Weight cycling and the risk of developing type 2 diabetes among adult women in the United States.
OBJECTIVE
To assess the role of weight cycling independent of BMI and weight change in predicting the risk of developing type 2 diabetes.


METHODS
A six-year follow-up of 46,634 young and middle-aged women in the Nurses' Health Study II was conducted. Women who had intentionally lost > or = 20 lbs at least three times between 1989 and 1993 were classified as severe weight cyclers. Women who had intentionally lost > or = 10 lbs at least three times were classified as mild weight cyclers. The outcome was physician-diagnosed type 2 diabetes.


RESULTS
Between 1989 and 1993, approximately 20% of the women were mild weight cyclers, and 1.6% were severe weight cyclers. BMI in 1993 was positively associated with weight-cycling status (p < 0.001). During 6 years of follow-up (1993 to 1999), 418 incident cases of type 2 diabetes were documented. BMI in 1993 had a strong association with the risk of developing diabetes. Compared with women with a BMI between 17 and 22 kg/m(2), those with a BMI between 25 and 29.9 kg/m(2) were approximately seven times more likely to develop diabetes, and those with a BMI > or = 35 kg/m(2) were 63 times more likely to be diagnosed with type 2 diabetes. After adjustment for BMI, neither mild (relative risk = 1.11, 95% confidence interval, 0.89 to 1.37) nor severe (relative risk = 1.39, 95% confidence interval, 0.90 to 2.13) weight cycling predicted risk of diabetes.


CONCLUSIONS
Weight cycling was strongly associated with BMI, but it was not independently predictive of developing type 2 diabetes.
Field
Alison E
AE
Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. Alison.Field@TCH.harvard.edu
Manson
JoAnn E
JE
Laird
Nan
N
Williamson
David F
DF
Willett
Walter C
WC
Colditz
Graham A
GA
D000328:Adult; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D015430:Weight Gain; D015431:Weight Loss