digest
Short Summary
Main recommendation: If you stall on a keto or low-carb diet, be patient and keep going for about a month before concluding you have a true plateau, while measuring calories rather than eyeballing them, since high-fat foods like oil, cream, cheese, and mayonnaise add up quickly. Dr. Eric Westman explains that the body adjusts its metabolism in response to energy loss, so weight loss often comes in a stair-step pattern rather than a steady line.
Key Points
- A stall is not a lack of weight loss over one or two days; Westman defines a true plateau as no weight loss for about a month.
- Dr. Westman says studies show the body partly lowers its metabolic rate to hold on to energy, but this reduction is smaller on a low-carb, high-fat diet.
- Losing inches while the scale doesn't move is a good sign, since body shape can change before weight does.
- Common stall-causing factors include antibiotics (possibly via gut bacteria changes) and medications such as steroids, nasal sprays, oral medicines, or joint injections.
- Dr. Westman says, based on his own observation, that fluid retention seems to make weight loss harder in hot, humid summer months.
- Dairy and artificial sweeteners affect some people but not others, and the only way to know is to test them personally.
Details Worth Noting
- Concrete instructions:
- Measure calories or track intake in an app instead of guessing, especially with oils, creams, cheeses, and mayonnaise.
- Avoid drinking calorie-containing items such as cream and oils; choose zero-calorie drinks.
- If you're unsure about dairy sensitivity, cut it out for one week and observe the result.
- If you suspect artificial sweeteners affect you, cut them out for one week and observe.
- Once you have lost a substantial amount (for example, after the first 100 pounds of a 200-pound goal), lower calorie intake further, and consider intermittent fasting, such as eating once a day.
- Without regular physical activity, calories must be reduced even more; if you rely only on food for weight loss, lower intake accordingly.
- Use a body composition analyzer to tell whether changes reflect fluid retention.
- Westman says he wouldn't call this adjustment pattern common, and in his clinic he tells patients to keep going because the weight typically drops again later.
- Calorie-dense items are a frequent cause of stalls for people who are not measuring their food.
- He notes that antibiotics may slow weight loss, probably due to gut bacteria changes, and says this research is new.
Bottom Line
Stalls are usually temporary adjustments, so the practical approach is to keep measuring intake, stay consistent for about a month, and test suspected triggers like dairy or sweeteners one at a time.
