What To Do If You're Not Losing Weight

1
Rule Out Any Medical Conditions

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More on what to do if you can't lose weight: Rule Out a Medical Condition | Assess Your Diet | Assess Your Workouts | Assess Your Situation and Lifestyle | Assess Your Expectations

If you're not losing weight despite exercising and changing your diet, you're probably frustrated, discouraged and maybe even depressed. Weight loss is a complex process involving a variety of factors we control, such as diet, exercise, activity levels, stress and sleep habits and some we can't control, such as genes, gender, hormones, age and body type.

So, where do you start if you're not losing weight? Step one is to see your doctor to rule out any medical conditions. This is especially important if you think you're doing everything right and you haven't seen any changes at all in the scale or your body after several months (or, worse, you're inexplicably gaining weight).

Some health problems and common medications can cause weight gain, including:

If you're on any of these medications, talk to your doctor about the side effects and possible substitutes, if that's an option for you. If not, knowing the side effects of what you're taking helps you become more proactive about your situation. You may need to work harder to lose weight and be extra careful with your diet. Keep a food diary, monitor changes in your weight and let your doctor know if you gain more than 5 pounds in a month without any changes to your diet or exercise.

2
Assess Your Diet

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More on what to do if you can't lose weight: Rule Out a Medical Condition | Assess Your Diet | Assess Your Workouts | Assess Your Situation and Lifestyle | Assess Your Expectations

The most important factor in weight loss is how many calories you're eating versus how many calories you're burning. Even if you think you're being very good with your diet, it's easy to underestimate how many calories you're actually eating.

Research has found that most of us underestimate how much we're eating, especially when we eat out. One research paper published in JAMA mentioned a study in which 99% of over 190 adults underestimated calories in high-caloric food. For example, when assessing fettuccine alfredo or chicken fajitas, the subjects often underestimated calories by 463 to 956, a huge difference and one that could easily sabotage your weight loss goals.

Careful scrutiny of your diet is the only way to know what you're really eating:

  1. Determine how many calories you need - You can useĀ an online calculator to determine how many calories you need.
  2. Keep a food diary - Use a printed form or an online tracking program, such as Calorie Count or FitWatch. Keep this diary every day for at least a week, being as specific as possible: Measure your portions, read food labels or access nutritional information if you're eating out.
  3. Analyze your diet - Online tracking websites will often give you an overview of how many calories you're eating as well as a breakdown of different nutrients. You can also turn an objective eye to your overall eating habits and look for ways to cut calories. Could you eat out less? Find healthier substitutes for some of your staple foods like yogurt, bread, cheese and chips? Find new, low-calorie recipes? You might even consider working with a registered dietician who can make more specific recommendations.

Keep in mind that you may have to continue keeping a food diary every day to stay on track. Successful weight losers regularly monitor both their eating habits and weight to avoid gaining weight. It may seem like a hassle but, if you really want to lose weight, it's a must.

3
Assess Your Workouts and Daily Activity

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More on what to do if you can't lose weight: Rule Out a Medical Condition | Assess Your Diet | Assess Your Workouts | Assess Your Situation and Lifestyle | Assess Your Expectations

Exercise is another crucial element to weight loss, along with your daily activity levels, but it's hard to know if you're doing the right workouts or burning enough calories.

Start by looking at your overall program to get a sense of how much you're exercising. For weight loss, experts often recommend up to 60-90 minutes of exercise each day. If you're not even close to that, this gives you a place to start as you work through your plateau.

This doesn't mean you have to start working out for 2 hours a day. In fact, that's a bad idea if you're not used to that level of exertion and could lead to injury, burnout or overtaining.

What it does mean is that you need to make a very important decision: Either you need to increase your workout time and intensity to match your weight loss goals or you need to change your weight loss goals to match what you're actually doing.

Don't forget, it's not just about structured exercise. Working out for an hour doesn't cancel out the next 8 or 9 hours of sitting (something many of us do). In addition to exercise, try to be as active as you can: Take regular breaks from the computer, take walks whenever possible, stretch, wear a pedometer to see how many extra steps you can get in, limit your TV time, etc. If you spend more than 8 hours sitting, that could be one more reason you're having trouble losing weight.

