If you’re struggling to keep up your weight loss momentum, listen in to learn what kinds of simple changes can help you get back on track. You’ll hear the honest questions you should be asking yourself, as well as my top ten suggestions for getting those pounds to start coming off again.
Katrina: You are listening to the Weight Loss for Busy Physicians Podcast with Katrina Ubell M.D. Episode number 48.
This is Weight Loss for Busy Physicians, the podcast where busy doctors like you get the practical solutions and support you need to permanently lose the weight and feel better, so that you can have the life you want. This is the resource you’ve been looking for to guide you on the journey to overcome your stress eating and exhaustion and move into freedom around food. Here’s your host, Dr. Katrina Ubell.
Katrina: Hey my friend. How are you? What is up? I’m so glad you’re here with me today on the podcast. So excited to record this podcast for you. I think this one’s kind of a long-time coming. I’ve had a number of questions over the past months about this one. I’m excited to share more with you about what to do when you get into a weight loss plateau.
But first, I want to talk to you about iTunes reviews. Woo-hoo! As of today, as I’m recording this, I had 199 reviews, way more ratings, which is the star ratings, which I totally appreciate.
If you’ve left me a star rating, but have not left me a review, I would so appreciate it if you could go back and just type in a couple of words about the podcast. It doesn’t have to be a lot. It would really, really help the podcast and help other people find us and get the help that they need, which really helps the podcast and helps me. So if you wouldn’t mind doing that, I would totally appreciate it.
Now if you’re also one of these people who listens and is getting good stuff out of this, but hasn’t left me a review, I would really, really, really appreciate it if you could do that. I have told you guys before that my goal is to get 500 reviews, and I’m at 199, so we’ve got a ways to go. Unless we get a bunch of people getting on there, I’m going to be asking for weeks and weeks and weeks at the rate we’re going.
So I would love it if you could just take a quick, quick moment to get onto iTunes either on your computer, which you can even do if you have a PC, or on your iPhone podcast app, the Apple podcast app. And just get on there, find Weight Loss for Busy Physicians, scroll all the way to the bottom, and it’s super easy now to leave a review. That would be so great if you could do that.
Listen I have two new reviews that I love, that I just have to share with you. One is from mammorad56.
She titles it, “Weight Loss Revelation”. “After winning the genetic lottery for metabolism,” lucky girl, “I was chagrined to see fat finally accumulating around my middle at age 61 after I stopped taking hormone replacement therapy. I felt I should be entitled to just exercise it off like I always had, but this strategy no longer worked. This podcast has provided me with the first new information I have ever heard about weight loss. Lose fat by eating more fat? Who knew? You mean I don’t have to feel guilty about not exercising? I love the podcast and have enjoyed the unexpected pleasure learning new strategies to cope with all aspects of life, even at my advanced age. Thank you for providing this wonderful information.”
You are so, so, so welcome. I do not think 61 is an advanced age. You’re only 20 years older than me, so maybe we’re both advancing. Who knows? The other review is from skicrazy333, which doesn’t she sound super fun? I love that. I wonder if you ski a lot.
She titles it, “The Best Yet”. “Thank you Katrina for doing these podcasts. I have listened to Ditching the Perfectionist three times. My mind is blown. I always thought something was wrong with me, but you nailed what goes through my head. I’m totally happy to do some B minus work and being fine with good enough is good enough. Thank you for helping me through this. Jessica.”
Jessica, you’re so welcome. I have been thinking about doing that topic for a long time, and I am someone who needs to have these topics kind of marinate in my brain for a little while. I need time to think, and so I had been thinking about the perfectionist topic for months, probably at least six months, what would be the best way to convey that to you all, gotten some really good feedback from that podcast episode. I’m so glad that it helped so many of you. That’s so great.
Okay, so today I’m going to talk about a plateau, what you do when you are in a plateau and how we deal with that. I have gotten many comments and questions about this over the last number of months.
Most recently, I got a message from Genny. She writes, “Hi Katrina. I am a fellow physician and found your podcast via a Facebook group. This episode was amazing.” She was referring to Episode Seven. “I have a question about plateaus. I have been doing intermittent fasting and moderately low-carb diet for seven months. I lost 20 pounds in the first couple of months, and since then hit a plateau. Have you seen this with your clients, and how does one get out of it? Thank you.”
So yeah, for sure plateaus are definitely something that we deal with on a regular basis. I definitely lost my weight, I would say in chunks. Nothing would happen, and seriously it would be almost two weeks. I’d even sometimes feel like my clothes were getting looser, but the scales weren’t showing anything at all. Then all of a sudden, I’d lose a pound or two or three. Then again nothing, nothing, nothing.
