Weight loss is a complex process influenced by various physiological, psychological, and environmental factors. Contrary to popular belief, it's rarely a linear progression. This article aims to shed light on the nonlinear nature of weight loss, exploring the reasons behind weight fluctuations and plateaus, and providing strategies to overcome these challenges for sustained success.
Introduction: The Myth of Linear Weight Loss
The idea that weight loss should be a smooth, consistent decline on the scale is a common misconception. Many individuals embark on their weight loss journey with the expectation of a steady reduction in numbers, week after week. However, the reality is often far from this ideal. Weight loss is a dynamic process, characterized by daily and weekly fluctuations, periods of rapid progress, and frustrating plateaus. Understanding this nonlinearity is crucial for maintaining motivation and achieving long-term success.
The Reality: Weight Loss is Not a Straight Line
The weight loss journey is rarely a straight line downwards. Your weight will fluctuate on a day-to-day basis. There will be days your scale weight goes up. There will be days your scale weight goes down. And there will be days your scale weight does not change. These variations can be mentally taunting. Most people see the overall weight loss, but what they don’t get to visualize are those variations.
Case study: Angie's Journey
Angie's weight loss journey exemplifies this nonlinearity. Despite losing a significant amount of weight, her progress was not a consistent downward slope. Her weight fluctuated daily, with some days showing an increase, some a decrease, and others no change at all. These variations, though potentially discouraging, did not negate the overall progress she was making. To stay motivated, Angie used multiple measures of progress, including before & after photos, circumference measurements, and how her clothes fit.
Why the Scale Can Be Deceiving
A scale is a dangerous tool but, only when we are not familiar with why we have “gained weight” according to the scale. On a day-to-day basis, the scale can fluctuate quite a bit, but it does not mean you have put on fat. You see, the scale measures weight. That weight consists of how much food you have in your stomach, how much water you’ve drunk, how much your bones weigh, how much your muscles weigh, and how much water your body is retaining.
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Factors Causing Weight Fluctuations
Several factors contribute to daily and weekly weight fluctuations. One significant component is water retention, which can be influenced by:
- Carbohydrate and sodium intake: Eating more carbs and sodium than usual can cause the body to retain water.
- Stress: Physical, mental, and emotional stress can also lead to water retention.
- Sleep: Not sleeping very well can affect your scale.
- Digestion: If your digestion is off, it can affect your scale.
- Menstrual cycle: A female experiencing her menstrual cycle can see fluctuations.
Additionally, as you strength train, both your muscles and your bones weigh more, which can also influence the numbers on the scale.
The Dreaded Plateau: When Weight Loss Stalls
Weight loss plateaus, characterized by weight loss slowing or stopping despite an individual continuing a diet and exercise regimen, affect approximately 85% of dieters. Regardless of the type of diet, plateaus occur weeks to months following the initiation of a weight management program. Understanding the mechanisms behind these plateaus, including hormonal regulation, metabolic adaptations, and theoretical models of weight regulation, is crucial when counseling about weight loss strategies.
Physiological Adaptations: The Body Fights Back
From an evolutionary perspective, stored fat is a protective reserve against periods of food scarcity, and the body resists attempts at significant weight reduction. Plateaus are complex and determined by physiologic, genetic, environmental, and psychological factors. The body adapts to reduced caloric intake with metabolic adaptations. External influences like the food environment and behavioral fatigue resulting in increased food intake and decreased physical activity contribute to the tendency for weight loss to halt and for people to regain lost pounds slowly over time.
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. Consequently, the body becomes more efficient at conserving energy, further contributing to the plateau.
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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.
Hormonal Changes: A Complex Balancing Act
Several hormones are critical in regulating energy expenditure and hunger during weight loss. Leptin, produced by adipocytes, promotes satiety and increases energy expenditure. Leptin levels decrease during weight loss due to reduced fat mass, while pre-existing leptin receptor resistance developed in response to longtime, obesity-associated elevated leptin levels may persist. These promote more food consumption and less 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 acts on Y2 brain receptors to promote satiety and reduce food intake, but PYY levels can decrease during weight loss, reducing the feeling of fullness. Neuropeptide Y increases during caloric restriction, promoting food intake, decreasing energy expenditure, and counteracting weight loss efforts.
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.
The set point theory proposes that a predetermined level maintained by physiological mechanisms regulates body weight. However, the set point theory does not account for environmental and social influences on obesity or the widespread increase in obesity rates since the 1980s.
