People often find themselves, after eating a healthy diet and exercising frequently, that their weight ‘plateaus’ — what are your clients’ experiences with this?

Have you asked yourself ‘why can’t I lose the last few kilos?’ Or ‘why aren’t I losing weight?’ If so, then you may be experiencing a weight loss plateau. This is very common and there are usually some underlying health and lifestyle problems that are the cause of this.

Reasons why people experience a plateau

There are several reasons why people may experience stubborn weight loss or a plateau, but some of the most common and neglected reasons are as follows:

  1. You’re eating too much – this relates back to that recipe for weight loss: calories in (from food and beverages) need to less than your calorie output (from exercise and basal metabolic rate). This might be obvious to many, but this also applies to healthy food. Some people may still overconsume healthy food thinking it is lower in calories.
  2. Hormone imbalance – Your hormones play a pivotal part in every aspect of fat loss including your metabolism, where you store your fat, your appetite and even your cravings. Despite following a healthy diet and fitness program, any form of hormonal imbalance will sabotage your fat loss efforts. Excess abdominal fat can indicate one or more of the following hormonal imbalances:
    • High Insulin (insulin resistance) – Insulin is a hormone that helps facilitate cellular uptake of glucose in the body, primarily in the muscles, liver, and adipose tissue where it is used as fuel, or stored as fat. When insulin resistance develops, the insulin response is impaired and glucose levels are no longer efficiently controlled. As a result, blood levels become elevated, causing the insulin-resistant individual to store stubborn abdominal fat and increase their risk of other chronic diseases such as type 2 diabetes and cardiovascular disease.
    • High Oestrogen – Men who have higher levels of abdominal fat are more likely to experience an increase in the conversion of testosterone into oestrogen. As oestrogen levels rise, so does the tendency to accumulate more abdominal fat. Similarly, women who are premenopausal and have high levels of oestrogen (also known as oestrogen dominance) are more likely have heightened PMS, too much body fat around the hips and struggle to lose fat. As oestrogen is the main sex hormone in women, higher levels are more likely to be seen in this population compared to men.
    • Low Testosterone – Testosterone levels decline with aging, obesity and stress. Low testosterone can be considered both a cause andresult of obesity. Men who have elevated fat mass experience lower testosterone because of the conversion to oestrogen. Other signs that may indicate low levels of testosterone include a loss of muscle tissue, depression, and decreased strength, stamina, libido and motivation. As testosterone is the main sex hormone in men, low levels are more likely to be seen in this population compared to women.
    • High Cortisol – While stress is an important adaptation essential for survival, long-term stress can be damaging. Chronic stress can lead to persistently elevated levels of the stress hormone, cortisol, which is detrimental to your health as well as to your body composition. Not only does it increase your appetite and cravings, it also increases fat cell growth and storage because visceral fat tissue contains a high number of cortisol receptors and responds to the circulating cortisol in the blood. As both men and women experience stress, elevated cortisol is seen equally among them.
    • Low DHEA – DHEA is a hormone produced by the adrenal glands. It is a precursor to the female and male sex hormones oestrogen and testosterone, and helps to counteract the negative effects of cortisol. DHEA declines with age and may lead to an increase in fat mass, reduction in lean body mass or central fat redistribution. This decline occurs equally in both men and women.
    • Low thyroid activity – The thyroid is the central regulator of your metabolism. it secretes thyroid hormone (thyroxine) to influence metabolism in a number of tissues. Thyroid dysfunction can affect body weight and composition, body temperature, and energy expenditure. Low thyroid function (hypothyroidism) is linked to decreased thermogenesis and metabolic rate, and weight gain. A thyroid imbalance is more common among women than men.
  3. You’re stressed – when we are chronically stressed, our body produces elevated levels of our stress hormone, Continuously high levels of cortisol promotes weight gain via visceral fat cell growth and storage. Cortisol also stimulates the neurotransmitters that signal hunger and decreases the signals for satiety. Another connection is cortisol’s effect on cravings for high-calorie foods, which may explain the association between emotional stress and increased food intake.
  4. You’re not getting enough sleep – When we get too little sleep, our metabolism slows down to conserve energy. As a response, our body triggers the release of the stress hormone, cortisol. As mentioned previously, consistently high levels of cortisol increases fat cell growth and storage because visceral fat tissue contains a high number of cortisol receptors which responds to the circulating cortisol in the blood. Additionally, high cortisol is linked to an increase in appetite. In a vicious cycle, sleep deprivation causes our bodies to release the hormone ghrelin (the hormone that signals hunger) and supresses leptin (the hormone that tells your stomach that it’s full). Another contributing factor to increased abdominal fat is that the body burns the most calories during REM sleep (deep sleep phase). Therefore, less sleep means less time in REM.
  5. You’re exercising too much/overtraining – excess exercise can cause health problems, especially if the diet is lacking in proper nutrition. Overtraining can signal the body to start burning muscle for fuel and store more fat, resulting in some weight gain. Overtraining with the addition of poor recovery can cause the body to produce excessive amounts of cortisol, which can lead to weight gain or stubborn fat loss.
  6. Poor gut health – A dysfunctional gastrointestinal system can virtually ruin your chances of weight loss. From a compromised immune system, to a stress hormone imbalances, to an altered sex hormones, to blood sugar irregularities — many of these problems start in the gut.
  7. You have an undiagnosed medical condition – There are some medical conditions that can lead to weight gain or make it much harder to lose weight. These include hypothyroidism, polycystic ovarian syndrome (PCOS) andsleep apnoea. Certain medications can also make weight loss harder, or even cause weight gain.
  8. Nutrient deficiencies – There are certain vitamin deficiencies that may contribute to fat metabolism, deposition and storage. These include:
    • Vitamin D – Low levels of vitamin D result in your body producing certain hormones that are responsible for fat cells to hoard and store fat rather than burn it.
    • Chromium – This mineral is responsible for the metabolism of fat and carbohydrates (particularly glucose), and insulin. People with a chromium deficiency are at risk of impaired glucose intolerance and therefore, type 2 diabetes.
    • Magnesium – Magnesium is a co-factor of many enzymes involved in glucose metabolism. It has an important role in the action of insulin, and insulin stimulates magnesium uptake in insulin-sensitive tissues. Therefore, people with lower levels of magnesium may be at higher risk of insulin resistance, which causes fat to accumulate around the abdomen.

