While we don’t love this topic, we do get asked this question often by clients trying to adopt a healthy lifestyle. )If you have disordered eating, this may trigger you, please do not read.)

It can be frustrating when you are eating balanced and taking time out of your life to fit in exercise and the scale doesn’t budge. We often meet clients who come to us because they have hit a plateau in their weight loss journey, despite their efforts. It is often not just one thing that stops your journey, but sometimes a combination of both medical and lifestyle situations.

You are eating too much
Underestimating your portion sizes of foods and drinks can impact your total calorie intake, putting your energy expenditure over, causing weight gain or a plateau. Often grains and starches such as pasta, bread, rice, pretzels, oatmeal, cereals, and quinoa can pack 60 calories per ½ cup on average. Who eats just a half cup of pasta? When you make dishes like chili, pasta and casseroles, it can be helpful to use a recipe analyzer, like myfitnesspal, to determine how much calories and macronutrients (carbs, protein, fats, fiber) a serving yields. Snacking while cooking and work also can add up. Take a few days that are your typical eating and record on myfitnesspal what you are eating. Use measuring cups and scales to help you become more aware of serving.

You are not eating enough
Yes you might lose a significant amount of weight in a short period of time, but your body will always work to create equilibrium and balance and after some time, your metabolic rate will slow down because your body goes into “starvation mode” and tries to slow down how many calories you need. In general, majority of research shows weight loss slows if a person eats 1200 calories or less. Slowly increase your caloric intake weekly by 150 calories, focusing on fiber rich vegetables and proteins.

You are drinking too much
The alcohol in beer, wine and spirts (seltzers too!) is 7 calories per gram, which is not a low calorie food, in fact protein and carbohydrates are only 4 calories per gram! Having more than one serving a day (5 oz of wine, 8.5 oz beer or 1.5 oz of a spirit) for women and more than 2 servings for men can increase inflammation, increasing premenopausal breast cancer risk by 5% and postmenopausal risk by 9%, increasing cortisol levels (pretty much the opposite of when we have a drink to relax right?), changes hormones which causes thyroid disfunction (the regulator of your metabolism), and causes you to overeat due to decreased inhibitions specifically foods higher in lower quality carbohydrates and fats). Your brain’s hypothalamus thinks you are starving when drinking, and can cause intense hunger cues by blunting the hormone leptin and glucagon-like peptide-1 (GLP-1) that makes you feel full, so you might eat more.
Don’t get us wrong, one serving of red wine, (due to polyphenols that are antioxidants), can reduce cardiovascular disease by raising HDL and reducing stroke risk by thinning blood so please enjoy a cocktail in moderation. Many of our clients did the “Dry January” challenge and noticed significant changes in their weight, mood, energy levels and sleep. Taking off from drinking alcohol during the week is another strategy while still enjoying your favorite adult beverage.

You are experiencing hormone changes
Lowering testosterone in men and lowering estrogen in women as we age increases the amount of fat our body has which decreases our metabolism. Some patients find they do need medical intervention to help increase energy levels. Strength training can help decrease the amount of body fat and increase metabolism, helping to balance those hormones. A diet rich in fiber and omega 3 foods such as salmon, tuna, halibut, fortified egg yoks, walnuts, chia seeds, flax seed and hemp can also help to “boost” your hormone level.

You are not exercising enough
Since COVID many of our clients are now working from home and as a result saw an increase in their weight related to less movement as their day. Are you one of these people? If you are aiming for weight loss, research supports 200 minutes of cardiovascular exercise with strength training 3-4 times per week. We have observed since COVID, our patients find they are working from home, need to include walking or some other movement in addition to their visits at the gym. If you wear a Fitbit, Apple Watch or your phone’s step counter, aiming for 10,000 steps a day is another way to stay aware of your activity levels.

You are stressed
If I asked you 1 out of 10, 10 being highest, 1 being lowest, what are your current stress levels? If you said 7 or higher, if may be affecting your weight. Cortisol is a hormone that increases when you experience stress. The hormone insulin increases with cortisol, causing insulin resistance. As a result, you feel bloated and have difficulty losing weight. A lower carb, but high fiber diet of 25 grams a day, can help when stress levels are high. Walking or working out after a large meal can also help decrease cortisol and insulin levels. Creating a stress management and self-care plan is important to help you hit those health goals. We refer to mental health specialists often and have a stress management program, often with these interventions are utilized, our clients start seeing weight loss.

You are not sleeping enough
If you get less than 7 hours of uninterrupted sleep per night, it will affect your weight. We have circadian rhythms (your bodies clock) that become off with lack of sleep causing insulin resistance and increasing oxidative stress in our cells (inflammation). Creating a sleep routine, putting down your phone away from your bed and finding soothing activities like reading a book before bed may help unwind you. Many of our clients have found it helpful to see a sleep doctor and get a sleep apnea test.

You have insulin resistance
When you eat carbohydrates, your pancreas releases the hormone insulin to break down the carbohydrates into glucose helping it to enter the blood stream. Insulin helps lower our blood sugar, but too much insulin can release from the pancreas when you overeat, have elevated blood sugars or too much body fat. This is often insulin resistance. Over time insulin resistance can cause body fat to accumulate in the liver, negatively affecting your body fat and negatively affecting your cholesterol levels. Eating too many carbohydrates accelerates this fat accumulation. If your blood sugars are under 100 mg/dL fasting, you can still have insulin resistance. We recommend testing your insulin annually with your preventive health visit, (there is no copay for an annual preventive visit with your healthcare provider and they spend a lot more time with you at this visit!). If you think you are becoming insulin resistant, consider focusing on half your plate with non-starchy vegetables like salads, green beans, asparagus, broccoli, squash and cauliflower. ¼ your plate should be a protein rich source that ranges from 20-30 grams of protein, such as 4 oz chicken, fish or tofu. Aim to have 15-30 grams of fiber rich carbohydrates per meal (vegetables, whole grains, beans, dairy), focusing on eating the starches/carbohydrates at the end of the meal to lower the spike in blood sugar. This will prevent less of an insulin spike. Intentional movement after a meal can also make your muscles more sensitive to insulin and help to lower your overall glucose and insulin levels.

If you are struggling on your weight loss journey, Downingtown/Kennett Nutrition is here to help! We take majority of healthcare plans, often without a copay. Additionally, we offer metabolic testing to determine if your resting metabolic rate is slow. This can help determine how much to eat and how much to exercise.