Explore how to overcome weight-loss plateaus by adjusting your body's set point. Photo / 123rf
There is a reason our bodies don’t like us to shed kilos – even when we stick to our calorie goals.
Sometimes, no matter how positive our intentions, losing weight isn’t as smooth a journey as we hope. Perhaps we’ve made great progress in the first few weeks or months, then suddenly, despite sticking to our calorie goals, found the numbers on the scales just aren’t budging any further.
“Weight loss plateaus are something I see all the time,” says Dr Andrew Jenkinson, a consultant bariatric surgeon at University College London Hospital and the author of How to Eat (and Still Lose Weight). “They can be overcome, but it may require further changes to reset your metabolism.”
“For evolutionary reasons, our bodies don’t like us to lose weight,” explains Jenkinson. “When we’re in a calorie deficit, there’s a battle going on between the change in our food intake and our metabolism.”
In the past, when humans often went long periods without food, we survived by storing fat; we’re still programmed to do that now. “The metabolism adapts by becoming as low as the calorie intake, and that’s when we hit a plateau,” he says.
Rhian Stephenson, a nutritional therapist and founder of wellbeing business Artah, says that what we eat can contribute, too. “If we eat food that’s devoid of nutrition and instead consume a lot of fake foods, artificial chemicals and emulsifiers, it will impact our metabolism by disrupting cellular communication, increasing inflammation, and impacting our blood sugar.” She says that an imbalance of bacteria in the gut can also slow our process.
Jenkinson says the weight dieters feel stuck at is likely down to their body’s reluctance to get too far away from its “set point”.
Our “set point” is the weight the body is determined to maintain – like an anchor to which we’re pulled back whenever we drift too far above or below it. Everyone has a natural set point determined by genetics, but it can be influenced by other factors including stress and our unhealthy Western diet, full of refined carbohydrates which lead to higher insulin levels (the hormone that controls blood sugar).
According to Jenkinson, the slowing down of the metabolism triggered by low-calorie diets also causes dieters’ weight set point to shift higher over time, making it harder to lose weight and keep it off. “Dieting signals to the hypothalamus [the part of the brain that regulates hunger levels] that there’s a famine and that you’d better put on a little bit more weight for the future. That’s why crash diets are counterproductive in the long run,” he says. Rather we need to find a healthy way of eating that we can sustain forever.
“We need to stop thinking in terms of a short-term fix, but rather a lifelong change,” says Jenkinson. Stephenson agrees that the first task is to remove the foods which “hijack our metabolism”.
Nutritional therapist Rhian Stephenson says that ‘fake foods’ devoid of nutrition can negatively impact metabolism.
Most of us eat too many refined carbohydrates, which are essentially sugar and cause our insulin levels to spike; cutting out food such as white bread and pasta and anything sugary including cakes and chocolate is the perfect starting point.
Both omega-6 and omega-3 fatty acids are needed for optimum health, but for many of us, the balance between the two is way off, thanks to all the omega 6, found mainly in vegetable oils, added to prolong the shelf life of highly processed food. This can cause poorer insulin function, leading to an increase of insulin and a dulling of the response by leptin, the hormone which regulates weight by telling the hypothalamus how much fat we have. Avoiding ultra-processed foods can redress the balance and help reset the metabolism.
Stephenson suggests focusing on whole foods, healthy fats such as oily fish and avocado, a diversity of vegetables and herbs, and natural fermented foods. “When we eat this way, we provide the vitamins and minerals needed for a healthy metabolism, the phytonutrients that our microbiome need, and the natural live bacteria to help promote microbial diversity,” she says. Dark-coloured fruit and vegetables, green tea, ginger and turmeric can stimulate AMPK, an enzyme known as the body’s master regulator of metabolism.
Timing can play an important part, too. “Time-restricted eating or intermittent fasting will help lower insulin load, improve inflammation and promote gut health,” says Stephenson. Jenkinson favours eating two good meals a day and avoiding snacking in between.
Weight loss drugs such as Ozempic work by mimicking GLP-1, a natural hormone involved in appetite control – but we can do this ourselves by selecting certain foods.
“Eating high protein and high fibre will increase GLP-1 secretion,” says Stephenson.
Ghrelin is another crucial hunger hormone, which is produced in the stomach and signals to the brain that it’s time to eat. One study of postmenopausal women on a low-calorie diet showed that levels of ghrelin increased both during and after weight loss, making the women hungrier – and the task of keeping the weight off much more difficult. Research has shown that protein decreases ghrelin.
“Getting a good amount of protein in your first meal can be transformative for managing hunger; this benefits appetite control throughout the entire day and has been shown to reduce late-night eating,” says Stephenson. She also suggests increasing fibre by adding milled flax seeds and psyllium to meals, as well as opting for beans and lentils over grains.
After the first few weeks of any weight loss programme, it’s common for motivation to dwindle, particularly if the results are diminishing too. Dr Heather McKee explains that with weight loss, there’s usually a number we’re aiming for, but that this “is not what keeps us engaged”. Instead, we should go back to our intrinsic motivation, or our “why?”
“Knowing why what we’re doing is meaningful, and what it contributes to our life, is what creates that long-term change,” says McKee. “We need to ask ourselves, ‘Why does it matter to me, and me alone, to do this?’ – because research has shown that if we’re doing something for another reason, say, because the doctor told us to, it’s going to be very difficult to stick to.
“It could be, ‘It gives me energy and confidence, I feel stronger, I’m more focused at work, I’m a positive role model for my children.”’
McKee advises trying to build habits we actually enjoy. “It could be dancing to Beyoncé, or hiking – if you can find the joy, the rest is easy,” she says. “And focusing on the feeling you get from those activities, such as accomplishment, or clarity, trains the brain to want to engage.”
Small changes are key. “Focus on building a minimal viable habit – something small which we do consistently, because that consistency is key,” she says. “If we tell ourselves we’ll do just 10 minutes of exercise, and we do it and maybe even supersede it, dopamine is released in the brain which makes us want to do it again and again.
“That’s how we beat plateaus and make lifestyle changes manageable and sustainable.”
A growing body of evidence suggests that resistance training is essential for weight loss: one Harvard study found that weight training is more successful for reducing belly fat in men than either moderate or vigorous aerobic activity.
“A great way to accelerate fat loss is to focus on increasing muscle,” says Stephenson. After the age of 30, muscle mass naturally drops by up to 8 per cent per decade until the age of 60, after which the rate of decline is even faster – but this can be reversed.
“Muscle has a huge impact on metabolic health and blood sugar regulation,” says Stephenson. “In simple terms, it acts as a sponge for sugar and bypasses the need for our bodies to produce and release insulin, which decreases our insulin load, making it easier for us to burn fat. In addition, muscle burns calories even at rest, increasing our metabolic rate.”
She also recommends adding in extra spots of exercise throughout the day: “Studies have shown that just 15 minutes of brisk walking after a meal can help lower postprandial glucose and contribute to healthier blood sugar balance, which can be especially impactful if you’re at a desk all day.”
The average age of patients in the study was just 38, highlighting risks for younger adults.