Diabetes Self-Management Blog

How many of you have attempted to lose weight in the past? How many of you ever hit a “plateau” when you were actively attempting to lose weight? As if losing weight weren’t hard enough, hitting a plateau is another hassle to deal with.

What is a Weight-Loss Plateau?
It happens to just about everyone who is in the midst of a weight-loss program. A weight-loss plateau is when you stop losing weight despite continuing to follow your diet and/or physical activity plan. Everything seems to be going along just fine, thank you… You’ve shed some pounds, your clothes are fitting you better, you’re eating healthfully, you’re walking more, you feel great. But for some mysterious reason, there comes a day or week when the scale stubbornly refuses to budge. It’s not moving. Nothing’s changed, you say. The scale must be broken, you rationalize. Or someone has snuck some calories into your food. You rack your brain trying to figure it out. What’s going on?

Why Plateaus Happen
If you think about it for a minute, it almost makes sense as to why plateaus occur. Let’s say you weigh 180 pounds and you (or your dietitian) have determined that you currently eat about 2400 calories each day. You want to lose 20 pounds; therefore, you have to shave off calories somewhere and/or start burning some up through exercise. Think back to your physiology: a pound of fat is roughly equivalent to 3500 calories. In order to lose one pound, you need to knock out 3500 calories from your food choices.

Of course, you want to be smart about it and lose weight in a way such that it’s healthful and that you’ll keep the weight off (which means no fad diets!). Guidelines for smart weight loss tell us that if you trim 500 calories from your daily food intake, you’ll lose approximately one pound per week. Trim 1000 calories and you’ll likely lose two pounds per week (this is called safe, gradual weight loss). You may lose more, you may lose less.

Blame It on Your BMR
Back to our example. Whether you cut back by 500 calories or 1000 calories per day, you’ll likely notice that you lose more weight at the beginning of your weight loss program because your body is burning glycogen, a storage form of energy. Glycogen is stored in your muscles and liver, along with water. When you burn glycogen for fuel, you also lose water weight, so that’s why you see those nice results at the start of your weight-loss program. For some people, it’s almost like the weight is practically melting off! Everyone loses weight at a different rate, however, so it could take you anywhere from 5 to 20 weeks (plus or minus) to lose those 20 pounds.

But lo and behold, there’s a high probability that your weight loss can (and will) taper off at some point, even if it’s a temporary taper. Why? What many people don’t realize is that the more a person weighs, the higher his basal metabolic rate (BMR), which is the rate at which one burns calories for energy to fuel all the processes that occur in the body, including breathing and digestion. As you drop weight, you also drop your BMR. It makes sense, in a way, because there’s less of you to move around. It doesn’t require as much energy to keep your body going.

Something else happens, too, when you lose weight: As you lose weight, you not only lose fat and water, you lose muscle mass, too. Muscle is a “metabolically active” tissue; it burns more calories than any other type of tissue in the body, such as fat. In fact, muscle burns calories even when you’re lounging on your couch with the remote in one hand or curled up in bed sleeping. So, muscle is a keeper. But the reality is that you do lose some muscle when you lose weight. And if you aren’t exercising as you’re losing weight, you’ll lose more muscle and less fat (this is a hard lesson to learn, for some).

Now What?
So, you’ve cut back on your calories, you’ve stepped up the activity, you’ve lost some weight, but now you’re stuck. The weight loss has stopped! The reason: Your BMR has dropped because a) you’ve lost muscle mass and b) there’s less of you. You’re burning fewer calories even though you’re working hard at watching your food intake and being more active. Oh, the injustice of it all! Plateaus are no fun. But all is not lost. Tune in next week. And feel free to share your secrets to breaking the weight loss plateau.

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Comments
  1. i understand completely. I have hit a pleteau after I changed my diet and added exercise.
    How long does the pleteau last and can it reoccur again. Should I increase exercise , decrease calories/add more protein or just ride it out?

    Posted by nanags3 |
  2. Thanks for your article. I too have been bothered by chronic weight gain and loss. Please visit http://www.joyfuldiabetic.com/2009/01/24/vicious-diet-cycle/ for one explanation.

    Lately I’ve been using Shaklee CINCH products and they really work. The meal bars and shakes contain leucine which encourages our bodies to burn fat rather than muscle, thus maintaining a good metabolic rate.

    Posted by Will Ryan |
  3. Thank you for this article. I look forward to next week’s installment. I’ve been stuck on a plateau for a couple of months now and it is VERY frustrating. I’ve raised and lowered calories, changed up my type and duration of exercise and tried everything else that I can think of to shake myself loose.

    I guess that I should focus on the positive aspect of “I’m not gaining any weight” but it is so frustrating.

    Posted by Cathy R |
  4. My husband is on a 1,500 cal. 125 carb. low salt diet. He lost 110 lbs. He has gained most of it back slowly. Found out that 5 of the 9 meds he’s on causes weight gain. Any comments or advice?

    Posted by Linda Eastman |
  5. This makes sense if dieting is your main avenue for weight loss. But in years past,I started jogging fast 6-8 miles a day, without a big change in my diet, and I lost about 20 pounds, and then plateaud. Worse, if I ddn;t run for 1 day ,I gained 2 pounds.

    Posted by artcohn |
  6. As I call myself, “the mother or weight loss,” since I’ve done this so many times, I have discovered many ways to break weight loss plateaus.