That’s why it’s so important to get on the scale every day, so that you really start to see the fluctuations that you get. And how what you weigh daily doesn’t even mean that much. The only reason it gets us so upset when we weigh every day is if we give so much meaning to the scale.
Also, if you are fluctuating a lot or nothing’s really moving and your body’s changing. Say you get on the scale a week later or 10 days later and nothing’s changed. Then you start thinking, gosh everything I’ve been doing isn’t working. That doesn’t necessarily mean anything at all. Right? Two or three or four days later, you might have a big drop, but if you don’t get on the scale again for another week or two, then you wouldn’t know.
So in my opinion, for most of my clients, I ask that they weigh every day. I think that’s one of the best things you can do. I thought I was horribly pathologic when I first started doing it, and I think I’ve shared that with you before. It’s great. I absolutely love it. It’s such a great thing to do for yourself.
Let’s first start off by talking about what a plateau is because some people are coming to me three days of no weight loss, and they’re like, “I’m plateaued.” And you definitely are not. It’s only been a couple days.
A plateau in my world is defined as no weight loss for two to three weeks. Okay, so other people may define it in a different way, but as far as my clients and people I work with, I define it as no weight loss for two to three weeks. When you find that it’s been two to three weeks, and your weight has not budged, you need to ask yourself some questions first. Okay? These are the questions.
One, do you have a discreet plan that you’ve been following? What I mean by that is have you really written out how you are eating. How many meals a day are you eating? Are you snacking? What do you eat at your meals? It doesn’t need to be the specific food, but it can be a serving of protein, a serving of salad with fatty dressing, and a serving of cooked vegetables, something like that. I’m just making that up, but you have a basic protocol, a basic skeleton for yourself on how you eat. So then the question is, are you following that.
If you have your plan, do you have it all written out? Or is it just kind of floating around in your head. I strongly recommend that you write it out for yourself. Every time I changed my protocol to get through any kind of plateau, I always had it written out on a sheet of paper sitting on my kitchen island because I swear it would take like 10 days at least for it to become totally stuck in my head, where I really didn’t even need to look at it anymore. I would always look and double check. Am I following this right? Yes, I am.
The next question, are you food journaling every morsel of food that enters your mouth because you know what our brains like to do. Right? What we tend to do is we eat something off plan, and then we promptly forget about it.
This particularly can happen if you save all your food journaling for the end of the day. This happens to me sometimes, and it’s not even just that I’m eating something off plan. It’ll just be that I forgot that I added some avocado to my salad, and I don’t write that down.
So is it so important? It might be. It might be interesting for me to see what happens when I eat avocado and when I don’t eat avocado. That’s why it’s important to have that information on there. If you are not food journaling every single thing you’re eating, every bite, lick, taste, all of the things that you’re consuming, any beverage that might have any caloric content to it, then for sure, that’s gonna be something you’re gonna want to start doing.
Next question. How often are you doing a joy eat? A joy eat is just one food that you’re having. Then the next question is how often are you doing an exception meal. What I call an exception meal is when you have more than one thing off of your plan at a meal. Say you went out to dinner, and you had more wine than you usually do and bread and dessert. Right? That’s not a joy eat. That’s an exception meal.
If you’re doing those pretty regularly, typically, you’re not gonna lose weight when you do an exception meal. That’s just something you’re gonna have to see, but you’re gonna have to keep track of that.
The next question is: Are you planning your food out ahead of time? What I mean by that is like the day before. Okay, so the night before or the day before, planning out literally everything you’re gonna eat. Now I have clients who plan out their whole week at a time, and that works great for them. I personally have never done that. There’s too many different factors that come into play in my life. But if that works for you, and you can plan once for the whole week, let’s do it.
Remember when your food is really constrained, it shouldn’t take you long at all. Literally, less than five minutes, probably more like one to two to just quickly jot down what you’re gonna eat. If you’re not planning your food ahead of time, then what you’re doing is making decisions in the moment.
And guess who makes the decisions in the moment for you, particularly related to food. You’ve got it, your primitive brain. That’s the part of your brain that tells you in the moment, it doesn’t really matter. You can have another serving of fruit. You can have more berries, twice as many berries as you kind of had thought you would. Just those little sneaky things.