More About How to Exercise for Weight Loss

4
Assess Your Situation and Lifestyle

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More on what to do if you can't lose weight: Rule Out a Medical Condition | Assess Your Diet | Assess Your Workouts | Assess Your Situation and Lifestyle | Assess Your Expectations

Diet, exercise and physical activity are all crucial elements in weight loss. However, there might be other contributing factors that make it harder to lose weight. If you're not losing weight, assess your situation and lifestyle for other contributing factors such as:

  1. Age - It's frustrating, but one side effect of aging is slower weight loss. After 40, your metabolism starts slowing down and hormonal changes (for women, menopause and for men, andropause) make it harder to lose weight. That doesn't mean you can't lose weight, just that you may need to adjust your expectations for a more realistic timeline.
  2. Gender - Men usually have more muscle than women and, as a result, often lose weight faster.
  3. Genes - Some people are genetically predisposed to be obese. Our genes regulate how our bodies store and and burn the energy we get from food and, for some of us, our genes have a tendency to hustle those calories into the body, lock them in and throw away the key. If you have a family history of obesity, there may be a genetic component that makes weight loss harder. However, that doesn't mean you're at the mercy of your genes or that you can't lose weight. In fact, studies show that exercise can actually offset this propensity to hold onto weight.
  4. Stress - Chronic stress can contribute to weight problems in a variety of ways. There are stress hormones (like cortisol) which can increase appetite and fat storage and then there are our responses to stress, which aren't always healthy: Eating too much, drinking too much, escaping with TV or computers and avoiding exercise. Find out if your stress levels are unhealthy and learn how you can manage stress with exercise, breathing exercises, meditation and more.
  5. Sleep - Lack of sleep can also contribute to weight problems, not only because you're too tired to exercise, but because sleep deprivation can affect metabolism and could make you feel hungry, even when you're not.

You may not know exactly how each of these elements factor into your weight problems, but knowing what stands in your way and all the reasons weight loss is hard can ease the frustration a bit and give you more clarity into your situation.

5
Assess Your Expectations

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This may sound strange, but just because you're not losing weight doesn't mean you're not getting results. Often, the results we expect are based on one thing: The scale. If it doesn't move, we decide we're failures regardless of what's actually happening both inside and outside our bodies.

Take some time to find out if you're realistic about weight loss and the results you can expect to see by asking yourself these crucial questions:

  • Are my weight loss goals realistic? - Experts agree that a realistic weight loss goal is to focus on losing about .5 to 2 pounds a week. Any more than that and you would have to cut your calories so low, it may not be sustainable.
  • Am I seeing any results? - Forget about the scale and determine whether there are other changes happening that may indicate you're on the right track such as:
    • Losing inches, even if you're not losing weight
    • Your clothes fit differently
    • You're slimming down somewhere - You may see it as a failure if you're losing weight, but not from the areas you'd like. Maybe you want to lose fat over your abs or thighs, but instead you're seeing weight drop from places you'd like to keep the way they are or from places you don't care about. We can't choose where the fat comes off and, just because it's not coming off according to your expectations doesn't mean it isn't happening. Pay attention to all the changes in your body and you may find you really are getting results.
  • Have I giving myself enough time to see results? - It often takes 3 or more months to see significant changes and, for most people, it will take up to a year. And, keep in mind that the process isn't always linear. Unless you're perfect 100% of the time with your diet and exercise program, you won't lose weight at the same rate from week to week. It takes years of bad habits to gain weight, so expect to spend more than a few weeks to undo those habits and take the weight off.
  • Are there other benefits I'm getting beyond the scale? - Results don't only just show up in the scale - They show up in your mind and your body. Are you getting anything else out of your exercise and weight loss program? Do you feel better? Sleep better? Feel stronger? Make a list and refer back to it if you ever feel discouraged.

If you're not getting the results you expect, it's crucial to find out if it's because of something you're doing (or not doing) or if it's because you're expecting something your body just can't deliver. If you're having trouble, consider hiring a personal trainer who can help you set more realistic goals.

Sources:

Ahmad T, Chasman D, Mora S., et al. The Fat-Mass and Obesity-Associated (FTO) gene, physical activity, and risk of incident cardiovascular events in white women

Berman M, Lavizzo-Mourey Obesity Prevention in the Information Age. JAMA. 2008;300(4):433-435.

Rampersaud E, Braxton M, Pollin T. Physical Activity and the Association of Common FTO Gene Variants With Body Mass Index and Obesity. Arch Intern Med. 2008;168(16):1791-1797.

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