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In contrast, the settling point theory proposes that body weight is not actively regulated around a set point but rather stabilizes at a point where energy intake and expenditure are balanced, influenced by factors such as diet, physical activity, genetic predisposition, and external influences. The settling point theory accommodates the impact of social and environmental factors on body weight and better explains the obesity epidemic of recent decades.
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. Unlike the set-point model, this theory considers body weight as a flexible range rather than a single target. It helps explain why people hit plateaus during weight loss as the body adapts to defend its prior state, adjusting hunger and metabolic rate to favor weight regain when caloric intake is increased. 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.
Strategies to Overcome Plateaus and Fluctuations
Clinical Significance: As a first step in managing weight loss plateaus, clinicians should provide anticipatory guidance about the physiologic changes and their effects on weight loss. Patients who understand the mechanism will more likely embrace effective strategies for achieving sustainable calorie deficits by adjusting their diet and physical activity.
Re-evaluate and Adjust Your Caloric Intake
Clinicians should reassess each patient with an updated dietary intake and exercise history, noting any changes in eating habits or activity levels. Patients might not be aware that they have gradually begun eating more than they did previously. If you’re tracking calories, working out and still aren’t losing weight, then you might need the help of an endocrinologist or dietician to help adjust your macros.
Even though you have continued to consume the same number of calories that helped you lose weight, your metabolism can still work against you and slow the rate of weight loss. Reaching a weight loss plateau may be a signal that you need to reevaluate your food intake and consider tracking your food consumption more carefully.
Remember that you’ll need to continuously adjust your calorie intake as you lose weight, based on factors like your age, gender, and activity level.
Prioritize Sleep
Adjust your schedule to go to bed earlier. A good night’s sleep will recharge your battery and when you are awake for longer, you are more prone to get the midnight munchies. Your sleep quality and quantity are just as crucial for weight loss as the food you eat and how much you move. There is no way around the reality that your body needs between 7 to 9 hours of quality sleep every night.
Incorporate Strength Training
Lifting weights and moving more are essential to long-term weight loss and weight maintenance. Switch from strictly cardio (walking/biking/running outside) to strength training and cardio inside using Youtube workouts. Strength training combined with a reduced-calorie and high protein diet favors muscle gain and fat loss, resulting in body recomposition.
Change Up Your Exercise Routine
Once your body has adapted to the exercise routine you’ve been doing, you need to provide a new challenge. You can lift heavier weights, try out a different routine, switch to a new-to-you activity like biking or swimming or take a fitness class you’ve never tried before. Anything that changes up what you are doing can give you the boost you need.
Increase Non-Exercise Activity Thermogenesis (NEAT)
Move more during non-exercise hours. People who are more active throughout their day can burn up to 2000 more calories than sedentary people. So, find ways to add more movement to your non-exercise hours.
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. Helpful dietary changes include a protein intake of 1.2 to 1.5 g/kg/day to preserve lean mass and promote satiety. Eating more fiber-rich foods will lessen hunger by delivering fewer calories per volume of food and slowing gastric emptying time.
Monitor Progress Beyond the Scale
Relying solely on the scale to measure your progress when trying to lose weight is not ideal. Besides, your ratio of muscle to fat is a better indicator of health than your body weight is. Use other things than a scale to show us progress (i.e., before & after photos, circumference measurements, how clothes fit, fitness level, etc.).
Manage Stress
If you find that you’re maintaining a calorie deficit, other factors such as stress or a lack of sleep can increase hormones that can prevent weight loss and even promote weight gain.
Medical Intervention
The American Association of Clinical Endocrinologists and the American College of Endocrinology guidelines outline the role of pharmacotherapy and bariatric surgery for those with inadequate weight loss after lifestyle modifications.
The Psychological Aspect: Staying Motivated
Mindset
Instead of thinking of all these hormones as working against you, cultivate a mindset of cooperation. Your body just wants to protect you.
Focus on Long-Term Goals
When working towards a fat loss goal, keep your mind focused on the long-term. It’s normal for weight loss to happen quickly at times and slow at others. Remember that the ups and downs are all part of the journey.
Each weight loss plateau can be a great opportunity for you to re-evaluate your short-term and long-term goals. So, be more introspective as you reach each new phase.
Consistency
Weight loss comes from a caloric deficit but there are lot of ways to get there, I had to find the ways that worked for my changing circumstances.
Don't Give Up
Just like Angie, you have to dig deep and keep on crushing it! You have to keep giving it everything you’ve got to reach your goal.