Can under-eating cause a plateau?

Yes. A very common reason why people can’t lose weight is that they are considerably under-eating for their body’s energy requirements.

This may happen because there is not enough energy (calories) supplied to the body to fuel what the individual is doing. A perfect example is fad diets that call for severe restriction of calories, especially fat and carbs, and to exercise hard. This may be counterproductive in that our bodies require fuel to function effectively and when we exercise, we need more fuel, not less. Reducing fuel (energy) intake and doing extreme exercise takes its toll on the body. A good analogy is if you were to fill a car with half the petrol it needs to go a certain distance, but still expecting it to go the full distance. If you want to reach a destination, then you need the right amount of petrol (fuel).

If we consistently and chronically consume less calories than what our body needs, especially combined with exercise, our body may fall into a state of “stress”. As a result, hormones can become unbalanced, which may affect our metabolism.

What is considered a healthy weight?

This very much depends on what the goals of the individual are. For example, a male training for a body sculpting competition is going to have a very different outlook on what a healthy weight is, compared to a female who is wanting to look good for their wedding. It is the role of the health practitioner such as a Nutritionist and/or Dietitian to help guide the individual to not only reach their personal goal but to make sure that they remain within a healthy weight range.

Everyone has different perceptions of what is considered a “healthy weight”, however, it doesn’t necessarily mean that those perceptions are a true representation of what a clinically healthy weight is. Rather than focusing on a number on the scales, or a pant or dress size, the focus should instead be on health. If you are feeling well and free of disease, eating well, exercising regularly and full of vitality then this is the most important thing.

What can you do/eat to get out of a plateau?

Firstly, it’s important to rule out any medical condition that might be contributing to your plateau. A doctor or health professional can assist you with the investigation and provide a full health assessment.

If there are no health concerns, then there are a few things I advise my clients to implement to get the weight falling off again. These include:

  • Stress management – if you suffer from stress or stress-related conditions, it is very important to implement some stress-reducing techniques such as deep breathing, meditation, yoga, Tai Chi or progressive muscle relaxation. This have been proven to reduce cortisol levels.
  • Change up your training – if you’re not currently doing any resistance or strength training, add it into your program. Lean muscle mass is important in boosting your metabolism.
  • Get more sleep and recover well from exercise – the importance of sleep, both quality and quantity has been well documented. To optimise hormone balance, it’s important to have good sleep hygiene. Implement a regular sleep routine where you go to bed at the same time every night and wake at the same time every morning. Make sure room is dark and quiet and at a cool temperature. Dim the lights and avoid electronic devices such as iPhones, iPads, computer screens before bed.
  • Get your hormones checked – your GP or health professional can assist you if they feel it is important to investigate. The main contributing hormones to you weight include sex hormones, insulin, thyroid, leptin and cortisol.
  • Keep hydrated – many people claim they are too busy and forget to drink water consistently throughout the day. As a result, they become dehydrated. Dehydration may alter hormone function as well as cause fatigue, making it more difficult to be active. Therefore, aim to drink water regularly throughout the day, especially when exercising.
  • Eat whole foods (predominantly vegetables), lean protein and healthy fats. Avoid processed foods, refined carbohydrates and added sugars that cause inflammation.