You've been shedding pounds like a pooch drops fur in the dog days of summer, and then, suddenly, things come to a screeching halt. Don't be discouraged; you've hit a plateau and there are actions you can take to break through it.
A phteao—-which I define as an inexplicable pause in weight loss that cannot be traced back to dietary misdemeanors or lifestyle changes—-is not an uncommon occurfence. It usually happens in the later stages of weight loss, after the easy pounds have come off. Fortunately, plateaus are seldom permanent. I counsel a calm approach to the problem, followed, if necessary, by aggressive action. But first you have to figure out if you're really on a plateau.
The Definition of a Plateau
If a pause in weight loss is a genuine plateau, I require that it meet the following criteria:
·You have experienced no weight loss or loss of inches for at least four weeks. (increased muscle mass will decalve the scale because muscle weighs more than fat-but inches will continue to disappear.)
·You have not started a new medication, such as hormone therapy, altered your exercise regimen or made any other significant lifestyle change.
·You have examined your physical state carefully and are able to conclude that you have no symptoms indicative of a diet-related disorder (see Chapters 24-27) or a thyroid problem.
·You can take a close look at your eating habits and honestly say that you've adhered to the same healthy, controlled carbohydrate eating plan that has brought you success up to now.
Now let's examine these criteria one by one.
Losing Pounds Isn't Everything
For too many of us, trying to lose weight induces a fixation on the bathroom scale. I have patients who get upset when the scale doesn't show a change for three consecutive days, so you can imagine how crazy they get when it doesn't budge for four weeks.
Remember two things: First, your body is not a machine. Nor is it a duplicate of anyone else's body. It has its own system, its own agenda, and its own timetable. In the long run, it nearly always responds to sensible management by the person in charge—you. But, in the short mn, your body may decide to go its own way, for its own reasons, which perhaps we don't understand. Don't get mad at it. It's a good body or it wouldn't have gotten you this far. Be patient; you can afford to outwait it,
Second, loss of pounds is not the only way to measure success. Look at the other markers. Are you feeling better than you used to? Do you have the energy to do things you want to do? If so, then something is happening to your body. Do your clothes feel looser? Have you tried on those clothes that "felt a little too tight" just a few weeks ago? I hope you've followed my advice about measuring your chest, waist, hips, thighs, and upper arms. If you're losing inches, the scale will eventually catch up.
Did Somethlng Happen?
If you're losing neither inches nor pounds and four weeks have passed, let's consider the next possibility.
People frequently get frustrated after a week or two without weight loss, when a lime reflection 'would tell them what's gone wrong. Certainly if you've been put on some new medication including hormone treatment or birth control pills—around the time you stopped losing, you'll need to consider its possible metabolic effects. Turn to Chapter 20 for guidance in dealing with this problem. Medications are a common and often formidable obstaele to weight loss, and I outline many of the problem drugs and chemicals in that chapter and offer alternatives that a physician may be able to prescribe for you.
Significant changes in your lifestyle also can alter the rate at which you consume energy daily. Maybe you've been hit with an urgent deadline at the office and you've been glued to your chair for three weeks. No more lunehtime walks, no more half-hour sessions at your health club and no more tenblock strolls with your spouse after dinner because you've been eating too late.
If you've reached OWL (see Chapter 14) or PreMaintenance (see Chapter 16), changes like those could be enough to halt your loss for a few weeks. Not only are you burning fewer calories, but when you get less exercise, your metabolism tends to slow down Oust ns increasing exercise revs it up). Dear reader,from a health perspective, exercise is a beautiful thing. I just wish I could inject a love-exercise gene into all my patients—-and readers. It would make their lives a lot easier.
Having mentioned lifestyle, I wouldn't want you to forget the obvious. Have you been living it up on a vacation, eating all sorts of foods of dubious carbohydrate content? Did the holidays come and, with them, four hors-d'oeuvre-laden parties in the past three weeks? And now you're blaming me? If so, I hope this makes you blush, and I hope you had a good time. Not guilty? Well, then, let's look at a more serious panoply of problems that might cause your weight loss to plateau.
