Guest blog by: Lillian Craggs-Dino, DHA, RDN, LDN, CLT Starting a weight loss journey can feel exciting and rewarding, but it can also come with challenges, especially when you hit a plateau or stall. These pauses in weight loss are completely normal, and while they may be frustrating, understanding why they happen can make it easier to manage them. In this blog, we explain why plateaus happen, the health benefits of keeping weight off, and simple, practical ways to overcome these challenges so you can stay on track with your long-term weight loss and health goals. Understanding Weight Loss Plateaus and Stalls Weight loss plateaus and stalls are normal parts of the weight loss journey, whether achieved through metabolic and bariatric surgery or other methods. Interestingly, when we lose weight, the body often reacts by trying to regain it. This response is influenced by genetics and physiology, as well as diet, exercise, and lifestyle factors. The Health Benefits of Sustained Weight Loss Research shows that reaching and maintaining at least a 10% weight loss can improve health and reduce the risk of conditions like diabetes, high blood pressure, and sleep apnea.1 Metabolic and bariatric surgery, in particular, has been effective in helping put these conditions into remission. Unfortunately, plateaus and stalls can sometimes lead to weight recurrence, and regaining even 5-10% of lost weight can reactivate these health risks.2 What Causes Weight Loss Plateaus? A weight loss plateau occurs when you’ve lost all the weight achievable on your current diet and exercise plan. For those who have undergone metabolic and bariatric surgery, plateaus are typically seen around six months post-surgery or after achieving a 5-9% weight loss.3 Stalls can arise for several reasons: Set-point theory: According to this theory, the body has an inherent “set weight” regulated by physiological feedback systems based on genetics and environmental responses.4 Metabolic adaptation: Rapid weight loss is often followed by a decrease in resting metabolic rate (RMR) in a phenomenon called “metabolic adaptation" or “adaptive thermogenesis.” This adaptation can slow weight loss efforts and even lead to weight regain.2 Myths and Realities of Weight Recurrence While metabolic and bariatric surgery provides a powerful tool for weight loss, it’s a myth that all patients regain their lost weight. Although modest weight recurrence can occur, the goal is to minimize it. Successful weight loss management post-bariatric surgery involves a combination of diet, exercise, and self-monitoring. How to Break a Plateau If you’re experiencing a plateau or minor weight gain, here are some steps you can take: Follow a bariatric diet: Patients should adjust their diet based on their stage post-surgery, their tolerance for different foods, and a focus on protein. Carbohydrates and fats should also be balanced according to activity levels. Set realistic goals: Long-term success is often tied to setting achievable, realistic goals and making incremental changes. Self-monitor: Keeping track of dietary intake and exercise can help you identify areas for adjustment. Sometimes, small changes to your diet or routine are all that’s needed to break a plateau. Take your supplements: Don’t forget your essential vitamins and minerals to support overall health and weight management. Conclusion The weight loss journey is unique for each individual and requires patience and adaptability. Remember, it’s not about perfection—it’s about progress and effective management. Reach out for support when needed, and celebrate each milestone. Every day brings new challenges and opportunities to continue your journey. Embrace them! References 1. Fruh SM. J Am Assoc Nurse Pract. 2017;29(S1):S3-S14. 2. Farhana A et al. Metabolic Consequences of Weight Reduction. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572145/. 3. Yu EW et al. J Clin Endocrinol Metab. 2015;100(4):1452-9. 4. Ganipisetti VM et al. Obesity and Set-Point Theory. [Updated 2023 Apr 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK592402/.