Association of weight change, weight control practices, and weight cycling among women in the Nurses' Health Study II

OBJECTIVE: To assess the association of weight cycling with weight change, weight control practices, and bulimic behaviors. METHODS: A nested study of 2476 young and middle-aged women in the Nurses' Health Study II who provided information on intentional weight losses between 1989 and 1993. SAMPLE: In total, 224 women who were severe cyclers, 741 women who were mild cyclers, 967 age- and BMI-matched controls (noncyclers), and 544 women who did not weight cycle and maintained their weight between 1989 and 1993 completed a questionnaire in 2000-2001 assessing recent intentional weight losses, weight control practices, and weight concerns. RESULTS: After controlling for age and body mass index (BMI) in 1993, when weight cycling was initially assessed, mild cyclers gained an average of 6.7 pounds (lbs) more and severe cyclers gained approximately 10.3 lbs more than noncyclers between 1993 and 2001. Weight cyclers preferred to change their diet rather than to exercise to control their weight. Severe weight cyclers were less likely than noncyclers to use frequent exercise as a weight control strategy (odds ratio [OR] = 0.8, 95% confidence interval (CI) 0.6-1.1). Cyclers were also more likely than noncyclers to engage in binge eating (mild cyclers: OR = 1.8, 95% CI 1.4-2.4; and severe cyclers: OR = 2.5, 95% CI 1.7-3.5). Independent of weight cycling status, age, and BMI, women who engaged in binge eating gained approximately 5 lbs more than their peers (P < 0.001). CONCLUSIONS: Weight cycling was associated with greater weight gain, less physical activity, and a higher prevalence of binge eating. Low levels of activity and binge eating may be partially responsible for the large amount of weight regained by weight cyclers.