What to Do If You Stop Losing Weight or Reach a Plateau
Plateaus have hit everyone at some point in their weight management journey. It can be frustrating to see the scale stall, especially after putting in so much effort. Understanding that this is a normal part of the process can help in finding ways to move forward.
In this episode, I’ll answer some frequently asked questions about weight plateaus, including:
When should you consider that you've hit a plateau?
What should you do about weight fluctuations?
Why do weight loss plateaus happen?
Tips for managing a weight loss plateau.
What I do for my patients who experience plateaus.
If you feel stuck and the weight just won’t budge, this episode is for you. Remember, experiencing a plateau is normal, and it doesn’t mean you’re not making progress. The insights and tips shared today can help you navigate this challenging phase. So, stay tuned, and let’s explore how to overcome those plateaus together.
Weight Plateaus: A Turning Point in Your Journey
A weight plateau can be a frustrating phase for anyone on a weight loss journey. Essentially, a plateau happens when a person's weight loss progress comes to a standstill despite following the same routines and habits that initially led to weight loss. It’s a period where the scale no longer moves as it once did, remaining more or less stable each day.
There isn’t a strict definition of how long it takes before this stagnation becomes a plateau. In some clinical perspectives, if weight has not changed for two to three months, it’s likely a plateau. At this stage, many find themselves questioning whether they need to adjust their approach or if they might actually feel satisfied with the progress they’ve made. It often becomes an introspective moment, balancing health goals with the realities of personal lifestyle, habits, and preferences.
This phase offers an opportunity to reconsider goals. For some, reaching this point might mean re-evaluating priorities and possibly embracing the weight as their new baseline. For others, it could prompt the exploration of new strategies to continue progressing. Ultimately, it’s a decision that requires looking inward and asking what feels right for personal well-being and health, rather than just a number on the scale.
Ups and Downs: Weight Fluctuations
Weight loss rarely follows a straight path. While clinical trials may present smooth, linear progress, individual journeys often look different. Weight can fluctuate daily or weekly, influenced by factors as varied as dietary changes, water retention, menstrual cycles, or even stress and sleep patterns. These ups and downs are common; weight may drop significantly one week, hold steady the next, or even show slight gains. Such fluctuations don’t necessarily mean progress has stalled but are part of the natural ebb and flow of weight loss.
Maintaining a broader perspective on these patterns helps to keep expectations grounded. Regular weighing can be helpful, but the frequency should fit one’s mindset and comfort level. Some find daily tracking helpful, while others prefer weekly or even monthly checks. Ultimately, the goal is to observe trends over time rather than fixating on daily shifts, which can create unnecessary frustration. Keeping the big picture in mind supports a healthier, more sustainable relationship with weight tracking on this journey.
When Weight Loss Slows Down
Finding the right frequency for weighing oneself is personal and can depend on one’s comfort with the process. Some find weekly weigh-ins helpful, while others prefer daily checks or even monthly measurements, especially if fluctuations tend to be discouraging. The goal is to track broader trends, not fixate on small shifts.
If weight has stayed the same for about 8 to 12 weeks—fluctuating within a couple of pounds without a clear decrease—this may indicate a weight plateau. Plateaus are common, especially six to twelve months into a weight loss journey, as the body often adjusts after an initial period of steady loss. For those using oral weight loss medications, most progress happens within the first six to nine months, followed by a slower rate. Newer medications, like Wegovy and Zepbound, often support weight loss for over a year but tend to slow after 60-70 weeks.
With lifestyle changes alone, weight loss patterns vary widely. While some people continue to lose weight steadily, many find that progress begins to taper after six months unless adjustments are made. This natural slowdown is often a sign that the body has adapted to the new habits, making plateaus a normal part of long-term weight management.
Why Weight Loss Plateaus Happen
Two primary mechanisms contribute to weight loss plateaus: metabolic and appetite adaptations. As people lose weight, their metabolic rate naturally decreases, meaning they burn fewer calories, even beyond what might be expected for a smaller body size. This drop in metabolism can lead to physical symptoms like fatigue, feeling cold, hair loss, and brittle nails, reflecting the body’s effort to conserve energy. The "Biggest Loser" study notably highlighted how significant weight loss can result in a metabolic rate that burns up to 500 fewer calories daily than anticipated.
At the same time, appetite adaptation causes an increase in hunger, which can make it difficult to maintain weight loss over the long term. The body perceives weight loss as a threat to its energy reserves and thus triggers hunger to encourage calorie intake, aiming to regain lost weight. Medications, surgery, or dietary strategies—like high-fiber or high-protein diets—can help manage increased hunger during this phase.
