Achieving a goal weight can be challenging. Weight tends to come off fairly rapidly at first, but at some point, it can seem as though weight won’t budge. The inability to lose more weight after initially successful quick weight loss is known as a weight loss plateau or stall, which can be frustrating and discouraging. However, several strategies may help to begin losing weight again.
Understanding the Weight Loss Plateau
A weight loss plateau is a normal part of the weight loss journey and expected. It’s typical for weight loss to slow and even stall. Being stuck at a weight-loss plateau eventually happens to everyone who tries to lose weight. It means that the body has adapted to the new routine and is settling into a new normal weight, and if pursuing additional weight loss, additional change will be needed.
What Causes a Weight Loss Plateau?
There are various reasons for hitting a weight loss plateau, including overeating, not eating enough protein, not getting enough exercise, and not getting enough sleep. A weight loss plateau occurs when the balance of calories consumed (calories in) vs. calories burned (calories out) nears equal balance.
Initially, the changes made to the eating and exercise routine made it so calories consumed were less than calories burned. Some may think that the reason for a plateau is either food or activity related, but calorie “balancing” happens on both the calories consumed and calories burned sides of the scale.
Calories Consumed
As you lose weight, you need fewer calories to maintain your new body weight. So if you continue to eat the same number of calories as when you started to lose weight, you’re likely to maintain the plateau you’re in.
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Additionally, your body’s absorption of calories from the food you eat becomes more efficient to slow weight loss, and if consistently eating foods in a similar daily routine, your body will become more efficient at digesting those foods, promoting weight maintenance.
Calories Burned
If you always stick with the same exercises and workout routine, your body will become more efficient at those movements and burn fewer calories doing them, no matter if you’re walking, running, swimming, lifting weights, dancing, or any other movement. As you become more experienced with that movement, you will burn fewer calories unless you increase the time or the intensity.
As you lose weight, you may have lost muscle, which results in slowing your metabolism, meaning that every day you are burning fewer calories than you were previously.
If you focused on cutting carbohydrate calories as a path to weight loss, you likely burned through your muscle stores of glycogen. Glycogen is the energy that is stored in your muscles and liver. Glycogen is partly made of water and that water is released when glycogen is used for energy. Some of that initial weight loss may have been the result of losing water weight, and once you are done losing that weight, your weight loss will plateau.
Hormonal and Metabolic Adaptations
Weight loss plateaus are complex and determined by physiologic, genetic, environmental, and psychological factors. The body adapts to reduced caloric intake with metabolic adaptations. From an evolutionary perspective, stored fat is a protective reserve against periods of food scarcity, and the body resists attempts at significant weight reduction.
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Adaptive thermogenesis is the primary physiological adaptation that contributes to weight loss plateaus, slowing or halting weight loss as the body's REE decreases to match the lower caloric intake. REE reduction is greater than the extent predicted by the loss of fat-free mass alone. A lower BMR or REE leads to a lower TDEE. The decrease in BMR may reduce mitochondrial uncoupling protein activity, decrease thermogenesis, and reduce cellular heat production. Consequently, the body becomes more efficient at conserving energy, further contributing to the plateau.
Calorie restriction and weight loss also disrupt energy homeostasis, increasing hunger and maintaining fat stores. These adaptations can decrease leptin levels, increase ghrelin levels, and reduce overall energy expenditure, making it more difficult to lose weight. Weight loss causes loss of adipose tissue and lean mass, and the resulting smaller body mass burns fewer calories during NEAT, further contributing to the plateau. These changes increase hunger and fatigue, often leading to discouragement and diet cessation with resultant weight gain.
Several hormones are critical in regulating energy expenditure and hunger during weight loss. Leptin, produced by adipocytes, promotes satiety and increases energy expenditure. Ghrelin, known as the "hunger hormone," stimulates appetite, triiodothyronine (T3) influences the metabolic rate, and insulin regulates macronutrient metabolism and inhibits muscle protein breakdown. A reduction in GLP-1 levels can lead to increased appetite. PYY levels can decrease during weight loss, reducing the feeling of fullness. Neuropeptide Y, a potent appetite-stimulating neurotransmitter, increases during caloric restriction, promoting food intake, decreasing energy expenditure, and counteracting weight loss efforts.
How Long Does a Weight Loss Plateau Last?
How long a weight loss plateau lasts varies from person to person. It can be a few weeks or a few months. The American College of Cardiology (ACC) and the American Heart Association (AHA) indicate individuals generally achieve maximal weight loss at 6 months, followed by weight maintenance or slow regain. According to the American Association of Clinical Endocrinologists and the American College of Endocrinology guidelines, weight loss plateaus with pharmacologic treatment typically occur later than with lifestyle intervention, between 6 and 12 months.
Strategies to Break a Weight Loss Plateau
Here are several evidence-based strategies that may help to begin losing weight again.
