Diabetes Self-Management Blog

Last week we examined the typical reasons for those dreaded but all too real weight-loss plateaus (when you stop losing weight despite eating right and exercising regularly). They’re frustrating and discouraging, but they’re common (so at least you’re not alone!).

Luckily, if you’re in the midst of a plateau or if you ever have been stuck in one, chin up. There ARE things you can do to break that barrier and reach your weight goal. However, a word of caution: There’s no magic bullet for busting those plateaus, just as there’s no magic bullet for losing weight. You may need to try different approaches until you find what works…for you!

Nine Tips for Taking on (and Tripping up) the Plateau

1. Blast up your BMR… with food. Remember that BMR (basal metabolic rate) that we discussed last week? This is the rate at which your body burns calories to perform basic functions like breathing. You need to do everything in your power to give it a boost because it’s very likely turned a little sluggish at this point. A slowdown in your BMR happens because you’ve lost weight, particularly muscle weight. Here’s one way to jump-start it: make sure you’re eating enough (yes, that’s right!). If you’ve whittled your calorie intake down too much (less than 1600 calories for men, less than 1200 calories for women), you’ve probably gone too far. Your body has entered starvation mode, which means that it’s slowed everything down in an effort to preserve and conserve. Break the cycle and rev up your engines to get back on the calorie-burning bandwagon by eating more. If you need help, meet with a dietitian.

2. Dig out your pen and paper. Remember those days when your dietitian asked you to keep food records? If you’ve blocked that out of your memory, think about revisiting record keeping. Food record keeping can seem like a painful chore, but this process really does serve a purpose: By writing down everything that you eat and drink (and you need to be honest about it), you really can get a good picture of where things may have gone awry. Because let’s face it, sometimes weight loss slows down due to those sneaky little calories that seem to pile up when you’re not looking. Or, it may be that you let your emotions get the best of you and you deal with them by eating. You can uncover these things by keeping records, even for just a few days each week. (By the way, successful “losers” who are part of the National Weight Control Registry use record keeping as one of their tools for keeping the weight off.).

3. Figure out your food. By this, I mean, take a good hard look at what you’ve been eating. Food records will help you do this. Even if you refuse to keep records, it pays to focus on your food choices. Have you become too lenient with what you’re eating? In other words, are fatty or empty-calorie foods making their way back into your eating plan? They’re sneaky like that. What about your portions? When was the last time you actually weighed and measured your food? Are you SURE you’re only eating one cup of pasta? Dust off your meal plan or, if you don’t have one, get thyself to a dietitian, or consider joining a commercial weight-management program (such as Weight Watchers) or an online program to get back on the straight and narrow.

4. Ditch the dining out. You don’t have to forgo eating out altogether, but if you routinely eat lunch and dinner out, you’re pretty much guaranteed to consume far more calories than you realize…or need. Treat yourself to a meal out once a week and keep it at that.

5. Add resistance. In addition to scrutinizing your food intake, you have to take a hard look at your activity. Hitting the gym or walking is great, but your body needs to be pushed beyond its comfort zone. This doesn’t mean becoming a marathon runner, but if you’re doing the same old exercise routine day in and day out, you need to kick it up a notch. Particularly, you need to add strength training to your routine. This means using weights or resistance bands, or even using your own body weight as resistance. Remember that muscle burns calories, so you need to focus on building up your muscle mass.

6. Just do it…in intervals, that is. Interval training means changing up the intensity of your workout, not necessarily adding more time to your workout. To learn more about how to do this, speak with an exercise physiologist or a trainer at your local gym or Y. Read more about it here.

7. Drink water. There is some evidence that drinking water, especially cold water, can speed up your metabolism. And some people find that drinking water helps them curb their appetite.

8. De-stress. Some experts believe that constant stress affects metabolism by triggering the release of cortisol, a hormone that can lead to weight gain, among other things. Stress can also affect your food choices and interfere with being active. Deal with stress head-on by taking up yoga, practicing meditation or relaxation, or, if you need help, meeting with a mental health specialist.

9. Take a break. A prominent physician in the field of weight loss with whom I used to work always told his patients: “You first need to stop gaining weight before you can lose weight.” He also believed that it’s OK to maintain for a while. In other words, take a break, if you need it. Recharge and remotivate.