    The main thing you must do is to hang in there with your weight loss plan, as in my case, Weight Watchers, and no matter what don’t give up. If you quit when you just can’t seem to break the plateau, then your weight will go back up, and you’ll be right back to where you started in the first place-so all is lost. Take a good look at what you are doing, and try to change some things. These are things you can do:

    1. Are you tracking your eating? What are you eating and how about your portions? Have you grown so complacent in your diet plan, that maybe your portions are a bit bigger than they ought to be?

    2. What are you doing for exercise? Are you doing the same old routine day in and day out? If so, why not change your routine and try mixing things up and doing some different exercises? This usually helps to break stubborn plateaus.

    3. Are you drinking enough water? If you are not doing this, then it is time to start. If you are only drinking three glasses of water daily, why not step it up to 6?

    4. Try to incorporate some new foods in your diet that you haven’t had before. This may also help as eating the same old foods on your diet plan may cause your weight loss to stop.

    Changes in your weight loss plan will often get you going down the scale again. I know from experience by doing the above!

    Posted by Jennifer Kirkman |
  7. So what are we supposed to do? I’ve lost about 60 #S and gained some back. Now I’m trying lose another 15 to 20 #s and it’s not working. Help.

    Posted by Terri Lynn |
  8. Thanks for this detailed explanation. Could you also add something about the role of insulin and insulin resistance in the management of weight. Exercise plays a significant role in reducing insulin resistance which then aids weight loss, perhaps more than the burning of calories. Maybe the weight loss could be assisted by trying exercise at a different time or after a meal when the work of insulin is greatest and it needs the most support. Also spreading the carbohydrate load more evenly across the day so as to reduce the glycaemic load at any one point while still eating adequately for nutrition.

    Posted by Martina |
  9. I lost over 80 pounds, gained a lot of muscle mass thru exercise and good nutrition then the weight loss stopped. I dropped my calorie intake, changed my work out routines and never lost another pound. I am still just over 200 lbs, so its not like I do not need to lose more. I keep my calories between 1200-2000 a day, work out with 45 min of cardio and 60 of weight training 5 days a week, 2 hours of water aerobics a week. I am also waiting for a hip replacement and have a spinal fusion that resulted in failed low back syndrome. Any suggestions on how to restart my loss would be appreciated.

    Posted by Diane |
  10. I am a Type I diabetic. I want to lose weight, but my caloric intake is already very low and if I try to do even a little exercise, my sugar drops too low and I have to eat a lot to bring it back up. I wear an insulin pump. What can I do to lose weight? I’ve talked to my doctors and they are overweight too, but they don’t offer any suggestions. Please help.

    Posted by stephen |
  11. Hi stephen,
    My first recommendation for you is to meet with a diabetes educator (nurse or dietitian) who is familiar with pump therapy. But, if that’s not possible, you need to consider the time of day when you’re exercising and make an adjustment in your insulin. For example, if you exercise after a meal, you would need to decrease your meal bolus dose (perhaps start by taking 25% less). If you exercise at other times, you may want to try using a temporary basal rate, set at 10-15% lower than your usual basal rate at that time. When setting a temp basal rate, don’t forget to account for the fact that your blood glucose may continue to drop several hours after exercising. Start the temp basal rate at least 20 minutes before you exercise. You can also disconnect from the pump for exercise, but be careful about doing this in order to avoid DKA. The best way to see how this is all working is by trial and error, and that means checking your glucose before, during and after exercise. Also, make sure that you’re eating enough carb at your meals so that you have some glycogen stores to prevent or at least lessen the chance of low blood glucose during exercise.

    Posted by acampbell |
  12. Hi Linda,
    You didn’t mention what medications your husband is taking, but since quite a few of them have weight gain as a side effect, is there a possibility that any of them can be changed? That would be worth a discussion with his physician. At any rate, it may help to look at other possible reasons for the weight gain. For example, have food portions grown in size? Is he eating higher fat/higher calorie foods? Is he eating out a lot? Especially important is exercise. Being physically active is key to keeping weight off. Dieting alone isn’t always successful. People who are part of the National Weight Control Registry (”successful losers”) say that they have exercise pretty much every day in order to keep the weight off. He could also meet with a dietitian for more specific guidance.

    Posted by acampbell |
  13. Hi Everyone,
    Thanks for your questions, comments and helpful advice! Next week I’ll focus on a few ways to break the plateau, so stay tuned.

    Posted by acampbell |
  14. Hi Martina,
    Some of the thinking around insulin resistance is that it can lead to weight gain. What happens with insulin resistance is that the body is releasing insulin in an effort to move glucose from the blood into cells to be used for energy. However, the cells aren’t able to use insulin very well, and as a result, glucose levels build up in the blood. The pancreas keeps putting out more and more insulin. Insulin is a storage hormone, so some researchers believe that the more insulin you have, the more likely it’s going to store excess glucose as fat. Obviously the solution is to break the insulin resistance. This can be done by losing weight (a lower carb diet can often help, but not a “no carb” diet), increasing physical activity, and taking medication, such as metformin or exenatide or liraglutide, for example. It’s still not really known when the best time is to exercise. What’s most important is that you just do it. As far as spacing out food intake, that does seem to make sense, not only from a glycemic load standpoint, but also to help reduce hunger.

    Posted by acampbell |
  15. I actually have many tricks for breaking the peak.

    1.Try increasing calories for just a day. Not to to much but around 300-500 calories. This will rev up your metabolism so when you cut it down again your body is confused into losing weight.

    2.Do more cardio. Add in an extra cardio session 1-2 times a week and see if that helps if it does not do trick 1.

    3.Change your micro ratio for a day. If your on say a contest diet add in a 40 40 20 diet for a day the extra carbs will be absorbed by the muscles and throw the body up.

    Posted by Sean |

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