It doesn’t have to be going totally off the rails, but when your primitive brain is behind the wheel, you can often find that you’re not really following that plan, not very well at all. So really, really important that you’re planning your food out ahead of time, at least 24 hours in advance, meaning the night before.
Then when you do plan, are you following what you plan to eat 100% of the time. This happens often, where we make a plan, then the next day, oh the plan’s changed, no big deal. But then we’re doing the same thing, making all these decisions from the primitive brain in the moment. That’s what we want to avoid.
With my clients in my big group right now, my Weight Loss for Doctors Only group, we’ve had to work through this so much with so many of them. It’s kind of like under what circumstance is it okay to go off my plan? And when is it not okay? Say you’re planning on eating some salmon, but when you go to heat it up or cook it, it’s bad. Well then clearly, you need to go off your plan and pick something, swap out something that’s similar.
If you have some last-minute plans come up like your parents ask you to come over to eat, that’s fine. But then you need to have your backup plan for what if they don’t have food that works for your plan. Right? Then you don’t eat with them, and you come home and eat something else.
You need to really have that all laid out for yourself, so you’re never finding yourself in that situation where you quote/unquote had to eat whatever, anything. Right? You always have a plan, and then another backup plan. You guys have heard me talking about having plans A through G. Literally having all these plans, all these backups for yourself, so that you can always stay on times. Very important.
The next question. How often are you snacking? As you know, if you’ve listened to the early podcasts, snacking is not something that we do. And definitely, even just a little bit can really derail your efforts.
Then the last question is where on the hunger scale are you when you finish eating? You should be aiming for about a plus four on the hunger scale. If you’re not sure what I’m talking about with the hunger scale and what a plus four means, be sure to go back to Episode Six and listen to that again. That’s gonna give you all the information you need about the hunger scale.
If the answer is no to any of these questions, then you need to make some adjustments on that. Then start following your plan 100% of the time for the next two weeks and see what happens. Very, very often, this is all that needs to be happening. We’ve gotten a little bit slack with things. We’re not really following it exactly as we should be. Or we’re overeating a little bit, eating to maybe a plus five or plus six sometimes or having a number of meals out and thinking, oh it’s not a big deal, but it can make a big deal.
So definitely, those are the things to work through. But if the answer is yes, that you have been doing all these things, and you have been following your plan 100% of the time, then you are in a plateau, and it’s time to tweak that plan. Just like with a medical problem, we don’t change everything all at once. You don’t go from ketogenic diet to like a high-carb diet. I don’t know. Something total ridiculous and crazy, change everything all at once.
If you’ve had a plan that was working for you, and now it just isn’t anymore, then that plan is allowing you to maintain where you are. A plateau, really all it is, is just maintenance. It’s just not maintenance at the weight you want to be at. Okay? When you look at it from a very neutral place like that, it’s not a big deal. It’s just like, okay, if I kept eating this way forever, then I would maintain this weight. Except I’d like to weigh less. That means that I need to change things.
And it doesn’t always mean that you eat less food. I want to make sure that you understand that. When we have that old calories in, calories out kind of way of thinking, we often think that we just need to cut back. Our portions are too big. That maybe true, but if you feel like, no I’m really good at not overeating. I’ve been stopping at a plus four, then there’s a good chance that that’s not what you need. What we need to do is just change up what you’re actually eating, or how often you’re eating.
Really, maybe one or two things could be a problem. Maybe there’s a number of things, but if we pick one or two things that are most likely to be the problem, and then we change those and follow that plan for the next two weeks 100% of the time to see what kind of results we get before we change anything.
I have 10 ideas of things to try here, plus one bonus one. Eating more vegetables, particularly non-starchy ones. Okay? I find that as I get my clients off of flour and sugar, and they’re loving eating all these amazing delicious higher-fat foods, those in particular, who haven’t been big vegetable eaters in the past, will just still not eat very many vegetables. Depending on their bodies and depending on how much weight they have to lose, sometimes they’ll lose a good chunk. And then they won’t anymore.
Also, some of them find that they are eating vegetables, but mostly they are starchy veggies like potatoes, sweet potatoes, other root vegetables, winter squash, things like that. So what we often have to do is start subbing in more vegetables, particularly those non-starchy ones. With the starchy veggies, if we’re having a lot of those, sometimes we’ll alternate those every other day. Or maybe even back them down to just a day or two a week.
Then depending on the person, how close they are to goal, other issues that are going on, sometimes we’ll even take a full break from them for a little while. It kind of depends. We’re never saying you can’t ever eat a potato again. It’s just as we’re trying to break through this plateau and encourage the body to release a little big more body fat, so more vegetables for sure.
