Research on Yo Yo Dieting (fwd)

[Laura Larsson]

Friends:

I'm passing along a comment by a colleague on this topic.

Regards,

Laura Larsson
Health Services, University of Washington
larsson at u.washington.edu
listowner: PHNUTR-L, PHNURSES, PNWHEALTH, PHSW, HSR-L +
http://depts.washington.edu/hserv/hshome.html
http://depts.washington.edu/hsic/hsichome.html

"The illiterate of the 21st century will not be those who cannot read and
write, but those who cannot learn, unlearn, and relearn. "  Alvin Toffler

---------- Forwarded message ----------
To: <pre at po.cwru.edu>, "'jon robison'" <robisonj at pilot.msu.edu>,
        "'Sally Ann Lederman'" <sal1 at columbia.edu>
From: Gail Woodward-Lopez <gwlopez at nature.berkeley.edu>
Subject: RE: Research on Yo Yo Dieting
Cc: "'Gaesser, Glenn A'" <GAG2Q at hscmail.mcc.virginia.edu>,
        "'pre at po.cwru.edu'" <pre at po.cwru.edu>, <a_macpherson at seam.upr.clu.edu>,


Hello all,  the subject of weight cycling is of great interest to the 
Center for Weight and Health (at UC Berkeley).  We are considering writing 
a position paper on the topic and were wondering if any of you are planning 
on doing so--please let us know so we don't duplicate efforts.  We will 
keep you posted should we decide to proceed with a paper on this topic and 
most certainly will be seeking your input.  Great discussion!--Gail


At 10:50 AM 11/10/00 -0500, Paul Ernsberger, Ph.D. wrote:

>Jon et al.:

>

>Excellent points.  One point that is often missed is that there are always

>alternatives to dangerous weight loss practices.  The Health at Any Size

>movement is often attacked because it is "unproven" --meaning that a size

>accepting paradigm has not been tested in a double blind clinical trial.

>But the Health at Any Size paradigm is to any treatment that has been

>clinically proven.  Diet pills, behavior mod, and other diet methods have

>not been proven to improve health over the long term (5 years or more). On

>the positive side, eating more vegetables, getting more exercise, taking

>medicines to reduce risk factors and treat diseases common in obesity --all

>these are PROVEN to prolong life for fat and thin people alike.  My MD

>colleague Richard Koletsky maintains that health at Any Size is just

>old-fashioned conservative medicine --use only the interventions that proven

>effective in improving health over the lifetime of the patient.  True

>conservative medicine eliminates the use of diet pills, surgery,

>supplemented fasts, low-carbohydrate diets as unproven, ineffective and

>potentially dangerous.

>

>A final point on weight cycling --it is often believed that without

>intervention, fat people will continue to gain weight.  Indeed, it is true

>that about one-third pf people in weight loss programs gain back more than

>they lose.  But if you look at fat people in the general population, they

>actually tend to lose weight.  This was shown by Stanley Garn in the

>Tecumseh. Michigan study, for example.  If you look at the fattest people in

>a population, they will tend to lose weight, just as the thinnest people

>tend to gain weight.  Studies of fat people in the general population and

>not just those who are going to weight loss clinics show loss rather than

>gain.

>

>--Paul Ernsberger, PhD

>

>-----Original Message-----

>I am afraid that this discussion of weight cycling, as it often does, is

>obscuring the real issue - which is the damage that the obsession with

>thinness is doing in this country. <<snip>>

>  So, what is the point? The point is that people in

>this country, particularly women are being pushed to continue to engage

>in practices that have no demonstrated efficacy and are often harmful to

>health, in the name of improving health. The results - anorexia nervosa,

>bulimia, binge eating, disordered eating and exercise behavior,

>increasing rates of smoking in young girls, body hatred, heart valve

>damage, leaky stools, children being abducted from their families for

>being fat or being subjected to potentially dangerous medical procedures

>because their parents are fat, etc., etc., etc., will continue to cause

>untold damage unless we have the courage to stand up to the "Diet

>Pharmaceutical Industrial Complex" and say - enough is enough. What we

>as health professionals are doing, despite good intentions, IS NOT

>HEPING PEOPLE TO BE HEALTHIER!! Until such time as we have a safe,

>effective, long term intervention for weight loss, we must focus on

>helping people to be healthier by creating more balance in their lives,

>trusting that the body knows what it ought to weigh. To do anything

>else, in the face of what the data says about traditional interventions

>to date is unscientific, uncompassionate and unethical!