These adaptations are natural, reflecting the body’s inclination to preserve weight for energy storage. A plateau is a normal part of the weight loss journey, and while it can be extended with medical interventions or lifestyle adjustments, it serves as a reminder of the body’s resilience in maintaining energy balance.
Getting Back on Track
In weight maintenance, the key is to keep doing what has been working and regularly check in to make sure it's still effective. But sometimes, people may want or need to lose more weight, especially if specific goals, like improved comfort or health markers, are still unmet. This could include situations where high blood sugar, cholesterol, or symptoms of sleep apnea persist. In such cases, deeper reflection can be helpful to determine if additional weight loss might improve their quality of life or health.
When exploring additional weight loss, it starts with identifying any underlying issues. Factors such as insulin resistance, side effects from medications, stress, sleep quality, hormonal changes, or thyroid function could play a role. Addressing these underlying causes may help progress weight goals and improve overall health.
Nutrition is another area to revisit. While most people maintain a balanced, healthy diet, sometimes a more structured approach can aid further weight loss if medically necessary. Options like fasting, a fast-mimicking diet, or a ketogenic plan can provide structured alternatives, although these may not be desirable or sustainable for everyone. It’s essential to consider if these approaches fit one's lifestyle and are maintainable long-term.
Sometimes, adjustments don’t need to be dramatic. Minor shifts, like increasing protein intake, focusing on more vegetables, or even returning to food logging, can be effective. Often, people who initially succeeded with weight loss have found that a gradual drift from their early routines can stall their progress. Revisiting these strategies can bring structure back and potentially restart weight loss, but only if it aligns with personal health goals and lifestyle choices.
Weight Plateaus and the Role of Exercise
While exercise is often emphasized as a key component of weight loss, its role is primarily in weight maintenance rather than weight reduction. Regular physical activity is essential for overall health, contributing to longevity and improved quality of life. Most recommendations suggest aiming for 300 minutes of moderate-intensity movement per week (think a paced walk where you can hold a conversation, but won’t be able to belt out a song), complemented by resistance training twice a week.
In addressing plateaus, increasing exercise can help to some extent. This includes enhancing non-exercise activity thermogenesis (NEAT), which encompasses all the movements made throughout the day, such as walking, doing household chores, or even fidgeting. While increasing overall activity can definitely provide benefits, it is important to note that additional weight loss from exercise is often modest.
Evaluating Habits and Shifting Mindsets in Weight Management
When faced with a weight plateau, evaluating habits is crucial. Over time, nutrition and eating patterns can drift, leading to unintended changes in caloric intake. For individuals who have previously logged their food intake, it may help to restart this practice to ensure they are meeting their goals, particularly in terms of protein and overall calories. On the other hand, those who have successfully lost weight without logging might find it helpful to begin tracking their intake to gain insights into their current habits.
Identifying and addressing specific eating patterns, such as late-night snacking or unplanned eating, is essential. These habits can accumulate and hinder progress. Additionally, stress and sleep quality can significantly impact weight management efforts. Addressing these areas can create a more conducive environment for sustainable weight loss.
Perhaps the most critical aspect of this evaluation process is the necessary mindset shift. Accepting the current weight or acknowledging that a 10% weight loss is a significant achievement can be transformative. It is important to reset expectations about what constitutes a healthy weight for the individual’s body. Recognizing that maintaining a 10% weight loss is commendable and a major achievement can alleviate pressure and promote a healthier relationship with one’s mind and body.
Exploring Medication and Surgery as Solutions for Weight Plateaus
When facing a weight plateau despite maximizing nutrition, exercise, and addressing underlying causes, the next step may involve medication or surgery.
In cases where someone has never used a weight loss medication, introducing a suitable option may be beneficial. Alternatively, for those already on medication, adjusting the dosage or changing to a different medication might be necessary to enhance effectiveness. Some individuals may even require a combination of medications to achieve their weight loss goals.
For those already utilizing the most potent medications, such as Wegovy or Zepbound, yet still experiencing a plateau that hinders health and wellness, bariatric or metabolic surgery may be the most viable solution. This approach often results in the most significant and sustained weight loss outcomes.
Most importantly, being mindful of how you feel and your health goals can offer some valuable insight into whether additional interventions are necessary. Consider whether the current weight—whether it reflects a 10 percent, 15 percent, or even 20 percent loss—might actually be a new, acceptable weight. Embracing this new weight could be perfectly fine for one’s health and really, should be celebrated.
To get the full picture on managing weight plateaus and practical tips to keep your progress going, be sure to listen to the full episode! There's a lot to uncover, and these insights can make all the difference on your journey.
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