Then the next thing is make sure that you have plenty of good fat with these veggies. Always really important. When I mean good fat, I don’t mean things that are deep fried. Anything that is trans-fat, none of that kind of stuff. We’re looking for healthy oils, full-fat dairy, full-fat meat, and olive oil, olives, avocado, guacamole, things like that. That’s what we’re looking for, coconut products.
The next one is cheese and/or nuts. As I said, when we start getting fat adapted, it’s so fun. We get to eat all the cheese and nuts that we want. Right? It’s so amazing. I should probably add nut butters into that too because for me, nuts aren’t a big draw, but nut butter definitely is, peanut butter.
Oftentimes, I find that my clients are using cheese and/or nuts and/or nut butters as kind of like a dessert. And so they’re having like a couple slices of cheese, or they’re having a little handful of nuts at the end of the meal, kind of to signify to themselves that they’re done, or that sort of feels like their dessert to them.
I always remind them, we don’t do dessert because dessert makes us feel like we need a treat after eating. And all we’re doing is fueling our bodies, so dessert isn’t really something that we want to think about.
But what we can do is if you’re thinking of say some nuts as your dessert, then just incorporate them into your meal. I mean you can eat them, it’s just if you’re looking at it like, oh I got to a nice plus four, now I’m having a little bit more as my dessert, then you’re overeating. Right? That’s a problem.
So very often, we’ll lose a bunch of weight, then get into a plateau. Then we have to start reducing the cheese and nuts. Some people decide to take a complete break from the nuts. It depends. Some people find they could eat nuts like they’re candy, you know like it’s popcorn, just like boom, boom, boom. Other people it’s not as big of a draw, same for cheese, But that’s a place to look is cheese and nuts, especially if you’re on a moderately low-carb diet.
Then next one’s alcohol. This is a big one. Right? So many people don’t want to give up their alcohol. You know my stance on that. I’ve talked about that previously on the podcast, but it really comes down to why you’re drinking it, and how it’s making things better in your experience then.
And if you’re finding that you’re really enjoying your wine, and you like your reasons, but you’re not losing weight. That’s a great place to cut back. Again, not saying you can’t ever have any alcohol, just saying cutting back can be very helpful.
The next one is possibly scaling back on the size of a joy eat. Some people will kind of go, oh okay, well the joy eat is this one food, so I’m just going to eat a whole meal of that one food. Say you go to a restaurant where they have those ginormous slices of cake. Right? And you go, okay, well for this whole meal, I’m just gonna have this enormous piece of cake because that will fill me up.
And there’s nothing wrong with that at all, but if you’re in a plateau, then that might be a place to cut back and just go, you know what? I really probably don’t need to eat from like a minus four to a plus four only in cake. Maybe I’ll get to a plus one or plus two with some food that’s fuel for my body, and the rest of it eat in cake.
That might only end up being five or six or seven bites. When you really spend the time enjoying the food, really tasting it, really tuning in, that can be plenty. That can be just enough to make you feel like you got the pleasure out of the food that you wanted.
The next one is reducing the amount of fruit. First, I often will find that clients who eat a lot of tropical fruits like bananas, mango, and pineapple, will end up in a plateau at some point. So sometimes we’ll just try switching to lower sugar fruits like berries and apples and things like that.
But even so, with the berries and apples, sometimes it’s still not working. We’re still not losing. Then we’ll back fruit down to just once a day or maybe even every other day.
Now I have some clients who find the fruit is so sweet, it’s like candy for them. And once they start eating it, like grapes, they just cannot even stop. And they end up eating so many cups of them. Sometimes, we just have to take a complete fruit break because their urges to overeat fruit are so strong, and we want to make sure that we are cutting back on that.
The next one is look at whether you’re having any urges to considerably overeat or binge. If you are binging, even just once a month or even less frequently, that can really slow down your progress. For my clients who have binging issues, I always ask them to tackle the binging first, then we work on losing weight.
Definitely doing any extended fasting or restricting food too much can bring on the urges to binge much more strongly, and it just ends up being this up and down, up and down. You lose some weight, then you binge and gain some back. It’s just, you can imagine trying to be at maintenance, while still binging. It’s just so much more challenging than if it’s not a big deal at all, so for sure dealing with the urges to binge first, and then really focusing on losing the weight.
