We are frequently asked this question. "I have been following my program but have reached a plateau. Why can't I lose any more weight?" We can look at just a few of the many possible barriers:

1. Do you actually know what you are doing now? How many calories are we eating on a weekly average? How many calories are you using on a weekly average? Are you skipping meals to reduce caloric intake during the day and then overeating at night thinking that it balances out? To lose one pound per week, you need to deficit 3500 calories (500 per day), ideally half from food (250 calories) and half through exercise (250 calories).
2. Is it a body composition problem? A high percentage of body fat — say, 30% — even at an appropriate weight can mean the difference of two clothing sizes larger than someone at the same given weight who has more muscle mass and just 20% body fat. Exercise is very important as well as diet in changing body composition.
3. Do you need to lose more weight? Are you within the recommended weight range? Is it a body image problem affected by other things in your life that are 'not right'?
4. Are you working at increasing your metabolic rate through resistance training 2-3 times per week?
5. Has your body become used to your current diet and exercise program? Is it time to 'shake it up'?

We are all genetically given a body type that includes frame size and basic body shape — look at your relatives. The goal you set has to be realistic. The bottom line is to focus on health and a healthy weight for you to be able to maintain without a chronic caloric/nutrient restriction. That being aside, if you truly reached a plateau during a healthy realistic weight loss program we can go back to some of the first five points. It is not uncommon for weight loss to slow after the first two weeks; in fact, it is expected. If you are working with professionals who know that, they can help you with the next behavioral change. The key at this point is slow and steady: look at the long haul. We may need a change in attitude about what healthy weight loss is.

1. Self monitor. Record food eaten and time spent exercising to determine the balance of calories consumed and calories expended over a week's time. If you are at a balance of more than 10-11 calories per pound body weight for women or 12-13 calories per pound body weight for men, weight loss will be very slow, especially without adequate exercise. For example, a 150-pound woman needs to be at a balance of about 1500 calories per day when food eaten and energy expended in exercise are accounted for.
2. Don't assume that the scale is always a true measure of what is going on with the body. If exercise levels are at adequate levels 5-7 days a week, you may be putting on muscle but losing fat, thus losing inches even if you are not losing pounds. It is always a good idea to do several body measurements in the beginning to have a second objective way to monitor progress.
3. What else is going on in your life? Is the stress level too high and energy draining? Do you let that stress undermine your self-image, commitment, energy, and self-worth? A visit or two to a professional may help, or join a support group, or treat you to a spa or special retreat for renewal. (See Overstressed? No Need to Overeat! for more tips on stress management.)
4. Increase your metabolic rate by increasing muscle mass with resistance training (weightlifting). Muscle utilizes up to 22% of your baseline calories, fat 3%, bones and blood 5% and our organs 70%. Someone who weighs 200 pounds can expend 500 calories per hour doing light strength training and eventually utilize more calories daily even while sitting still than someone at the same weight with less muscle mass.
5. Our bodies do adjust to a level of fitness and caloric energy. Here is where an endurance activity such as a 1-1/2 hour to 2-hour walk or hike on the weekend can start weight loss again. The best programs for weight/fat loss emphasize safe, injury free techniques, endurance or longer distances, and increased frequency (5-7 days is best) or increased intensity. Interval training works well here. An example would be walk for 10 minutes, racewalk or jog for 12 steps, walk, and alternate per your fitness tolerance to build stamina and increase caloric expenditure.

Other techniques include finding simple ways to add short bouts of activity throughout the day. Try walking hills and/or using walking poles to increase calorie output. Add a 10-20 minute walk after dinner or use an exercycle. Take an exercise class such as yoga or Pilates to help reduce stress. There are many ways to get off a plateau, but they take effort, commitment, and balance in a healthy lifestyle.