GLP-1 cycling can negatively impact weight loss efforts by leading to weight yo-yoing.
“If the intervals between shots are long enough, this can cause some weight regain, which can be very frustrating for patients,” says Meghan Garcia-Webb, MD, a board-certified internal, lifestyle, and obesity medicine physician in private practice in Wellesley, Massachusetts. When repeated over time, losing and regaining weight can also carry metabolic and psychological consequences.
“In general, repeated cycles of weight loss and regain is associated with worsened cardiometabolic risk factors,” says Sara Velayati, MD, obesity medicine specialist and assistant professor at Albert Einstein College of Medicine in New York City.
A study of over 83,000 adults who received treatment at Vanderbilt University Medical Center in Nashville, Tennessee, between 1997 and 2020 found that more than half were weight cyclers.
Compared with those who maintained a stable weight, people who experienced weight yo-yoing had significantly higher risk for heart failure, obstructive sleep apnea, metabolic dysfunction-associated steatotic liver disease (MASLD), and type 2 diabetes. These associations held true even after accounting for factors like baseline body mass index, age, sex, smoking status, race, and medications.
While the study is observational and doesn’t prove that weight cycling causes chronic conditions, it does point to potential explanations. The authors note that each cycle of losing and regaining weight tends to shift body composition toward more fat and less muscle. You lose both fat and muscle when you lose weight, but when you regain the weight, the body prefers to pack on fat. Over time, this muscle loss slows your metabolism, making future weight gain easier. Weight cycling also triggers inflammation, which is linked to chronic conditions including heart failure, MASLD, and type 2 diabetes.
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