>

>Jon Robison PhD, MS

>

>

>

>

>Sally Ann Lederman wrote:

> >

> > On Wed, 8 Nov 2000, Gaesser, Glenn A wrote: It would seem to

>me that to

> > really know if weight cycling were harmful, you would have to

>know what

> > happens to people who do not lose and regain. Some of the discussion

> > seemed to assume that the approporiate comparison is people who hold

> > their weight steady, even if overweight.  But perhaps the more likely

> > scenario is that, without repeated attempts at weight loss,

>people would

> > just increase weight more over time.  That would mean an ever

>increasing

> > risk, too.  Weight cycling might be lower risk than continued

>weight gain.

> >

> > Sally Lederman

> >

> > > Paul, I'm glad you raised those points.  I could add that

>Wing and others

> > > have actually argued that weight cycling would be preferred

>to maintaining a

> > > constant "overweight" status, the logic being that at least

>during the

> > > period of weight loss CVD risk factor profile is improved (e.g., BP,

> > > lipids).  Of course this is not always true, and may

>actually be the reverse

> > > (e.g., low-carb diets, for LDL-C and HDL-C in women).

>Also, this argument

> > > is without any support from the epidemiological studies, as

>no study to date

> > > has actually reported reduced CVD risk/mortality with weight

> > > fluctuation...and most report increased risk, as you mention.

> > >

> > > FYI...in the latest NEJM there are two articles of

> > > interest..."Phenylpropanolamine and the risk of hemorrahgic

>stroke" and

> > > "Adverse cardiovascular and central nervous system events

>associated with

> > > dietary supplements containing ephedra alkaloids."   More

>ammo for the

> > > non-diet movement.  Please pass this information along to others.

> > >

> > > Glenn

> > >

> > > > -----Original Message-----

> > > > From:        Paul Ernsberger, Ph.D. [SMTP:pre at po.cwru.edu]

> > > > Sent:       Wednesday, November 08, 2000 10:26 AM

> > > > To: 'jon robison'

> > > > Cc: 'Ann Macpherson'; jikeda at socrates.berkeley.edu;

> > > > ce-homeeconomics at ucdavis.edu; fnspec_mg at ecn.purdue.edu;

> > > > Sneeze at aesop.rutgers.edu; partnershiphwm at ucdavis.edu;

> > > > phnutr-l at u.washington.edu; APeterso at dhs.ca.gov; kknapp at cde.ca.gov;

> > > > melfant at dhs.ca.gov; WIN at info.niddk.nih.gov; 'Miriam Berg';

> > > > naafa at naafa.org; DebBurgard at aol.com; Erdman at cdnet.cod.edu;

> > > > fge2 at earthlink.net; mjfeeney at pathfinder-research.com;

> > > > fleming at nature.berkeley.edu; Glenn.A.Gaesser at virginia.edu; 'MOLLY

> > > > kretsch'; lynn at sprynet.com; plyons at earthlink.net;

>ritchie25 at earthlink.com;

> > > > 'Dennis Styne'; naschonfeldwarden at ucdavis.edu; 'Marilyn Wann';

> > > > gwlopez at nature.berkeley.edu; THECOUCH at aol.com; Azmoni at aol.com

> > > > Subject:    RE: Research on Yo Yo Dieting

> > > >

> > > > Jon:

> > > >

> > > > Valid points, certainly.  But the broader context here is

>the following:

> > > >

> > > > 1.  Several longitudinal studies, including the

>Framingham study, showed

> > > > that coronary heart disease and cardiovascular death were

>increased by

> > > > weight cycling.

> > > >

> > > > 2.  Cross-sectional studies of dieters by Rena Wing and

>others failed to

> > > > find any increase in risk factors compared to

>non-dieters.  On this bases,

> > > > the Obesity Task Force and others declared the

>longitudinal studies to be

> > > > invalid, because there was no known biological mechanism

>for a harmful

> > > > effect of weight cycling.

