Overcoming Weight Loss Plateaus

Overcoming Weight Loss Plateaus

What Is Weight Loss Plateau?  

Weight loss plateau refers to a period when little to no weight loss occurs after achieving initial weight loss in a hypocaloric diet.1 Almost everyone undergoing a weight loss intervention experiences weight loss plateau typically at 6 months into dieting.2


Why Does Weight Loss Plateau Happen?  

Although various hormonal, neural, and psychological factors play a role, people often mistaken the phenomenon to be caused by lack of willpower and can lead them to entirely forgo their diet.2 Research is ongoing to understand the underlying mechanisms, but here are some ways experts propose may cause weight loss plateaus.  


Hormonal Adaptations – Metabolic, neural, and hormonal factors tightly regulate body weight, and changes to it can lead to series of physiological mechanisms that compensate and adapt to a hypocaloric environment.3 During weight loss, several hormonal changes occur. For instance, leptin, a hormone that regulates body weight and prevents starvation, decreases during weight loss, leading to increased appetite, excess food consumption, and weight regain. Another example is an increase in ghrelin, a hormone that stimulates hunger, which further stimulate excess food consumption during weight loss periods. A combination of various hormonal changes can lead to increased caloric intake as well as reduced metabolism.


Decreased Energy Expenditure – Other physiological mechanisms also kick in during weight loss in an attempt to stabilize weight.3 During what is known as adaptive thermogenesis, the body’s resting metabolic rate slows down, decreasing the body’s energy expenditure. It is thought that this metabolic adaptation occurs to conserve energy during periods of low energy supply and to potentially mitigate the effects of prolonged starvation.


Decreased Adherence to Weight Loss Plan – A common reason for experiencing weight loss plateaus earlier than expected is due to intermittent lack of adherence to dietary plan, which may be greatly influenced by the aforementioned physiological changes.1 Even small and subconscious daily deviations from weight loss plan can lead to an early plateau in people’s weight loss journey.


How Do You Overcome Weight Loss Plateau?  

Don’t Quit – The combination of increased hunger, increased fatigue, and slowing down of weight loss can easily discourage individuals to quit their weight loss plan.2 Studies show that only 10-20% of individuals who successfully lose weight are able to maintain that weight loss, which can lead to a vicious cycle of weight loss and weight regain for most people, also known as the “yo-yo dieting”. Instead of quitting when weight loss slows down and becomes more challenging, understanding the various factors that impact weight loss can equip individuals to overcome periods of plateau.


Allow for Recovery Phase – When feeling “stuck” in a weight loss plateau despite continued caloric restriction, allowing for a recovery phase can help. Recovery periods allow individuals to increase food consumption as well as endurance exercises aimed for muscle gain.2 Consuming more nutrition and calories can help decrease hunger and allow hormonal imbalances to return to normalcy, while focusing on endurance exercises can help regain lost lean muscle mass which can improve metabolism and energy expenditure.


Physical Activity May be Key – Physiological mechanisms that fight against weight loss can be intense.4 Studies show that decreases in energy expenditure and increases in appetite and hunger are amplified during dieting and require individuals to engage in their weight loss plan with persistent intensity to combat the adaptive mechanisms. Simply eating a hypocaloric diet can lead to the loss of lean muscle mass and exacerbate these physiological changes that fight against weight loss. Studies have consistently shown that physical activity is associated with long-term weight loss and moderate weight regain, allowing maintenance or even gain of muscle mass that help metabolism as well as allowing the consumption of more calories without greatly affecting total energy consumption. 


Receive Support from a Team – As neural, psychological, and hormonal changes occur during weight loss, having support from individuals with varied expertise can help combat weight loss plateaus.2 Working with a team of health care professionals, dietician, psychologist, and supportive family and friends can help individuals be better informed and supported during their weight loss journey.

Diabetes is a complex chronic condition that needs the care of a multidisciplinary team with special attention to diet and nutrition.1 Dieticians, therefore, play a critical role in diabetes management by providing dietary education, counseling, and support. 


Who Are Registered Dietician Nutritionists?

Registered dietician nutritionists (RDNs) are licensed experts with professional and academic training in food and nutrition.1 They are an important part of diabetes care. RDNs provide nutritional counseling, assess nutritional status, support weight management, and are the primary and preferred deliverers of medical nutrition therapy for diabetes management.


What Is a Medical Nutrition Therapy?

Medical nutrition therapy (MNT) is an evidence-based nutrition intervention provided by

RDNs.2 Studies have shown that MNT is effective and important in managing diabetes,

prediabetes, and obesity. The goals of MNT include:3


How Do Dieticians Help With Diabetes Management?  

RDNs with training in diabetes care are the preferred members of the health care team to provide diabetes-focused MNTs and play a critical role in establishing and maintaining a healthy eating pattern.3 The Academy of Nutrition and Dietetics describe the various roles RDNs play in diabetes management:2

  • Ensure that individuals at risk for type 2 diabetes mellitus (eg, overweight/obese adults) to be screened for diabetes
  • Ensure that individuals with type 2 diabetes mellitus are referred to receive MNT
  • Implement 3-6 MNT sessions in the first 6 months and follow up with at least 1 annual MNT
  • Formulate a nutrition care plan based on medical tests and data, medication usage, food-related history and behavior, and psychosocial situation
  • Individualize nutrition care plan according to evidence-based guidelines and personal needs and goals
  • Educate individuals on carbohydrate management strategies (eg, dietary fiber, glycemic index, use of sweeteners)
  • Educate individuals on the role of protein intake in diabetes management
  • Encourage physical activity
  • Educate individuals on self-monitoring of blood glucose
  • Coordinate with health care team, caregivers, and family members
  • Monitor effectiveness of MNT

1. Thomas DM, Martin CK, Redman LM, et al. Effect of Dietary Adherence on the Body Weight Plateau: A Mathematical Model Incorporating Intermittent Compliance with Energy Intake Prescription. Am J Clin Nutr. 2014;100(3):787-795. doi:10.3945/ajcn.113.079822
2. Sarwan G, Rehman A. Management of Weight Loss Plateau. In: StatPearls. StatPearls Publishing; 2024. Accessed February 9, 2024. http://www.ncbi.nlm.nih.gov/books/NBK576400/
3. Evert AB, Franz MJ. Why Weight Loss Maintenance Is Difficult. Diabetes Spectr. 2017;30(3):153-156. doi:10.2337/ds017-0025
4. Aronne LJ, Hall KD, Jakicic JM, et al. Describing the Weight-Reduced State: Physiology, Behavior, and Interventions. Obesity (Silver Spring). 2021;29(Suppl 1):S9-S24. doi:10.1002/oby.23086



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