Whether it happens in Phase 2, Ongoing Weight Loss (OWL), or Phase 3, Pre-Maintenance, at some point everyone experiences a temporary halt in weight loss. Such a plateau is perfectly normal; however, it’s all too easy to assume one is on a plateau when there’s another reason for stalled weight loss. You may want to rule out some other possibilities by asking your patients to look carefully at their recent behavior before deciding they are truly on a weight-loss plateau.
As a person becomes increasingly accustomed to eating the low-carb way, it’s all too easy to get sloppy about tracking carbs. Instead of the 35 grams of Net Carbs she thinks she’s consuming, for example, she might actually be closer to 55 (or even 75). Whether as a result of carelessness, cockiness, overconfidence or testing the limits, “carb creep” can stop weight loss in its tracks. Worse, carb creep may block the body’s adaptation to burning primarily fat. A true plateau only occurs when progress stalls despite following the program to the letter. Ask your patients these questions and have them make course corrections if the answer to any of them is yes.
- Have you truly been eating the right foods, or have you been tempting fate with inappropriate ones? Recommended action: Eliminate any questionable foods.
- Are you actually counting carbs? Recommended action: go back to the carb level at which you were losing weight and remain there until it resumes.
- Have you added back too much fruit? Recommended action: eliminate fruit other than berries and, if necessary, cut back on berry portions.
- Are you eating excessive amounts of protein? Cut back to 4-6 ounces per day but maintain fat intake.
A True Plateau
The pace of weight loss is always erratic, but the definition of a plateau is when no weight loss occurs, despite doing everything right, over a period of at least four weeks. If a patient finds her clothes are fitting better and she’s lost inches, if not weight, she is not on a plateau. A plateau can try the patience of a saint, but patience is exactly what is required on a true plateau. To get things moving, in addition to the suggestions above, suggest some or all of these modifications:
- Tighten up journaling discipline; write everything down.
- Count all carbs, including lemon juice, sweeteners and so on.
- Find and eliminate “hidden” carbs in sauces, beverages and processed foods that may contain sugar or starches.
- Decrease daily intake of Net Carbs by 10 grams. An individual may have exceeded his or her tolerance for carbs while losing and inadvertently stumbled upon the tolerance level for weight maintenance. Once weight loss resumes, move up in 5-gram increments again.
- Increase activity level; this works for some but not all people.
- Increase fluid intake to a minimum of eight 8-ounce glasses of water (or other noncaloric fluids) daily.
- Cut back on artificial sweeteners, low-carb products and fruit other than berries.
- Do a reality check on caloric intake. Women losing weight should consume a minimum of 1,500–1,800 a day, and men, 1,800–2,200.
- Cut back or abstain from alcohol for now.
If none of these modifications makes the scale budge for a month, your patient is truly on a plateau. Frustrating as it is, the only way to outsmart it is to wait it out. Counsel continued compliance with the Atkins Diet and the other advice above. At a certain point, weight loss will resume.
Also see: Exercise and Weight Stall