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Comments
  1. I read both last weeks and this weeks articles in succession and I still can not make sense why I am not losing any weight. I am a type 2 diabetic with a BMI of 38+. Every endocrinologist I see in my life suggested me to lose weight. I have had limited success at one time or another to gain what I lost back at a later time due to mainly stress eating or bein complacent and not noticing my food intake. A few weeks ago, seeing 270 lbs on the scale was a rude awakening and I decided to lose at least 40 lbs in a short time, like by the end of this year.
    I am an office worker and I know my sustinence calorie need is about 1800 per day. So, according to the calculations I have seen here and elsewhere, if I cut down my calorie intake to 1200, I should lose about a pound every week, give or take, without much physical exertion on my body. Right ? Well, as a diabetic, I eat very sensibly to start with. I try not to intake any carbs unless it is absolutely necessary as part of the meal. I eat a very small oatmeal portion made with water and artificial sweeteners, Lunch usually is under 350 calorie frozen food (lean cuisine and likes) and dinner is what I cobble up at home, which usually is a vegetable dish with some sort of meat but not high in fat or otherwise calories and I eat a reasonable portion, nothing extra-supersized or anything.
    I also picked up walking. During the day, at my breaks, I walk around my workplaces parking lot and it is 0.7 miles. I do this twice or if possible 3 times while I am at work. When I go back home, I take my dog for a walk, at least an hour or more, resulting 2.5-3 miles of walk at a brisk pace. When I am back home, I am sweting profusely.
    And kicker is my weight is at 266 pounds for the last 3 weeks. I weigh myself weekly. I think 4 lbs is too little of an amount to plateau in the weight loss. I am seriously considering getting a lap band put in but as an engineer, I can not see the benefit of this darn thing as I am not eating that much to start with. What am I doing wrong here ? I am not a gym rat and I do not want to spend any time at the gym if at all possible. This basically limits my activity to outdoors and I am already doing that. I am plain frustrated.

    Posted by M. B. |
  2. Dear MB are you on insulin ?

    Posted by calgarydiabetic |
  3. M.B- sounds like you have had a rough road with your journey to trim down.

    M.B, are you a male or female at 266 lbs?

    You said you picked up walking- that is great and may I ask, how long are your breaks at work?

    Walking around the lot at work is a good thing, yet, I wonder if this is nearly enough to allow your body to actually enter serious burn mode. A break can’t be 20-30 min. can it?

    The dog walk is again a great mode, yet is it stop/start? This too will impact your caloric expenditure.

    Sweating profusely could be the response of a few things…perhaps the environment, your workload, your extra weight certainly. It is not always the measure of a strong caloric burn, especially if you are out of shape.

    Did you ever consider mini- circuit training blocks that perhaps last 30 seconds each, moving many different ways that may help your metabolism shift into a higher gear?

    There are all sorts of variations.

    I’d be happy to share some of them that I teach my clients to do at home. They are easy to do, you can do them anywhere and you need very little to get started.

    Let me know- I’d be glad to help.

    thanks-
    Lisa

    Posted by Lisa |
  4. Hi M.B.,

    I can imagine how frustrated you must feel. I would agree with Lisa in that what you should primarily focus on right now is your exercise. You should be commended for doing what you’re doing, but you may need to, as Emeril puts it, “kick it up a notch.” Definitely continue to walk on your work breaks and walk your dog, but it seems like now you need to devote time to a more focused exercise session, which, as Lisa mentioned, should include muscle-toning and strengthening exercise (circuit training, weights, kettle bells, resistance bands, etc.). You don’t have to join a gym to do these, either. Also, in terms of your food intake, be careful not to go too low in calories. Cutting back too much on your food intake can actually backfire and shift your body into starvation mode, which slows weight loss. And while it’s understandable that you want to watch your carbs, be careful not to go too low with them, either. Your body needs some carbohydrate for energy. It sounds like you’re still on the fence as far as getting a lap band. It’s certainly an option but you may want to try some of the above suggestions first.

