Overcoming Plateaus
Developed by Dr. Jessica Yu, Clinical Psychologist
Introduction to Overcoming Plateaus
You’ve been eating carefully and sticking to your program but your weight isn’t changing. What gives?
Weight loss plateaus.
Even though they’re a natural part of the weight loss journey, hitting a plateau can feel like hitting the brakes on our goals. What can we do to get our momentum back?
There’s a method.
Overcoming Plateaus uses three skills from cognitive behavioral therapy (CBT) to help us get back on track:
Self-monitoring
Problem solving
Goal setting
Let’s look at what a plateau is and how we apply these skills to overcome them.
What Causes Plateaus?
At the beginning of weight loss treatment, we tend to experience early and rapid weight loss. After some time, our weight loss can stall—making it difficult to lose more weight or avoid regaining it.
While everyone’s journey is unique, weight loss plateaus typically occur between 6 and 16 months1. A few factors exist as to why:
Genetics: 40% to 70% of our BMI is attributable to our genetic makeup2. Meaning, if we have family members who struggle with overweight and obesity, we’re more likely to encounter the same issues.
Environment: For Americans especially, our environment can make weight loss challenging. Inexpensive and highly processed foods, sitting at your desk for hours at a time, and cities that are built for driving more than walking can all contribute to a weight loss plateau3.
Physiological responses to weight loss: Our body is still wired to survive so when we start losing weight (especially if it happens rapidly) our metabolism slows down to conserve calories and energy, which can increase our appetite and slow weight loss.
Adaptation: When it comes to exercise in particular, we tend to see and feel differences in our body in the first few weeks. After about 16 weeks, our body adapts and we may not see the same results.
Overcoming Plateaus
Some weight loss factors are unchangeable (looking at you, genetics)—but many can be addressed through evidence-based interventions like cognitive behavioral therapy (CBT).
Skills to practice:
1. Self-monitoring
In CBT, self-monitoring is often the very first skill patients learn because it increases awareness of problematic behaviors (and thoughts and feelings) — /and awareness is a precursor to change. Self-monitoring helps us objectively assess how we’re doing, increases motivation for change or treatment, and allows us to see our progress over time if done regularly.
2. Problem solving
Problem solving follows self-monitoring—empowering us with the confidence, resilience, and tools to view challenges, roadblocks, and stressful experiences as opportunities to implement solutions, rather than as insurmountable obstacles
3. Goal setting
Goal setting is a process that helps us identify specific goals and how they’ll be achieved. Goal setting goes hand-in-hand with self-monitoring and problem solving. Self-monitoring helps us identify a problem. Problem solving helps us identify a solution. Goal setting helps us work towards our solution.
Tips to Overcome a Plateau
It’s important to remember plateaus are par for the course—and often out of our control.
Almost all individuals engaged in weight loss interventions experience a plateau at some point4. With the right skills and tools, we can overcome each one that stands in our way.
For example:
Self-monitoring might help us identify that lack of regular exercise could be slowing weight loss.
Problem solving might help us discover that a new exercise routine can reignite our enthusiasm and commitment to it.
Goal setting can help us set an intention and plan to start a new exercise class.
Self-monitoring
Using a journal, we can use self-monitoring to track behaviors that may be influencing our plateau for at least 1-2 weeks, keeping a log of:
Diet: Notice what, when, and where eating takes place. What’s the context around it? Was it in response to an emotion? Are we eating in order to be social?
Exercise: How often are we exercising? What kind of exercise is it?
Sleep: Are we keeping a consistent sleep schedule? Feeling well rested during the day? Or are we staying up late and eating into the night?
Water: How often are we drinking water? Are we drinking more caloric beverages over water? Are we eating when we may actually be thirsty?
After 1-2 weeks, review data and look for any interesting or problematic patterns.
Find the full CBT course on Problem-Solving in the Hims app for more information.
Problem solving
Once you’ve identified a problematic pattern, you can move into problem solving.
Step 1: Identify the problem.
Step 2: Brainstorm all possible solutions.
Step 3: Consider the pros and cons of each solution.
Step 4: Choose a solution to implement.
Step 5: Implement the solution.
Step 6: Assess how well the solution is working.
For example, we may identify the problem as late night snacking while staying up late for work. Possible solutions could include avoiding work after hours, closing the kitchen after a certain time, and stocking the pantry with only healthy snacks.
Goal setting
Once we’ve chosen a solution to implement, we can set our goals. Experts recommend SMART goals5 — goals that are:
Specific
Measurable
Achievable
Relevant
Time-bound
For example a SMART goal look like this:
“I will close the kitchen after 8 PM each night so as not to engage in late night snacking that gets in the way of my weight loss. I’ll start this next Monday and aim to achieve this goal at least four nights of the week for the next two weeks before increasing the goal.”
Goal setting should also come with action planning—a clear plan for what steps may be necessary to achieve the stated goal.
In the example above, the action plan could include setting an alarm for 8 PM each night and putting notes on the pantry or refrigerator doors to discourage late night snacking.
Next steps
Weight loss plateaus are part of the process—but they’re also possible to overcome with the right tools. Check out more CBT skills in the Hims app to identify any current plateaus that might be in the way of weight loss.