Yeast, Food Intolerances and Thyroid Problems
Perhaps, as you have moved through the weight loss phases of Addns, you have inadvertently added into your regimen a particular food that is triggering a metabolic reaction. This reaction can cause you to hit a weight loss plateau.
In Part Four, I discuss problems that I've long referred to as diet-related disorders. These aren't problems that arise from embarking on a weight loss program. I'm using the word diet in its larger sense, to signify, simply, the types of foods you eat. So let's take a quick look at some of those disorders to see if they might account for your plateau.
YEAST
If you've been eating a high-sugar diet for years, it's quite possible that your digestive tract has an overgrowth of an orgenism called Cand/da aibicans. In addition to overgrowth of yeast in the gastrointestinal tract, most people also experience an allergic inflammation of the mucous membranes throughout the body. This can result from exposure to environmental mold (in your cellar, for example) or eating foods that contain yeast. Symptoms include constipation, diarrhea, gas, bloating, heartburn and even abdominal pain and rectal or vaginal itching. All are a sign of yeast overgrowth in the mucous membranes. Symptoms such as fatigue, depression, headaches (even migraines), post-nasal drip, brain fog and water retention are often signs of allergy resulting from ex posure to environmental mold or mold in food products such as cheese and nuts.
In addition to its other annoying or painful symptoms, Candiada overgrowth or allergy can keep you from losing weight by causing cravings for sweets. Indulging those crav ings will cause unstable blood sugar and more carbohydrate cravings. Canalida thrives on Sugar, but with Atkins you've already sent all that wretched, tempting sweet stuff into deep Siberian exile. However, Atkins does allow cheese, nuts, vinegar, mushrooms and pickle-all of which are aged or fermented items and will provoke symptoms. If you discover or suspect you have a yeast problem, those foods will have to go for at least some period of time to give your body a rest from exposure.
Here are some examples of how a yeast problem could lead to a weight loss plateau. Say you had always been sen sitive to a food such as cheese, but were eating very little or none while you were on a low-fat regimen. When you started doing Atkins, you began to eat more cheese, which eventually triggered a yeast overgrowth or allergy. Another scenario: You were prescribed an antibiotic for a sinus infec tion, and that triggered an overgrowth of yeast. Yet another possibility is that the increased environ 'mental mold typical of humid summer weather might have tipped you over the edge. Finally, hormonal changes can trigger yeast reactions. Any of these could cause your weight loss efforts to stall. Although the mechanism that links yeast to aplatean.is not well understood I have observed this to bea problem in many patients,and they had to address it to make progress in their weight losselforts, if you feel you might be sensitive to yeast, take the "Yeast Symptoms"questionnnaire on page 332. if you have a major yeast problem, your engine will most likely stall out at some point in the prigran, so-even if your only concern is weight loss-take care.
FOOD INTOLERANCES
I believe that food allergies (more properly called indived. ual food intolerances) to substances other than yeast can be a major roadblock to weight loss. Without knowing it you may have added to your meal plan a food to which you are allergic. Wheat and wheat products are frequently culprits. Other common problem foods include milk, cheese, eggs and soy. Eating a food to which you're allergic may cause symptoms such as gastrointestinal or respiratory problems, joint pain and skin eruptions.1-2 From the point of view of someone trying to slim down, the most damaging aspect of eating a food to which you're allergic is its tendency to cause cravings, which, if indulged, can lead to unstable blood sugar. Your real challenge will be to discover that you have a food intolerance in the first place and then to determine which food is the culprit. Please read Chapter 26 carefully.
