Your metabolism is no fool.
Even if you initially lose weight on a certain diet or medication, to maintain those results, you have to constantly trick the metabolic system into letting you shed pounds.
Otherwise, you might find yourself stuck at what obesity doctors call the “weight loss plateau.”
This phenomenon is extremely common among obese and overweight patients, affecting close to 85% of all dieters. It happens when weight loss slows or stops, even if diet and exercise regimens remain the same. And it can happen to patients taking GLP-1 medications, too.
But given the WHO’s estimates that four million people die each year of complications with obesity, there’s an urgent need for a more sustainable solution.
That said, it doesn’t take drastic weight loss to save lives: Research confirms that a “modest” drop of anywhere between 5 and 10% of total body weight can make a huge difference in key health metrics like blood glucose levels, blood pressure and inflammation.
Even then, though long-term weight loss is statistically difficult, and only 20% of people have success.
Dr. Meena Malhotra, a double board-certified physician in obesity and internal medicine and the founder and CEO of Heal n Cure Medical Wellness Center, says there’s good reason for that pattern.
Why your weight loss has plateaued
“The body is very smart, it adapts,” Malhotra tells The Post. “When you start losing weight, your metabolism also slows down because the body thinks it’s in a low energy state. So the same calorie deficit which was working before is no longer enough.”
Evolutionarily, the body adapted to hold onto its fat reserves for times of food scarcity, meaning the body will often resist major weight loss.
Loss of muscle mass is another contributing factor, she explains. Without proper amounts of protein and strength training, a person’s weight loss might be more from muscle than fat.
“Less muscle means slower metabolism,” she says.
And then there’s hormones. Stress and poor sleep spike cortisol levels, which can trigger fat-storing mode regardless of a person’s diet.
Finally, there’s what some refer to as the “whoosh effect,” or the sudden loss of weight in the early weeks of a diet that’s mostly attributable to lost water weight. Some patients can be discouraged when they find they’re not maintaining the same rapid weight loss over time.
How to reverse a weight loss plateau
Research suggests that the loss of lean mass may then necessitate a “recovery phase” to help patients build muscle back up and ultimately reinvigorate their metabolism.
Doctors recommend that, during a weight loss plateau, patients may need to up their calorie intake — but with more protein and fiber so they’re satiated better, have more energy and are supporting their hormone levels.
It may also be a time to ramp up exercise efforts in and out of the gym, with an emphasis on more resistance training and strength-building to support muscle growth.
Regularly incorporating NEAT activities — short for “non-exercise activity thermogenesis” — like increasing daily step counts, opting for the stairs instead of the elevator or working at a standing desk will all help patients meet the AHA recommendation of at least 200 minutes per week of moderate-intensity physical activity to achieve long-term weight loss.
As the body changes, so do its needs, Malhotra explains.
She adds: “Weight loss has to be dynamic, not the same plan forever.”
