Yoyo Dieting, Post-Obesity Weight Loss, and Their Relationship with Gut Health

Abstract

Excessive body weight is associated with many chronic metabolic diseases and weight loss, so far, remains the gold standard treatment. However, despite tremendous efforts exploring optimal treatments for obesity, many individuals find losing weight and maintaining a healthy body weight difficult. Weight loss is often not sustainable resulting in weight regain and subsequent efforts to lose weight. This cyclic pattern of weight loss and regain is termed "yoyo dieting" and predisposes individuals to obesity and metabolic comorbidities. How yoyo dieting might worsen obesity complications during the weight recurrence phase remains unclear. In particular, there is limited data on the role of the gut microbiome in yoyo dieting. Gut health distress, especially gut inflammation and microbiome perturbation, is strongly associated with metabolic dysfunction and disturbance of energy homeostasis in obesity. In this review, we summarise current evidence of the crosstalk between the gastrointestinal system and energy balance, and the effects of yoyo dieting on gut inflammation and gut microbiota reshaping. Finally, we focus on the potential effects of post-dieting weight loss in improving gut health and identify current knowledge gaps within the field, including gut-derived peptide hormones and their potential suitability as targets to combat weight regain, and how yoyo dieting and associated changes in the microbiome affect the gut barrier and the enteric nervous system, which largely remain to be determined.

Keywords: gut microbiome; obesity; weight loss; yoyo dieting.

Figure 1

Overview of effects of yoyo dieting and post-obesity weight loss on gut health. Yoyo dieting refers to repeated phases of dieting and non-dieting leading to cyclic weight loss and regain. There has been growing evidence from animal studies suggesting that yoyo dieting is associated with increased susceptibility to weight regain, gut dysbiosis, and gut inflammation. The current literature also suggests that diet-induced weight loss is a potential approach to reduce gut inflammation. However, post-obesity weight loss in humans has also been associated with increased gut dysbiosis. ↑: increase; ↓: decrease.