading, find ways to incorporate some quiet downtime into your day. 

6. Sleep. Seven to eight hours a night is the sweet spot according to most studies. Much less—or more—is a recipe for disaster. 

Of course, conquering inflammation is only half the battle. It will definitely stop some of the yo-yo’s momentum. But to really break the up-and-down cycle, you also need to tackle the underlying issues that set it in motion in the first place. 

Five psychological saboteurs behind chronic weight cycling

The pitfalls that lead to “relapse” are primarily traps of negative or unrealistic thinking. And there are five in particular that I continue to see again and again.  

1. Unrealistic expectations. Yo-yo dieters get hung up on numbers. Don’t make this mistake. All weight loss is good—it doesn’t matter how much or how long it takes, as long as the trend is down.

2. Failure to achieve weight loss goals. This goes hand in hand with unrealistic expectations—and it’s why I never set specific weight loss goals with my patients. If you’re frustrated or disappointed that you haven’t reached some arbitrary number in your mind, you’re a lot more likely to throw in the towel.

3. Dichotomous (or “black and white”) thinking. It’s all or nothing for people who think this way. When anything less than your original goal is unacceptable, it’s easy to ignore the progress you have made, and ultimately, give up.

4. Eating to regulate mood.Eating your feelings” may be a cliché—but it’s also the biggest enemy of long-term weight management. You must find other, healthier ways to manage your emotions. A good counselor or support group can help.

5. Body image. It’s easier said than done. But loving the way you look is another key to success. Don’t be afraid of or overly critical toward your new body. Be proud, even if you’ve got further to go—you’ve earned it.  

Addressing these five psychological hurdles is essential work for anyone seeking long-term weight loss—and yo-yo dieters especially. 

But there are concrete strategies that can help along the way, too. 

In fact, a study addressing just this appeared in the Journal of the American Medical Association (JAMA) not too long ago.⁷ And its results shine a light on just how effective small, consistent changes can be in preventing a rebound weight gain.   

What to do if your weight starts creeping up

Following weight loss, the subjects in the study monitored their weight daily and reported it online or via text message. 

If the subjects’ weight started creeping back up, they received instructions for getting back on track…tips like cutting 100 calories per day and adding a little extra exercise to their normal workout. And these small changes paid off. 

The subjects not only reined in the slow “creep” on the scale…but they actually continued to lose weight. 

The takeaway here is simple, but powerful: Early intervention and self-regulation are essential. 

You know yourself. So keep an eye on your habits and adjust your course as necessary along the way.

Don’t wait until it’s too late and you’ve already gained 10 pounds. Take action NOW. And repeat the steps every single day.



Helping your gut “let go” for good 

Weight cycling may have its roots in psychology—but that doesn’t mean there aren’t physical roadblocks on the path to getting thin for good. In fact, one recent study showed that the microbiome has a “memory” of former obesity, too… and it could be dragging your waistline back into the past with it.⁸

This isn’t the first we’ve heard about gut bacteria’s role in weight gain. (In fact, I devoted an entire article to the subject back in the May 2014 issue.) But it’s a good reminder that supplements have a role in long-term weight maintenance, too. And of these, a high-quality probiotic might be the most vital.

Research shows that the obese microbiome is distinguished by its lack of diversity. So as always, be sure to select a product that features multiple strains of bacteria, like Dr. Ohhira’s. And take it every single day. 



Like it or not, “dieting” is for life

I’ve had the maintenance conversation with my patients many times over now. And the biggest question on everyone’s lips is always, “When can I go back to eating pasta (or bagels, or potato chips, or whatever)?”

You really can’t. I know it might be disappointing to hear. But sometimes we have to face the truth that we can’t eat all the old foods we used to love.

The answer to alcoholism isn’t drinking in moderation—it’s abstinence. And for the yo-yo dieter, food—usually in the form of sugar or refined carbohydrates—is an addiction like any other. 

So the key to real long-term success is to accept that “dieting,” is absolutely a lifelong commitment. And research shows a ketogenic Mediterranean-type diet (sound familiar?) is by far your best bet for long-term weight maintenance.5-6 Mostly because it’s so “liveable.” 

You can still eat food that tastes delicious. And a wide variety of it. So, it doesn’t have to feel like you’re “dieting” forever…even when, technically speaking, you are.



1. Bangalore S, et al.Body Weight Fluctuations and Outcomes in Cornary Disease.” (2017). N Engl J Med. 2017 Apr 6;376(14):1332-1340. Retrieved from:

2. Strohacker K, et al. “Roles of extrathyroidal TSHR expression in adipocyte differentiation and its association with obesity.” (2012 Jan 30). Front Biosci (Elite Ed). 2010 Jan 1;2:98-104. Retrieved from:

3. Montani JP, et al. “Metabolic syndrome: a closer look at the growing epidemic and its associated pathologies.” (2015 January 16). Obes Rev. 2015 Feb;16 Suppl 1:7-18. Retrieved from:

4. Rzehak P, et al. “ Weight changes, weight cycling and mortality in the ERFORT Male Cohor Study.” (2007). Eur J Epidemiol. 2007;22(10):665-73. Retrieved from:

5. Paoli A, et al. “long term successful weight loss with a combination biphasic ketogenic Mediterranean diet and Mediterranean diet maintenance protocol.” (2013 December). Nutrients. 2013 Dec; 5(12): 5205–5217. Retrieved from:

6. Schwarzfuchs D, et al. “Four-Year Follow-Up after Two-Year Dietary Interventions.” (2012 October 4). N Engl J Med. 2012 Oct 4;367(14):1373-4. Retrieved from:

7. Wing RR, et al. “Innovative Self-Regulation Strategies to Reduce Weight Gain in Young Adults: The Study of Novel Approaches to Weight Gain Prevention (SNAP) Randomized Clinical Trial. JAMA Intern Med.” (2016 Junes 1). 176(6):755-62. Retrieved from: 

8. Thaiss CA, et al. “The microbiome and innate immunity.” Nature. 2016 Nov 24. Retrieved from: