By Tamara Duker Freuman for U.S. News
Collectively, my patients have shed thousands of pounds through our work together. I've worked with preteens through octogenarians; men and women; healthy folks and others struggling with chronic diseases. While each patient's weight-loss journey is unique, there are some common threads I've observed along the way:
The number on the scale is not a precise measurement of your weight -- at least no more so than the account balance listed on your monthly bank statement is a precise representation of your wealth.
How much money do you have? It depends on when you check your bank account and can vary wildly even over the course of a day. Five minutes after your paycheck is directly deposited, you may appear flush, but once your monthly mortgage payment is automatically deducted six hours later, the picture changes significantly. Your bank account is a dynamic entity in constant flux, with deposits flowing in and bill payments flowing out. A snapshot at any moment in time -- such as the balance presented in your monthly bank statement -- may be the best indicator you have as to the state of your financial affairs, but it's not a static truth. A more accurate way to assess your financial status might be to consider your average account balance each week or perhaps for the month.
So, too, is the case with weight. My patients tend to fixate on the scale's pronouncement at consultations every other week. If the number is down, they're elated. If it's up, they're despondent. And yet, that number is a random snapshot of a single moment -- one of hundreds of thousands of moments in a week. Moments during which time their body is storing fat and burning it; retaining excess fluid and excreting it; fasting and recently fed; relatively empty of waste or just about to eliminate it. While a single scale measurement may be the most convenient indicator we have about directional trends in one's body mass, it's certainly not an irrefutable and precise truth.
I often ask my patients about their weight range when weighing daily (or weekly) at home. A rolling average of those numbers tends to be a more useful indicator of upward or downward trends than any single scale measurement in my office.
Your weight loss goal is a behavior, not a number. As the discussion above suggests, many factors contribute to the number on your scale at a specific moment in time, and not all of them are within your direct control. It can be extremely demoralizing then to set a numerical weight as your goal and not be fully equipped to achieve it.
A good weight-loss goal is something both controllable and measurable. I often counsel my patients seeking weight loss to focus on factors entirely within their control -- an eating or exercise behavior change -- rather than a factor not entirely within their control -- like a number on the scale. "I will go to the gym two times this week for 60 minutes each session" is a fully controllable and measurable goal. "I will lose 2 pounds this week" is not. In my experience, when the behaviors are in place, the weight loss follows.
Weight loss is not a linear process. If I read one more analogy likening the body to a car, I will scream. Our bodies are not machines that spit out uniform miles per gallon when "fuel" inputs are constant. And expert bodies have moved away from the long-held dogma that a 3,500-calorie deficit yields a pound of weight loss in all people under all circumstances. Contrary to what you've been told by countless experts who rely on this simple math, cutting out 100 calories per day for a year does not guarantee you'll lose 10 pounds in a year.
Meet your metabolism, a term that refers to the amount of energy (in calories) your body requires to complete all of the physical and chemical processes necessary to life, such as transporting oxygen to cells, removing waste from the body, maintaining adequate body temperature, contracting involuntary muscles and producing proteins and hormones.
The so-called metabolic rate adjusts dynamically and constantly in response to a long list of influencers: your age; body composition; exercise; body temperature; illness and stress; whether you're chronically well-fed or chronically malnourished; various hormone levels; and possibly even the type of bacteria residing in your gut!
We clinicians have sophisticated math equations that come reasonably close to predicting how many calories a given person burns in a day, but they are not precise instruments that should be held up as gospel. The complex calculations our bodies use when adjusting the metabolic rate defy our quaint desires for consistency and predictability when it comes to weight management. Your metabolism is a moving target.
Sometimes, available equations come close enough to approximating a given person's metabolic rate such that specified diet changes can reliably produce a desired weight loss of 1 to 2 pounds per week -- at least for a while. But just as often, I'll have patients who eat the same foods day in and day out -- and lose weight in erratic patterns: 4 to 5 pounds in one week, followed by a few weeks of plateau, after which time another small chunk of weight comes off.
In rare but frustrating cases, a patient's food journal suggests they're producing a calorie deficit that should result in a loss… but the scale doesn't budge. While you may average a loss of, say, 1 pound per week over a long period of time, it is unrealistic to expect that pound to come off at exact and regular intervals like clockwork.
Every plateau has a silver lining. At some point in your weight-loss journey, you will hit a plateau. It means you'll have to work even harder to continue to lose weight; even when you break through it, the loss may not continue at the same pace as before.
But consider the bright side: A true weight loss-plateau is your svelter new body's way of telling you this: "I'm so much smaller now that I need far less energy to keep my leaner self going." It also means you've mastered the dietary patterns required to maintain a slimmer new you. That's a major milestone worth recognizing and celebrating. Pause for a moment and enjoy the new skin you're in before setting off on the next leg of your journey!