THYROID PROBLEMS
The other diet-related disorder that can cause a weight loss plateau concerns the thyroid gland. This remarkable lit tle butterfiy-shaped organ regulates the production of energy in our cells. If it becomes underactive-a condition called hypothyroidism, which is not uncommon ns you age or de velop hormonal imbalances you will become sluggish and overweight. Whenever a person is incapable of losing weight on the best weight loss program available (namely, this one), my first suspicion is a thyroid problem. If nothing I tell you here or elsewhere works for you, then mm directly to Chapter 20 and follow the detailed advice it contains on how to diagnose and treat an underactive thyroid (see pages 269-271). This is one problem for which You'll certainly need a doctor's assistance. forbunately, treatments for hypothyroidism are straightforward and generally quite effective.
If you lost weight initially doing Atkins but now have plateaued, that does not necessarily exclude a thyroid explanation. Prolonged dieting (of any type) will sometimes cause reduction in thyroid funotion.3 Your body, feeling a little disturbed at all the pounds you're taking off, is playing with your "set point," the weight level it thinks it ought to keep you at to prevent starvation. Heed the thyroid discussion in Chapter 20 and you,Il get things back on track.
If you have any one of these three diet-related disordersyeast, food intolerances or thyroid problems—you must seriously address it or in time it will make your life an utter misery.
Of course, I hope that your problems are simpler ones. Many of you, in fact, will find that your plateau is easily solved in the next section.
Carb Creep?
Could it be that you've gotten sloppy? Are you doing whatever weight loss phase of Atkins you are now in with the same rigor with which you began it? Or has success gone to your head?
Perhaps you're the victim of an innocent error. It may be that those 5-gram increases in your carbohydrate intake have gotten out of hand and you've done a lot more of them than you think you did. Search your memory, examine exactly what you've been eating over the past five or six days, and compare it to what you were eating a few weeks ago. I've seen people who, once they really put their noses to the carb counter, discovered that it was 30 grams and not 5 or 10 that they had added on. Keeping a food diary is an indispensable tool for keeping an eye on your food intake and connecting it with patterns that may hinder progress.
Is it possible that you may have forgotten some of the rules of Atkins? Let's mn down the list of possible errors:
·Did you go to the supermarket and pick up low-fat foods? Always remember that manufacturers make up for the flavor missing in these foods by adding high carb fillers and sugar. Not only do such dreadful artifi cial foods have no place when doing Atkins but most of them are spectacularly unhealthy. Pry open the lid on file garbage can and stuff them in. That's where they be long.
·Check for the hidden carbs in prepared foods. Many canned and dried soups, salad dressings, sauces and gravies and frozen vegetables in sauce contain thickeners suchan cornstarch, fillers such as milk solids and even sugar.
·Watch out for condiments. Barbecue sauce, ketchup and sandwich spreads often have added sugar in one form or another. Teriyaki sauce? Three grams of carbohydrate in one tablespoon. If it's your passion, you need to count the carbs. A tablespoon of skim milk or lemon juice each has 1 gram of carbohydrate, a tablespoon of balsamic vinegar more than 2 grams. The numbers add up, especially if your "tablespoon" is more like a quarter-cup splash.
·Avoid aspartarne. Although the cause is as yet unknown, clinical observations show that certain individuals find weight loss slows with excessive intake of anpartame, the artificial sweetener sold as NutraSweet and Equal.
·Stay out of the java jungle. Excessive caffeine (found not only in coffee but in tea. chocolate and many soft drink) has been shown to cause a hypoglycemic (Low blood sugar) reaction, which will provoke cravings and cause you to overeat.4 Omitting caffeine may be a big sacrifice for you, but, in my experience, weight loss often sm up again as soon as people remove aspartame and caffeine from their regimen.
·Don't go whole hog on the cheese and nuts. These are acceptable foods, but they do contain some carbohy drates. If you've been munching without mercy, scale back the cheese and nuts. Then see what happens. Not much? Cut them out altogether for a week or two and see if that has an effect.
