A new study finds that "yo-yoing" weight loss—where one loses pounds, then puts them back on—can be particularly risky for overweight heart disease patients.

The study, published in The New England Journal of Medicine, suggests that yo-yoing as little as 8 to 10 pounds may put heart disease sufferers at a much higher risk of heart attacks and strokes—and can increase their risk of dying from any cause by 124 percent.

“This is the first study to explore short-term weight fluctuations and health outcomes in patients with known heart disease,” says lead study author Sripal Bangalore, M.D., director of research at the Cardiac Catheterization Laboratory at the New York University School of Medicine.

According to Bangalore, the results suggest that overweight heart patients trying to shed pounds should also take important steps to keep those lost pounds off.  

Dramatic Rise in Cardiac Problems

Bangalore and his team analyzed the weight changes of 9,509 heart-disease patients over about five years. 

The study compared the group that fluctuated by the smallest amount, 2 pounds or less, with those with the greatest weight yo-yo, an average of 8.6 pounds. The second group had a 136 percent increase in their stroke risk and a 117 percent higher risk of having a heart attack.

Additionally, says Bangalore, there was a 78 percent increased risk of developing type 2 diabetes.

Although the study involved people who already had heart disease, Bangalore says the cardiac risks might apply to everyone whose weight cycles up and down, because these fluctuations can stress the heart.

A Controversial Topic

Though the results are intriguing, the authors caution that weight cycling is only associated with increased risks of cardiovascular complications and doesn't necessarily cause them.

“There are a whole bunch of reasons why people lose weight, then gain weight, and then lose weight again,” says Eric Feigl-Ding, Ph.D., an epidemiologist, nutritionist, and health economist at Harvard T.H. Chan School of Public Health.

Feigl-Ding, who was not involved with the study, added that “it’s a very complicated thing; and up and down fluctuations could just be a marker of ill health.”

Bangalore said he and his team recognize the controversy and hope to better understand in the future exactly why or how weight fluctuations might be harmful, and whether the way weight is lost makes a difference.  

How to Lose Weight—And Keep It Off

Whether your goal is to lose just a few pounds or to go down several sizes, consider how you would maintain weight loss before you even begin. Start by making modest changes that are good for your overall health but will help with weight loss—such as cutting out sugary drinks; eating more fruits, vegetables, and whole grains; and taking a daily walk.

Here are a few tips to help with losing weight in the first place, and to make it more likely that you’ll keep the pounds off:

Don’t go to extremes. Studies suggest that people who get the most benefit from their diet or exercise routine are those who go from “nothing” to “something.” “If you’re a walker and then become a runner, it’s only incrementally better,” says Feigl-Ding. “But if you’re a couch potato and then become a walker, it makes a huge difference.”

Feigl-Ding says people new to exercise are often tempted to overdo it at the gym. But intense exercise—such as running on a treadmill for two hours—could make you so hungry that you overeat afterward. Start out slow, he says, then build up to more vigorous exercise. This will allow your metabolism to adjust.

Also, stay away from fad diets such as juice cleanses or protein shake fasts. They might help you lose a few pounds quickly, but it's not the way you’ll be able to eat for the rest of your life.

Time your meals. Some evidence suggests that front-loading your calories and consuming no more than 20 percent of your daily intake at dinner helps with losing weight and lowering the risk of heart disease and related conditions such as type 2 diabetes, according to the American Heart Association. Eating breakfast, in particular, may also balance your glucose and insulin levels, which may lower the risk of type 2 diabetes and obesity.

Set yourself up for weight loss. Your environment and mindset can have a big impact on how much you eat. Studies show that using smaller plates or sitting farther away from an all-you-can-eat buffet can help you eat less, says Feigl-Ding. Other simple strategies, such as keeping junk food out of your house and serving yourself larger portions of fruits and vegetables and smaller portions of more caloric foods, can help, too.

Your mood can also influence what and how much you eat. If you’re tempted to reach for a less-than-healthy snack or second helpings of dinner, ask yourself why. If the answer is you’re bored or feeling down, try to find a non-food way to change the way you feel. When you sit down to a meal, take the time to really focus on what you are eating, which will help increase the satisfaction you get from food.