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The Weight Loss Plateau

Here is a brief video in which I explain the issue of the weight loss plateau and how this proves an important challenge in weight management.

(e-mail subscribers will have to visit the blog to view)

Edmonton, Alberta


  1. Do you have another clip where you explain the physiology?

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  2. I agree with everything you say, except I think most people enter into loss earnestly. They don’t think the weight loss will maintain itself magically, but rather that they have found THE plan and THE lifestyle that is right for them, and that they’ll be able to maintain forever and ever on this plan.

    Problems happen when they get to maintenance (whether or not it’s at the number they’d hoped to reach) and they learn the hard lesson that they can’t even have a short vacation. They become friends with the regular gym rats, and start seeing them disappear from the gym from time to time, for a week or a month. The regulars come back and grouse about how they’re gonna feel it in their muscles, and they do, but they’re rejuvenated by the vacation from the routine. Meanwhile, the radical weight-loss maintainer knows that if she disappears for a week, that could mean a five-pound regain, and it will set in like there’s a ratchet built into her metabolism. The naturally trim people will say “Aw, don’t worry, it’ll come right back off if you return to your routine.” Well, that’s true for them, since they’re near their natural highest weight, and they’re losing “the top five pounds,” but a radical weight-loss maintainer is trying to relose the LAST or BOTTOM five pounds. Even though those pounds returned in only a week, it will take AT LEAST as long to relose them as it did to lose them the first time they dieted — three months? Six? And that’s only if the body cooperates and responds to the current regimen. A maintainer may have to tweak it up to an even more intense level. Ack.

    When doctors hear their patients talk about losing weight, it is only moral that they share with them the truth about what awaits in maintenance, and promise to continue to support them. Maintenance is, in fact, a bore (zippy, athletic “Julie” characters from the NWCR notwithstanding). And everyone cheers someone who is losing weight. Zero change in weight doesn’t even register as a legitimate “goal” for most people. It’s an assumption. We need our doctors to recognize it for what it is (as you do) and affirm us and cheer us, because NOBODY else cares much.

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  3. I left an article for you at the Weight Wise Clinic a few months ago. It was from MacLean’s Magazine and explained how patients that have bariatric surgery are given a card that various merchants have agreed to. It allows these patients to order off of the children’s or senior’s menu and buffet restaurants will only charge half price. As the Weight Loss Clinic considered looking into this? I notice that many of these American restaurants have Canadian branches.

    I am not saying it is good to eat out all the time but there are times it is unavoidable.

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  4. Thank you for this. It couldn’t have come at a better time. I plateaued 5 months ago, after 145 lbs gone, only 25 lbs to go to a “normal” BMI. It was perfect to be reminded that my new lifestyle is still working for me. That there is still something to celebrate. Maintenance. I’ve kept the weight off for five whole months. I’ve never done that before. It has also served as a reminder to encourage my patients to not look so much at the numbers and remark more on the goals they are achieving, and one of those goals needs to be not to regain the weight, no matter how small the weight loss achievement.
    Becca RN (RNY Sept 2011)

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  5. Your little talk underscores even further the horrific effects of a show like the Biggest Loser. On this show, a plateau or an uptick is seen as a massive failure on the part of the individual. The message is more than just erroneous–it is outright dangerous for the individual and further feeds society’s prejudice and hatred for fat people.

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  6. Once again, I find that DebraSY is painting an unnecessarily bleak picture of life in maintenance. While it’s true that someone who has lost a great deal of weight can’t afford to take a “vacation” from their regimen – which is why my husband (who is also maintaining a substantial weight loss) and I now go on active holidays and stay in self-catering accomodation – we can both quickly lose a small regain.

    If either of us regains five pounds or so, it takes a week (him) or two (me) to re-lose the extra weight – not 3-6 months.

    As for being affirmed and cheered on for maintaining, we both find the enjoyment we get from our active lifestyle to be reward enough.

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