Breaking Free
If you've looked through all the suggestions i've just of. fered and found precious few clues to explain why your weight loss efforts are stalled, you may indeed be on a plateau. If you've been on many diets in your lifetime, you may be surprised to discover that you've plateaued at the same point in the past. These are the weights at which your body naturally starts to resist weight logs. h may be that your perception of what you should weigh is inappropriate and unhealthy, it's unlikely that at 45 you can be quite as slim as you were at 18. It may be that if you are unable to lose, it's because you are already where you should be.
And if that definitely isn't the case, you really should lose more. Don't panic—the fat-burning engine usually starts up again.
I recommend spending a week in close examination of what you're eating. You might want to keep that food diary I mentioned earlier. It's easy to forget one or two spots of indulgence. Try backing off your carbs slightly. Take away the last 5 grams of carbohydrate you permitted yourself. You may have slipped slightly above your CCLL.
If you have not been in lipolysis for a while and are now stuck, you may want to gradually lower your cad) level by 5-gram increments until your lipolysis test strips turn purple again, lfall else fails, it's time to go back to Induction. Three to five days in Induction will usually start weight loss moving again. Sometimes the body just needs a little nudge. Then, when you move beyond Induction apin, skl on the carbohydrates a little more cautiously tlum you did before. It's quite possible that you have a fairly high degree of metabolic resistance.
If you're serious about following Atkins for life, I must reiterate that you have to invest some energy in exercise. Contrary to the messages our society generally sends us, your body was meant to move. Sitting around is unnatural. Working in an office is unnatural. A whole lot of modem life is unnatural. Parking in the far comer of the parking lot is not a mistake. It's where you should be, because exercise is not optional. It's an integral part of doing Atkins. It's often neglected and sometimes quietly scorned, but if you think you're doing the program and you're not exercising, you're not doing the program. This may be the time for you to read Chapter 22. Building exercise into your lifestyle is one of the most intelligent ways of cracking through a plateau.
Discouraging as a plateau may be, you can't let it beat you. It may comfort you to hear that some individuals lose weight in a pattern of plateauing for a month, then taking a dip of four or more pounds, plateauing again and so on. If you get discouraged and start to cheat before seeing results, you will sabotage your success. Read this chapter once, twice or three times if you have to, but be convinced. You will win out in the end.
KEY POINTS!
·A plateau is a halt in weight loss that lasts at least a month and has nothing to do with changes in food intake or lifestyle.
·Plateaus ire natural and not uncommon in lam' stages of weight loss.
·Causes for plateaus include adding a new medication, reduction in activity level, yeast and thyroid problems and food intolerances.
·Getting sloppy about counting carts or not being vigilant about watching for hidden carbs in condiments and other foods is different from being on a plateau.
·If a plateau does not come to an end, it may mean you are truly metabolically resistant and need to tv, ad Chapter 20.
A FREQUENTLY ASKED QUESTION:
My husband and l are both doing Atkins, but he zips along losing regularly even though he sometimes cheats. I follow the program religiously but have hit several plateaus. Do men have an advantage doing Atkins?
Yes, they do. Unfortunately, weight loss is not an equal opportunity activity. Gender and age play a role. There are at least three reasons that most men particularly young men-tend to lose more easily than women-particularly older women. First, men generally have greater muscle mass than women so they burn more calories than women do. Second, a woman's body is much more subject to hormonal fluctuations, which can play havoc with your blood-sugar and insulin response. Finally, estrogen supresses thyroid function, which.in turn slows your metabolism, making it more difficult to lose weight.
TIPS:
·A food diary and a carb gram counter are powerful tools to help you understand what may be blocking weight loss.
·Avoid aspartame and cut out all caffeine, candy (including sugar-free types), cheese, nuts and condiments and you may break through a plateau.
·Try reducing your carb intake by 5 grams a clay; then, if necessary, by 10 grams, if:weight loss is still stalled, go back to the Induction phase for three to five days.