By Alison Massey, MS, RD, LDN, CDE
You gingerly step up onto the scale and see it again, the same exact number that has been plaguing you for the last several weeks despite your continued efforts to lose weight.
It’s the dreaded weight-loss plateau, and although it can occur at anytime, research suggests it typically occurs around the six- to nine-month mark of the weight-loss journey. It’s frustrating, and this type of weight stability is perhaps one of the most difficult parts of the process to overcome.
Yet the unchanging number on the scale doesn’t have to derail your plans to reach goal weight. Developing a solid plan to jump-start the weight-loss process includes being able to differentiate fact from fiction when it comes to handling stagnant periods.
To help you get back on track and move that dial on the scale from stuck to success, here are the facts behind some of the most common myths about weight-loss plateaus.
The weight-loss plateau does not mean all hope is lost, but it is a warning flag that some old habits may have slipped back into your routine that aren’t helping you reach your goals. In fact, a study published in the American Journal of Clinical Nutrition found most weight-loss plateaus occur due to a lack of dietary adherence. Re-examining your daily habits by keeping a food and physical activity journal will provide insight and accountability to your current routine. It also may be a good time to seek additional support and expertise from a registered dietitian or your diabetes educator.
“The key to maneuvering a weight-loss plateau is to change up your exercise and eating routine,” advised Toby Smithson, MS, RDN, CDE, founder of DiabetesEveryDay.com and author of Diabetes Meal Planning and Nutrition for Dummies. Behavioral changes are needed for a change in weight. Change also can help shake up a monotonous routine. “A change in routine also breaks boredom with your weight-loss plan and gives you more momentum to continue your journey,” she said.
It is important to remain flexible and open to new behavioral strategies to help you stay on track with healthy lifestyle choices. Remember, it is a change in lifestyle and not a diet that will ultimately result in long-term success.
The energy balance equation — energy in versus energy out — has been used for decades, and while it seems easy, the mantra of eat less and lose more is not so simple. The National Institutes of Health Working Group Report on Innovative Research to Improve Weight Loss suggests the interaction of biology, environment, and behavior is at the crux of weight regain challenges. The lapse in healthy behaviors, however, may be the primary driving force behind stalls in the weight-loss process.
A study published in The New England Journal of Medicine suggests that with a decrease in caloric intake, the body also sees changes occur in the neuroendocrine system that may contribute to hormonal changes that increase hunger and decrease feelings of fullness.
How do we counter the physiological changes that may thwart weight loss and weight-loss maintenance efforts? It truly is the commitment to behavioral changes — meal-plan changes, physical activity, and a continued focus on the benefits of weight loss for health and well-being—that drives success.
Results from the Look AHEAD study, which examined long-term health consequences of weight loss in overweight and obese individuals with Type 2 diabetes, found those who successfully maintained weight loss over an eight-year period tended to adopt several key behaviors, including reduced calorie intake, self-monitoring of weight, and high levels of physical activity. It is that commitment to key behavioral changes that benefits individuals during both weight loss and weight-loss maintenance phases.
We know regular physical activity has benefits. It is “free medicine for the body,” improving cardiovascular health and lowering blood glucose levels, blood pressure, and low-density lipoprotein (LDL, or “bad”) cholesterol levels while helping us manage stress and boost mood. Yet simply incorporating 30 minutes of physical activity may not cut it when it comes to losing weight. Regular physical activity also plays a role in weight loss and weight maintenance, but the amount recommended per week may surprise you.
The American Diabetes Association Standards of Care 2018 guidelines suggest 200–300 minutes per week of physical activity for individuals with Type 2 diabetes aiming to lose weight. The American College of Sports Medicine (ACSM) has similar high activity guidelines, recommending more than 250 minutes per week for clinically significant weight loss.
And exercise shouldn’t stop once the desired weight loss is achieved. ACSM recommends dedicating at least 150–250 minutes or more of physical activity per week to prevent weight regain. A commitment to enough regular physical activity is an important part of the process, which means finding physical activity you enjoy is key. Consider how you like to be physically active and schedule it into your calendar as you would other appointments.
When it comes to the best meal plan for losing weight, the 2013 Guidelines for the Management of Overweight and Obesity in Adults published in the Journal of the American College of Cardiology suggest there actually isn’t one. A variety of approaches can work, as long as there is a decrease in total calories consumed. In fact, the best meal plan for losing weight and keeping it off is the one you will stick with, since the focus is on sustainable changes and not on a “diet” you would start and then stop.
“To be successful with weight loss and keep as many pounds off as possible, one needs to commit to permanently changing eating habits, food choices, and level of physical activity,” said Hope Warshaw, MMSc, RD, CDE, the 2016 president of the American Association of Diabetes Educators and author of Diabetes Meal Planning Made Easy. Warshaw acknowledges that losing weight and keeping those pounds off is challenging. “It is tough work. It takes fortitude and perseverance in our food-focused world. But where there’s a will, there’s a way! Any amount of weight you can lose and keep off is beneficial for your health, glucose, lipid, and blood pressure control.”
You may have heard your diabetes educator or dietitian suggest aiming for healthy weight loss of one to two pounds per week. Although this guidance provides a starting point, you shouldn’t expect to lose the same exact amount of weight each week of the weight-loss journey. Variance is to be expected, so instead of setting a hard deadline for reaching your weight-loss goal, assess where you are in your journey in improving not only your weight status but also your lifestyle. Flexibility and acceptance are two important traits to help you adjust your expectations of how quickly you will lose weight.
“It’s important to take a long-term view of the weight-loss process and embrace an attitude for both the weight loss and the weight-control process that you’re in it for the long haul,” said Warshaw. It also is critical to remember that even small amounts of weight loss, 5% to 7% of baseline weight, have been shown to produce clinically significant improvements in overall health and glycemic management for individuals with prediabetes and Type 2 diabetes. Each small, healthy behavior change and improvement in weight should be celebrated.
The weight-loss journey is long. Losing weight is only the beginning — maintaining the lifestyle change is lifelong. A recommitment to sustainable meal planning and physical activity and reaching out for support from a registered dietitian when you hit a weight-loss plateau are key to not only overcoming stalled progress but also increasing the likelihood you will be able to maintain your weight loss. Flexibility, acceptance, fortitude, persistence, and grit are traits to embrace when changing your lifestyle. Remember, the climb may be long, but by taking one step at a time, you can succeed in attaining a healthier weight, and a healthier life.
Want to learn more about weight management? Read “Tried and True Weight-Loss Techniques,” “Strategies for Weight Management,” and “Why Can’t I Lose Weight?”
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