> > > >

> > > > 3.  Both #1 and #2 groups of reports failed to consider decades of

> > > > laboratory research linking weight cycling to adverse

>risk factors in test

> > > > animals and in short-term studies of patients.

> > > >

> > > > 4.  A cross-sectional study shows risk factors are

>related to weight

> > > > cycling, contradicting the studies in #2.

> > > >

> > > > So in the ongoing scientific exchange over weight

>cycling, this last bit

> > > > is

> > > > actually significant, especially since the link between

>weight cycling and

> > > > coronary heart disease itself has already been firmly established.

> > > >

> > > >

> > > >

> > > >

> > > > I would like to caution all involved that this is one

>cross-sectional,

> > > > epidemiological study which at the very best suggests some sort of

> > > > potential association between two variables - no more -

>no less.  While

> > > > I firmly believe that weight-cycling cannot possibly

>contribute to a

> > > > healthy lifestyle, as health professionals we owe it to

>the population

> > > > as a whole to be extremely careful about suggesting or rejecting

> > > > causation from this limited information. Reading way too

>much into these

> > > > kinds of studies is a major reason why people in this

>country are so

> > > > completely confused and anxious about what they "should"

>and "shouldn't"

> > > > do to improve their health and particularly what they should and

> > > > shouldn't eat. While there maybe some significant

>relationship here, it

> > > > is just as likely that there is none at all, or that the

>one we think we

> > > > see is not the one that really is. I truly hope that we in the New

> > > > Paradigm camp will be more careful than the traditional health

> > > > establishment in the use (or misuse) of this kind of study.

> > > >

> > > > Jon Robison

> > > >

> > > > Paul Ernsberger, Ph.D. wrote:

> > > > >

> > > > > -----Original Message-----

> > > > > |From: Ann Macpherson [mailto:A_Macpherson at seam.upr.clu.edu]

> > > > >

> > > > > |Maybe the significant factor here is not yo yo dieting

>nor relative

> > > > > fatness,

> > > > > |but the level of physical capacity.

> > > > >

> > > > > Ann, I beg to differ. There is lab research going back to the

> > > > early 1960's

> > > > > showing that "refeeding" after a low calorie diet causes a

> > > > huge increase in

> > > > > production of triglycerides by the liver (up to

>15-fold).  Cholesterol

> > > > > production can be doubled.  This is a biological response to

> > > > weight cycling.

> > > > >

> > > > > \/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\

> > > > > Paul Ernsberger, PhD, Department of Nutrition,

> > > > > Case Western Reserve School of Medicine, 10900 Euclid Ave.,

> > > > Cleveland, OH

> > > > > 44106-4906

> > > > > Web address: http://www.cwru.edu/med/nutrition/ernsberger.htm

> > > > > Email: pre at po.cwru.edu;  FAX: (216) 368-6644

> > > > >

> > > > > ----- Original Message -----

> > > > > From: <jikeda at socrates.Berkeley.EDU>

> > > > > > YO-YO DIETERS SHOW LOWER

> > > > > >                     LEVELS OF "GOOD" CHOLESTEROL,

> > > > > >                     COULD POSE HEART DISEASE RISK,

> > > > > >                     SAY RESEARCHERS FROM NATIONAL

> > > > > >                     W.I.S.E . STUDY

> > > > > >

> > > > > >                     PITTSBURGH, Oct. 31, 2000 - Women who

> > > > > repeatedly gain

> > > > > > and lose

> > > > > >                     weight, especially if they are obese, have

> > > > > > significantly lower levels of HDL

> > > > > >                     or "good" cholesterol than do women who

> > > > > maintain their

> > > > > > weight, putting the

> > > > > >                     weight cyclers at increased risk of

> > > > cardiovascular

> > > > > > disease. These findings

> > > > > >                     were published in the November issue of

> > > > > the Journal of

> > > > > > the American

> > > > > >                     College of Cardiology

> > >


Gail Woodward-Lopez, MPH, RD
Academic Coordinator, Center for Weight and Health
University of California
College of Natural Resources
101 Giannini Hall
Berkeley, CA  94720-3100

Tel  (510) 642-1599
Fax  (510) 643-4483
e-mail: gwlopez at nature.berkeley.edu

For more information please visit the Center for Weight and Health web site 
at http://cnr.berkeley.edu/cwh.