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1. Reassess and Track Your Intake
Research suggests people have a tendency to underestimate the amount of food they eat. That’s why tracking your calories and macronutrients - protein, fat, and carbs - can provide concrete information about how much you’re taking in.
Using a tracking app or food journaling to see how much you are taking in each day can be helpful. Calories can creep into your diet from small extra snacks, beverages, or increased portions. Measuring foods for accurate portions and tracking when you eat can help you to be more mindful. There are multiple free or low-cost apps, such as MyFitnessPal, LoseIt, and Chronometer, to help track everything put into the mouth. This process helps to stay mindful of how much is being eaten. Consider keeping a food and activity diary for a few days.
2. Adjust Macronutrient Intake
Cut Back on Carbs
Whether carb restriction leads to a “metabolic advantage” that causes your body to burn more calories is a question that continues to be debated among nutrition and obesity experts. That said, there is some evidence that eating a low carb diet may help reduce hunger. This may lead to subconsciously eat less, making it easier to begin losing weight again without hunger or discomfort.
Don’t Skimp on Protein
If weight loss has stalled, increasing protein intake may help. Protein boosts metabolic rate more than fat or carbs. This has to do with the thermic effect of food (TEF) or an increase in metabolism that occurs due to the digestion of food. Protein digestion boosts calorie burning by 20-30%, which is more than twice as much as fat or carbs. Second, protein stimulates the production of hormones that help reduce appetite and make you feel full and satisfied. Consuming a diet with 25% of calories from protein led to a negative energy balance and a higher REE. Helpful dietary changes include a protein intake of 1.2 to 1.5 g/kg/day to preserve lean mass and promote satiety.
3. Modify Exercise Routine
Your body adapts to repetitive exercise. If you are doing the same exercise routine, day in and day out, you may need to take your fitness routine to the next level. Consider challenging your body more by scheduling an additional day of exercise, increasing the intensity of your workout, adding extra time to your activities, or simply thinking of ways you can move more minutes each day.
Increase Exercise Frequency or Intensity
Your metabolic rate slows as you lose weight. As weight declines, the progressive reduction in metabolic rate can make continued weight loss difficult. However, exercise has been shown to help counteract this effect. Research suggests that when it comes to losing weight, fat, and belly fat, aerobic training is more effective than resistance training. That said, resistance training also has a lot of health benefits, so a combination of the two might be best for overall health.
If you’re already exercising, working out an extra 1-2 days per week or increasing the intensity of your workouts may help boost your metabolic rate.
Incorporate Strength Training
Consider adding strength training to your routine. Strength training (or weightlifting) is a great way for you to increase your metabolic rate to help burn more calories. Research has shown that strength training can help you lose weight, but it is important for you to do so safely. Using exercises that preserve and actually increase muscle mass can be helpful in getting through a weight loss plateau. Consider adding strength training exercises a few times a week. You can utilize your own body for resistance with exercises such as pushups, sit ups, squats, and lunges or use exercise bands, free weights, or exercise machines. Maintaining muscle is important because muscle burns more calories, even at rest, than fatty tissue.
Increase NEAT
Decrease how much time you are sedentary and increase NEAT - non‑exercise activity thermogenesis. Do this by increasing the number of steps you take while cleaning house, shopping, or walking the dog. An easy way to increase NEAT is by standing up more often, including using a standing desk.
4. Manage Stress and Prioritize Sleep
Stress can often put the brakes on weight loss. In addition to promoting comfort eating and triggering food cravings, it also increases your body’s production of cortisol. Cortisol is known as the “stress hormone.” While it helps your body respond to stress, it can also increase belly fat storage. Producing too much cortisol can make weight loss difficult, but research has shown that learning to manage stress can help promote weight loss. A comprehensive stress management strategy can help support overcoming a weight loss plateau.
Sleep is extremely important for good mental, emotional, and physical health. It’s also becoming clear that not getting enough sleep can lead to weight gain by lowering your metabolic rate and altering hormone levels to drive appetite and fat storage. Poor sleep habits can also contribute to plateaus.
To support weight loss and overall health, aim for 7-8 hours of sleep per night. Having poor sleep habits and not managing stress well can often lead to poor eating habits and reduced energy to exercise. A good daily goal is 7-9 hours of quality sleep and to help with good mental health a daily goal to include stress-reducing activities such as yoga, meditation, or journaling.
5. Mindful Eating Habits
Eat More Fiber
Including more fiber in your diet may help break through a weight loss plateau. This is especially true for soluble fiber, the type that dissolves in water or liquid. To begin with, soluble fiber slows the movement of food through your digestive tract, which can help you feel full and satisfied. Another way that fiber may aid weight loss is by decreasing the number of calories you absorb from other foods. Eating more fiber-rich foods will lessen hunger by delivering fewer calories per volume of food and slowing gastric emptying time.
