Weight Loss Plateau

A weight loss plateau is a period when your weight stops falling, even though you are still following the plan that worked. Mayo Clinic says it eventually comes to everyone who tries to lose weight, and a review by Kevin Hall and Scott Kahan describes the usual pattern as early rapid loss that stalls after several months. Plateaus often arrive within three to six months.

Weight moves up and down from day to day with fluid, salt and food in the gut, so one flat week is not a plateau. These are the signs you have reached one:

• weight unchanged for several weeks on the same plan
• a waist measurement that has stopped falling
• hunger higher than when you started

Weight loss plateaus because your body changes as you lose weight, so the plan that created a deficit at the start no longer does. The main reasons are these:

• a smaller body that uses less energy than it did at the start
• hunger that rises as weight falls
• losing muscle along with fat
• the plan loosening over time, with bigger portions or fewer active days
• early weight loss that was partly water
• short sleep and stress

Hall and Kahan estimate that for each kilogram lost, the body burns about 20 to 30 fewer calories a day, while appetite rises by about 100 calories a day above where it started. They conclude that the rise in appetite likely plays a bigger part in a plateau than the slower metabolism.

Break a plateau by finding where the deficit went and closing it, one change at a time:

• Review intake honestly. Keep a full food and drink record for a week, including the weekend. Mayo Clinic notes that off-and-on loosening of the rules contributes to plateaus.
• Put protein in every meal to protect the muscle you have.
• Train for strength on at least 2 days a week, as the NHS advises.
• Move more outside the gym. Walking, stairs and time on your feet all add up across a week.
• Protect your sleep, because short sleep raises appetite.
• Consider a maintenance phase. Eating to hold your new weight for a few weeks is a legitimate goal and a break from dieting.

If you do cut further, Mayo Clinic advises staying above 1,200 calories a day, because less can leave you constantly hungry.

Set point theory is the idea that your body defends a particular weight, pushing appetite up and energy use down when you go below it. It is a theory, and researchers still debate how fixed that weight is. A 2010 review by Müller, Bosy-Westphal and Heymsfield found evidence of biological control of body weight, but described a series of settling points shaped by what and how much you eat, in place of one fixed set point weight.

In practice, the part of the theory that holds up is the pushback: hunger rises and energy use falls as you lose weight, which is why plateaus and regain are so common. The encouraging part is that the weight your body settles at can shift with habits you keep up over time.

Yo-yo dieting, also called weight cycling, is losing weight and regaining it again and again. It often follows diets that are too strict to keep. The British Dietetic Association warns that many fad diets cannot be sustained and can lead to yo-yo dieting, muscle loss, nutrient deficiencies and metabolic adaptation, which can cause more weight to be regained in the long term.

Each round tends to repeat the same pattern: fast loss, a plateau, rising hunger and a return to old habits. Breaking it means losing weight more slowly, at the NHS rate of 0.5 to 1kg a week, on a plan you could still follow in a year, with strength training to hold on to muscle. The BDA also notes that fad diets can lead to a disordered relationship with food. If dieting has started to feel like that, speak to your GP or contact Beat.

Maintaining weight loss means keeping most of the habits that got you there, at an amount of food that holds your new weight. Hall and Kahan describe long-term maintenance as much more challenging than the loss itself, because appetite keeps pushing back. These habits help you keep weight off:

• weighing yourself regularly, as the NHS advises, and acting early if the trend rises
• staying active, since NHS Better Health notes that moving more can help you keep the weight off
• keeping strength training and protein in the plan
• keeping an eating pattern you could live with, and dropping anything you only managed while dieting
• treating sleep and alcohol as part of the plan

If you are gaining weight after losing it, that is the pattern the research predicts, and it is a signal to adjust early.

Most plateaus are expected physiology, but see your GP if any of these come with one:

• weight rising again although nothing in your plan has changed
• tiredness, feeling cold or constipation
• swelling of the ankles, legs or tummy
• a plateau that began after starting a new medicine
• eating very little and still not losing weight

Never stop a medicine without speaking to your prescriber. If you are cutting food further and further to push past a plateau, or your weight is causing you distress, speak to your GP or contact Beat on 0808 801 0677. If the everyday reasons seem likelier, why you can’t lose weight goes through them one by one.

A first assessment arranged by Medical Weight Loss London at UNTIL Soho reviews what has changed since your weight stopped falling: food, drink, activity, sleep and any new medicine. It measures weight, waist and blood pressure and arranges thyroid function, HbA1c, a lipid profile, liver and kidney function and a full blood count, so a medical cause is ruled in or out before the plan changes. First assessments at London clinics cost about £150 to £310, with tests on top (what a programme costs). The tests are explained in the weight management glossary.

A medical weight loss programme plans for plateaus with regular reviews, including a phase to hold the loss. Ask what to get checked and UNTIL Health Concierge arranges the appointment with a registered clinician.