Yo-yo dieting and type 1 diabetes: caution for the kidneys

Food plays a central role in all people’s lives and is a particular focus when living with type 1 diabetes (T1D). Since eating is directly tied to blood sugar fluctuations, that relationship can be further complicated and unfortunately, disordered eating is more common among people living with T1D. 

Weight cycling or yo-yo dieting describes the off and on phenomenon of continually losing and then re-gaining weight, often a consequence of repeated unsustainable diets. In people without diabetes, yo-yo dieting can increase the risk for type 2 diabetes. A previous study in people living with T1D found that heart disease was more common in people who had greater weight fluctuations over time. Now, the researchers wanted to know if there is a link with weight cycling and kidney disease. 

Kidney disease is a complication of T1D

Significant hyperglycemia and fluctuations in blood sugar over time can lead to diabetes-related complications including kidney disease (also known as nephropathy). In the BETTER registry, more than 10% of participants have reported a diagnosis of nephropathy. Kidneys play an essential role in filtering out waste products from the blood and balancing water and mineral levels. When kidney function is impaired, high levels of proteins (e.g., albumin) may be found in the urine while waste products (e.g., creatinine) will build up in the blood. Healthcare providers monitor these changes to assess kidney health and function.

How does yo-yo dieting impact kidney disease in T1D?

This study looked back at data from a groundbreaking study, the DCCT/EDIC trial, that showed that intensive blood sugar management and aiming for normal blood sugar levels lowered the risk of long-term T1D complications. They were able to include 1432 participants using weight measures and kidney function over an average of 21 year follow-up. 

Researchers first divided participants into 3 groups from lowest to highest variations in their body weight over an average of 6 years. The group with the greatest variability in their body weight (highest differences between body weight measurements over time, regardless of their average weight) had more women, were younger, had lower body mass index, and higher HbA1c on average at the start of the trial compared to the other 2 groups. 

Kidney disease more common with greater weight changes

Even when taking into account other risk factors for kidney disease (body mass index, medication for kidney disease), weight cycling was associated with impaired filtering function, doubling of blood creatinine, and diagnosed (stage 3) kidney disease. Seven percent (102 people) of participants were identified as having a rapid decline in their kidney function and these individuals were more likely to have significant variability in their body weight over time. 

Stability over stop and start

Some weight loss and gain (e.g., medications, pregnancy, illness and more) is inevitable and shouldn’t be looked upon harshly. This study did not exclude participants who were pregnant over the trial period and didn’t take into account the reason or method of weight loss and gain. However, when they tested taking pregnancy into account, they found the results were very similar. In all, the researchers showed that large changes to body weight over time is associated with kidney disease in people living with T1D. 

Yo-yo dieting is often a result of poor relationship with food and body image. For nutrition, creating a long-term and sustainable eating plan that fits your life and preferences is in your best interest. Eating disorders, on the other hand, are very serious conditions that should be managed with the help of specialized healthcare professionals. 

Want to help improve our understanding of life with type 1 diabetes? Consider sharing your experience and joining the BETTER registry today!

Reference:

Camoin M, Mohammedi K, Saulnier PJ, Hadjadj S, Gautier JF, Riveline JP, Venteclef N, Potier L, Velho G. Body-weight Cycling and Risk of Diabetic Kidney Disease in People With Type 1 Diabetes in the DCCT/EDIC Population. J Clin Endocrinol Metab. 2025 Sep 16;110(10):e3334-e3342. doi: 10.1210/clinem/dgae852. PMID: 39902910.