    Posted by acampbell |
  5. While you are obviously putting in a sincere effort, you are not getting the expected results. Looking at it as an engineer that can only mean that you are either not doing what you think you are or your method is ineffective.
    What struck me was your comment about not wanting to use the gym. While going to the gym is not really necessary and it is relatively easy to get the same benefits on your own, that often doesn’t happen. The gym experience puts you in effect, in a working ambience. To accomplish your goals this is necessary. Walking the dog and taking a few turns around the parking lot may be alright to maintain a level of fitness, but unless you begin to test the limits of your capacities, whatever they may be, progress will be difficult.
    My own experience has proven to me the old saying “The hardest step is the first one out the door.”
    Many’s the time that I dragged mself unwillingly after a hard day, to the gym, only to come back feeling energized and great. Consider giving it a SINCERE try. Good luck.

    Posted by louis |
  6. No one in the medical industry seems to want to admit this, but basal metabolic rate is a genetic, not an environmental issue. Some of us simply evolved in areas where cyclical famine and starvation were common, and that evolution equipped us with biology designed to utilize calories efficiently and store the excess as fat for the inevitable famines to come. They’ve rightly observed that reduced caloric intake slows metabolism in these people, but they continue to advise diet and exercises as a cure for the very condition that dieting causes. The medical community is so married to the idea that obesity (and Type II diabetes)is caused by a lazy, gluttonous lifestyle they are unwilling to admit that it’s a genetic condition despite the mountain of evidence showing that it is. Instead we get starvation dieting, Olympic-level training programs and bariatric surgery shoved down our throats… figuratively and literally. Of the dozen or so people I know who’ve had gastric bypass or lap bands, all of them eventually gained back the weight (and more)despite their radically reduced caloric intake, because their bodies adjusted their metabolism in reaction to what it considered a prolonged season of extreme famine. Until the medical community focuses on a way of regulating metabolism rather than pushing unproductive lifestyle changes and dangerous unneeded surgery, yo-yo dieting, frustration, and the inevitable blaming of the patient will never end.

    Posted by still too fat |
  7. I have done great thus far, I am happy with my 75lbs weight loss. But I am stuck, have been for about 3 months. I have upped my working out to pretty much everyday. I watch what I eat, my carlorie intake is between 2000-2500 a day. I am still working my butt off and getting no where lately…

    Posted by Totally Frustrated |
  8. Thanks for all the suggestions. The reason I do not want to spend time in the gym is mainly due to time. Getting to the gym, dressing up/down, taking a shower etc is taking up much more time than actually working out, I realized in my few attempts in the past. I tried gym-like exercises at home with small free weights and resistance bands, etc, to find myself back at square one, because the motivation was not there.

    On the other hand my dog, a very hyper Jack Russell Terrier, needs a lot of exercise and walking with her 3 miles puts her down for the night easily and is a good workout for me too. Yes there are stops on the way to sniff every place another dog relieved himself or herself, but our walks (metered by runkeeper application on my android phone) are somewhere between 20-22 minutes per mile range in general. Not an extremely fast pace but we are not doing the dilly-dolly walking neither.

    More answers to the questions above: I am a male. Stand 5′10 tall, live in San Diego. My breaks are about 10-15 minutes. No time restrictions from work. I just complete 0.7 mile circuit in about 11-13 minutes at an 18 minute/mile pace. I try to do this every 2 hours if possible but sometimes it is not. My mom is a type-1 diabetic and my dad got diagnosed with adult onset diabetes after the age of 60. So, genetically I am predisposed for diabetes. I am a big guy since I started elementary school. I was always taller than and much heavier than my classmates until I reached college. The height became pretty much average but weight kept being a trump card for me :)

    Lap band is a thought I entertained for the past year or so. But again, my eating is not the problem. I can’t remember when was the last time I cooked pasta or rice pilaf, even though I love them, or ate more than a slice of bread with my meal. I do not snack like many people do, throughout the day. Some things said above make sense. My body most probably is in starvation or extreme preservation mode. I am not sure how basal metabolic rate gets to be measured or determined but I am sure mine is pretty low on that end.