Eat Vegetables at Every Meal
Vegetables are the ideal food for weight loss. Most vegetables are low in calories and carbs, high in fiber, and loaded with beneficial nutrients. In fact, research has found that diets that include lots of vegetables tend to produce the greatest weight loss.
Drink Water, Coffee, or Tea
While sugary beverages lead to weight gain, some beverages may help reverse a weight loss stall. Research has found that plain water can boost metabolism, which may translate into weight loss over time, especially in those who consume water before meals, which may help reduce food intake.
Coffee and tea may also help your weight loss efforts. Green tea, in particular, contains an antioxidant known as EGCG (epigallocatechin gallate) that may promote weight loss. Moreover, research suggests that consuming caffeinated beverages can significantly enhance the metabolism-boosting and fat-burning effects of exercise. Staying hydrated is also important in your weight loss journey. Make it a goal to include enough water each day. The general rule is 8 cups of water per day or 64 ounces.
Avoid Alcohol
Although one alcoholic drink (4 ounces (oz) of wine, 1.5 oz of hard liquor, or 12 oz of beer) contains only around 100 calories, it provides no nutritional value. In addition, you may have more than one drink at a sitting. Another problem is that alcohol loosens inhibitions, which may lead to overeating or making poor food choices. Alcoholic drinks have empty calories and lack any beneficial nutrition.
One study of 283 adults who completed a behavioral weight loss program found that reducing alcohol intake led to a reduction in overeating and greater weight loss among those with high levels of impulsivity. What’s more, research has shown that alcohol can suppress fat burning and may lead to belly fat accumulation. If your weight loss has stalled, it may be best to avoid alcohol or only consume it occasionally in small amounts.
6. Consider Intermittent Fasting
Intermittent fasting has become very popular recently. It involves going for long periods of time without eating, typically between 16-48 hours. The practice has been credited with promoting the loss of body fat and weight, though additional research may be needed to verify this.
7. Don't Rely on the Scale Alone
Scale reading may not always accurately reflect your progress, such as changes in your body composition. Rather than weight loss, your goal is actually fat loss. If you’re working out regularly, you may be building muscle, which is denser than fat and takes up less room in your body. So if the scale weight isn’t moving, you could be building muscle and losing fat, yet maintaining a stable weight.
In addition, you may retain water for a number of reasons, including your dietary choices. However, the most common reason involves changes in hormone levels that affect fluid balance, particularly in females assigned at birth (FAAB). Having a diet high in sodium may cause water retention, which can make the scale go up. Take a deep dive into what you are eating and limit highly processed food which are high in sodium. Be sure to limit the saltshaker also! About 65% of your weight on the scale is water weight.
8. Medical Intervention
If finding that struggling to break through a plateau and lose weight despite increased exercise and healthier eating, then speaking to a doctor about alternative solutions may be necessary. For those who have obesity or are overweight with at least one weight-related medical condition, certain prescription weight loss medications can be effective in combating emotional eating.
9. Be Patient and Persistent
Weight fluctuations may not necessarily be weight gain. Your body may just need a little time to adjust, so be kind and patient with yourself. Losing weight will have its ups and downs. Do not get discouraged by a plateau. It does not mean you have failed, but it may be a time for you to look at what you have been doing and develop some strategies to help you move forward and make some changes as you continue on your weight loss journey. Stay consistent and keep working and building on your goals.
Try to remind yourself that progress has been made to get to where you are now. It’s easier to maintain that progress than it is to claw your way back to that plateau from a higher weight. For that reason, set a short-term goal to maintain your progress. This can allow you time to work on a long-term plan to work off the plateau once and for all.
10. Consider a "Recovery Phase"
Patients who experience fatigue and have lost a lot of lean mass may need a "recovery phase" to regain lost muscle and positively impact their metabolism. Additional calories can decrease hunger, improve energy, and normalize altered hormonal levels during a short-term recovery period.
11. Theoretical Models of Weight Regulation
No one theoretical model of the complex interactions between genes and the environment in regulating body weight and adiposity thoroughly explains the observations from scientific studies. The set point theory and the settling point theory are the best-known theories. More research is needed to fully understand the physiologic basis of weight loss plateaus.
The set point theory proposes that a predetermined or "set" level maintained by physiological mechanisms regulates body weight. Evidence supporting this theory includes the body's resistance to weight changes through altered metabolism and appetite regulation mechanisms. In contrast, the settling point, or control theory, proposes that body weight results from passive feedback mechanisms, with changes in body adipose stores influencing energy intake and expenditure.
Another theory, the dynamic equilibrium model, hypothesizes that a balance between energy intake and expenditure regulates body weight while acknowledging this balance is adaptable and responsive to various internal and external influences. In the dynamic equilibrium model, changes in body weight in either direction cause involuntary changes in energy expenditure, and people usually find a balance that can move in either direction over time.