The next one is possibly less coffee and cream or tea and cream. We often find that those of us who like to just eat two meals a day will have some coffee and cream or tea and cream in the morning. That little bit of straight fat in heavy whipping cream can take away a lot of the hunger and make us feel really satisfied and give us good energy as we go into lunchtime.
But definitely can turn into snacking where people find themselves having two or three coffees in the morning, then between lunch and dinner another coffee. Then after dinner another decaf or another tea and cream.
So the question really then is are you really hungry? And if you are really hungry, can you just be okay with being hungry. Because remember, hunger is just a suggestion to eat, it’s not a requirement. You can let your body dine-in.
Now can you have black coffee or plain tea? For sure. Water, sparkling water, ice tea, any of those things are great. But looking at how much cream you’re having, sometimes that can be a bit of a slippery slope.
The next one is stop exercising. And I’ve discussed that in a previous podcast, how exercising can really actually prevent you from losing weight, particularly if you’re exercising in an intense manner. For sure, that would be something to consider if you’re exercising a lot.
Then number 10, the last one is get more sleep, like a lot more sleep. Okay, so really focusing for the next two weeks on getting lots and lots and lots of sleep. Also, working on active de-stressing, like regular meditation or things like that. For so many of my clients, especially as they reach their goal weight, this plan is so much more of a cortisol and stress-management program than an insulin-management program.
Of course, managing your insulin by the time you get close to your goal is what you’re doing automatically. That’s just kind of what you’re doing. But what they notice is that when they’re managing their stress and keeping their cortisol levels lower, that’s when they actually lose weight. So for sure that’s gonna be a big one.
Then the bonus one that I wanted to mention is just mixing up your fasting. So Gemmy, I don’t know how you’ve been fasting or what kind of hours you’ve been doing. This is very personal, but there’s lots of ways that you can play with your intermittent fasting. Maybe narrowing your eating window a little bit, maybe trying to do a little bit of a longer fast every now and then. And just working your way up to it based on how you feel and what works for you.
So many of my clients love doing a longer fast on a really busy work day because then they don’t even have to think about eating, and they’re so distracted, they barely even notice that they even get hungry, so that would be something to try too.
Finally, I just want to mention the second part of a plateau that you have to handle is managing your thinking. Right? You’re thinking about the plateau, and then also in general. So if you’re doing a good job of not eating your emotions, then you are by default feeling your feelings, which is what we’re trying to do. But that might mean that you’re experiencing a lot of stressful thoughts.
So be sure to do your thought downloads about what’s going on for you and decide what’s working, what’s not. Which thoughts are you useful for you? Which aren’t? Which thoughts are creating the results you want, and which thoughts are not? Then work on changing those.
Also, what are you making the plateau mean? Are you mad at the scale? I get this all the time. I get these emojis of these super angry emojis with the scale. It’s so funny to me. But are you making the plateau mean that you can’t be successful? It doesn’t make any sense to be mad at the scale.
Are you making it mean that your body’s broken, or that your set point can’t be changed? Are you making it mean, screw it. I’ll just go off plan, since following my plan isn’t working. You really need to be aware and tuned into why the plateau is a problem for you because it really can be neutral. Oh, all I need to do is change my eating plan a little bit. Oh, all I need to do is follow my plan 100% of the time.
I see this all the time with my clients where they have a lot of kind of going off and on and off and on little bits, and they’re not really losing. Then they get back on track, and they’re following their plan 100% and like boom, the weight loss goes so much more quick for them. And I’ll always comment to them, “Isn’t it so great to know that your protocol works when you follow it?” That’s so great.
You don’t have to tell yourself, I don’t know. You can’t indulge in confusion or overwhelm or, “I just don’t even know what’s working.” No, you know. It’s working. You just have to follow it. That’s all.
So make sure you get your mindset about your weight loss journey where it needs to be to have success. Get into that growth mindset, which means that you know there’s a solution out there. You just have to find it. Okay? So I’ve given you some good tips, good places to get started with this.
If you have any other questions be sure to head to the show notes page for this podcast, which you can find at katrinaubellmd.com/48, and let me know what you think or any other questions you have. Then for sure, please, please, please leave me an iTunes review. I would love you forever. I mean I already love you forever, but seriously, if you could just do it, I would really, really love you forever.
All right, have a wonderful week. I will talk to you next week. Take care. Bye-bye.
Thanks for joining us on Weight Loss for Busy Physicians. Now, take the next step and go to katrinaubellmd.com to download just what you need, the Busy Doctor’s Quick Start Guide to Effective Weight Loss. Join us again next week for more support to keep you in control and on the path to freedom around food.