    Yes the first step out the door is the hardest one I know but I force myself everyday even if I come home dead tired from work. Also, there is quite a bit going on my personal life which is not helping my weight loss case I am sure, but I am trying nothing to interfere with my food plan or exercise schedule, despite how insufficient it is. But at the time being, this is the best I am able to do. I will persist on this plan and at some point a barrier will break down I am hoping. One can only starve himself or herself until the body decided “okay there is no more food coming and let’s burn a little from the reserves”. I am hoping that day is reasonably close. I will try some gym style exercises at home. And if I can find one, I am going to sign up for a gym with a lap swimming pool. It is something I do not mind getting dressed for.

    Again thanks for all suggestions.

    Posted by M. B. |
  9. I too have struggled with yoyo weight loss. I am prediabetic, 5′9″, 198 lb, woman, age 63. I workout 3 times per week at the YMCA. I ride the recumbant bike 10 miles in 30 minutes. Then I ride the stationary bike 10 miles in 30 minutes. I then go to the stationary weight machines and workout there various exercises for 30 min. I walk my dog 20 min. nightly. I do eat out frequently, but have cut my sugar intake and carbs considerably. I will lose 4 lbs and then gain it right back. I can’t seem to get below 194 and stay or continue to lose. Recent blood test said I was very low in Vitamin D, potassium, and had high cholestral (240). Could I also have thyroid issues? I would really like to level off at 150 lbs. and remain there as I also have knee joint replacement looming in the distance. Any help you might offer would be appreciated. Maybe I have hit the dreaded wall of age where losing weight becomes difficult. On the plus side I have lost a whole dress/pant size, however, it is frustrating!

    Posted by Peace 2U |
  10. Oh by the way, yes I use insulin 2 or 3 times daily depending on what and when I eat. Usually a basal insulin (Humulin N) in the morning and 70/30 mix before dinner and also before lunch if it is not going to be one of my usual, 300 calories, frozen cardboard meals, like a very infrequent pizza party at work etc.

    Posted by M. B. |
  11. Hi M.B.,

    Thanks for sharing. Along with the great suggestions that others have offered, I just wanted to reiterate a few more things which may be helpful to many of you. First, as I posted previously, it won’t do you any favors to essentially starve yourself in the hopes of losing weight. Your body is pretty smart and it will slow down the rate at which you burn calories, making it harder to shed pounds (so M.B., 1200 calories is probably too low for you). Second, some people do better with weight loss when they eat their bigger meal in the morning, and also eat 4–6 times a day (smaller amounts of food, more often). You actually burn calories when you eat and digest your food. And if you can start swimming, that’s great. But really consider doing circuit or interval training (that’s the type of exercise that increases lean body mass, which is “metabolically active”). Finally, you might talk to your doctor about trying a GLP-1 agonist medicine, such as Byetta or Victoza, to help manage your diabetes. These can lead to weight loss in many people.

    Posted by acampbell |
  12. Amy,

    I spent close to 2 years term on Byetta (late in the term supplemented by insulin), before going into a pure insulin regiment and it seemed to contribute quite a bit to my weight gain. In those 2 years I think I gained about 20-25 lbs but of course this corresponds to a very hectic work schedule time and catered in lunches while we worked around the clock in the office and total lack of exercise throughout the work week, helped that a lot as well, but again eating or controlling myself against over-eating is not a problem of mine. Even though I can devour a hefty amount of food with no problem, I am pretty disciplined to stop myself from eating.

    I am willing to give another try to Byetta, next time I see my new endocrinologist if he/she suggests it. I’ll look into an interval training method. I will try to do some light jogging with the suggested sprinting or pushing harder in intervals, in the mornings, before it gets hot during the day. I am not sure how much of running my body, with this amount of weight can handle but I am willing to give it a try. I may even try to go back to my company gym before work, some of those days and use the multifunction equipment as you suggested.

    Thank you.

    Posted by M. B. |
  13. M-B I think that for some people insulin is a make fat drug. To minimize that nasty effect you could try to minimize the amount of insulin you use.

    You could ask your doctor to switch insulins from humalin N to lantus or levemir and use a fast acting insulin like apidra before meals this will give you much better control. Ask the doctor to add metformin to the mix. This cuts the required insulin dosage by up to 40% for some diabetics.

    Lantus or levemir are much more expensive than N but byetta is much much more expensive. So you may wish to try the more modern insulins that DO give better control before the trying the byetta.

    Posted by calgarydiabetic |

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