Weight plateaus are a normal, but frustrating, feature of your weight loss journey


 Here are some words of wisdom and encouragement from a health care professional who knows how discouraging weight loss plateaus can be. Don’t let weight stabilisation lead you to jack in your efforts.
When Losing Weight, Warn ‘em!

Diabetes in Control November 8th 2016

I work in obesity medicine. As many of us know, losing weight isn’t the problem for most, but weight regain is.

As the saying goes for many, you can’t be rich enough or thin enough. Many of our patients come in with unrealistic goals regarding their weight loss, and don’t give themselves enough credit for the weight they have lost. Many, for many reasons, regain.
Woman, 58 years of age, class II obesity, prediabetes (A1C 6.0%), HO depression, on antidepressants, weight of 188, BMI 38. Started on metformin and lower carb meal plan.
Warned her early on it’s not just about losing weight, but what’s important is keeping it off. We need plans for both.
Her treatment plan does not end when she loses weight.  Over 6 months she lost 22 pounds. This is a 12% weight loss. BMI 33.5 now.  No further weight loss since the 6-month period, but no weight gain.
Patient frustrated. She has upped her exercise. No longer wants to continue metformin. Encouraged her to continue her meal plan, metformin and bump up her exercise plan. Praised her for her weight loss and not regaining.  And, reminded her this is what we discussed from the start. She remembered and said she’ll stay with the plan.
Lessons Learned:
  • Keeping weight off is a different stage of the weight loss journey.
  • Reminder that losing 3-5% total body weight can improve health outcomes.
  • 5-7% weight loss was shown in the DPP to prevent or delay type 2 diabetes.
  • From the beginning, let patients know there are stages to losing weight. First is to lose, then it’s to keep off the weight lost. Make a plan for both.
  • Regarding weight loss, put more emphasis on the food side.
  • Regarding weight maintenance, put more emphasis on exercise.
  • Remind patient of discussion and encourage patient to embrace the weight loss they have been able to achieve and keep off.


Margaret Coles: Invite this Physiotherapist into your home

At  www.movingtherapy.co.uk. you can find Margaret Cole’s free educational resource to help your health and well being.


Margaret worked as a community physiotherapist and when she retired she decided to put her knowledge and experience to good use. She produced videos covering a lot of different situations that you can face regarding your physical and mental states and has put them on the site. She also gives advice on how to lose weight.   People from all over the world have visited the site since 2011.

NHSinform Scotland and her local authority also promote the site.



Gloomy news if you are overweight

diabetes in cats
He’s a pudgy pussy – but may have a better chance than humans of getting slim again

Obese Have Low Chance of Recovering Normal Body Weight

From Diabetes in Control July 17th 2016

The chance of an obese person attaining normal body weight is 1 in 210 for men and 1 in 124 for women, increasing to 1 in 1,290 for men and 1 in 677 for women with severe obesity, according to a study of UK health records led by King’s College London. The findings suggest that current weight management programmes focused on dieting and exercise are not effective in tackling obesity at population level.

The research, funded by the National Institute for Health Research (NIHR), tracked the weight of 278,982 participants (129,194 men and 149,788) women using electronic health records from 2004 to 2014. The study looked at the probability of obese patients attaining normal weight or a 5% reduction in body weight; patients who received bariatric surgery were excluded from the study. A minimum of three body mass index (BMI) records per patient was used to estimate weight changes.

The annual chance of obese patients achieving five per cent weight loss was 1 in 12 for men and 1 in 10 for women. For those people who achieved five per cent weight loss, 53 per cent regained this weight within two years and 78 percent had regained the weight within five years.

Overall, only 1,283 men and 2,245 women with a BMI of 30-35 reached their normal body weight, equivalent to an annual probability of 1 in 210 for men and 1 in 124 for women; for those with a BMI above 40, the odds increased to 1 in 1,290 for men and 1 in 677 for women with severe obesity.

Weight cycling, with both increases and decreases in body weight, was also observed in more than a third of patients. The study concludes that current obesity treatments are failing to achieve sustained weight loss for the majority of obese patients.

Dr. Alison Fildes, first author from the Division of Health and Social Care Research at King’s College London (and now based at UCL), said: ‘Losing 5 to 10 per cent of your body weight has been shown to have meaningful health benefits and is often recommended as a weight loss target. These findings highlight how difficult it is for people with obesity to achieve and maintain even small amounts of weight loss.’

“The main treatment options offered to obese patients in the UK are weight management programmes accessed via their GP. This evidence suggests the current system is not working for the vast majority of obese patients.” “Once an adult becomes obese, it is very unlikely that they will return to a healthy body weight. New approaches are urgently needed to deal with this issue. Obesity treatments should focus on preventing overweight and obese patients gaining further weight, while also helping those that do lose weight to keep it off. More importantly, priority needs to be placed on preventing weight gain in the first place.”

Professor Martin Gulliford, senior author from the Division of Health and Social Care Research at King’s College London, said: “Current strategies to tackle obesity, which mainly focus on cutting calories and boosting physical activity, are failing to help the majority of obese patients to shed weight and maintain that weight loss. The greatest opportunity for stemming the current obesity epidemic is in wider-reaching public health policies to prevent obesity in the population.”

Kings College London News Release
Alison Fildes. American Journal of Public Health. Published online ahead of print July 16, 2015: e1–e6. doi:10.2105/AJPH.2015.302773

Public Health Collaboration Website – Live


The Public Health Collaboration (PHC) website is now live!

The website promotes the PHC, a non-profit organisation that is focused on supporting research and investigating pressing health concerns in the UK. and one of its members is our very own Dr Katharine Morrison.

The PHC was set up because members have become concerned about the rates of obesity (25 percent of adults) and type 2 diabetes in the UK, which has risen by 65 percent in the past 10 years.  The current ‘solutions’ being used to tackle the issues just aren’t working.

The PHC will be publishing solution-based reports on a quarterly basis, alongside running co-ordinated campaigns and implementing initiatives to improve public health. There’s also a conference scheduled for June.

Read more about the work of the PHC here.

Book review and discussion: What experts say about solving the obesity epidemic

“The shape we are in: how junk food and diets are shortening our lives” by journalist Sarah Boseley is a £13 paperback in which many of the factors that have contributed to the obesity epidemic are discussed.

For much of her material Sarah has gone to obesity “experts” but not a single low carber.  So she has ended up with a  different opinion from what we may have on the causes of the massive surge in obesity over the last 30 years.  Although I don’t share the government “experts” view as to the benefits of a low fat diet,  I think that reading the opinion of “the other side” is a good way to broaden my view and possibly learn a few things that could actually improve the situation. With this in mind I was looking for what I recognise is familiar and  true and also had a chuckle at some of the material as well.

Very little was contentious. I have starred * my own contributions (which I would have given had she interviewed me!)

Behavioural changes at family/individual level: 

Eat meals at meal times at a table with your family. Make meals from proper food. Not processed junk.

Stop dieting and eat good food all the time.

Reduce the amount of processed food that we eat.

Do 45 minutes or more exercise a day to improve mood and use calories.

Don’t snack or eat only healthy snacks such as nuts, cheese and fruit.

Stair climb and walk at every opportunity.

Health service changes:

Offer cognitive behavioural therapy to the overweight.

Expand the provision of bariatric counselling and probably offer this at younger ages.

Advertise the futility and actual harm of crash diets and make such an idea an object of ridicule.

Advise on muscle building exercise for all*

Advise on the benefits on health and physique of the low carb diet*

Educational changes:

Teach cooking in primary school and beyond.

Expand the range of foods served in schools.

Stop serving puddings in schools.

Political changes: 

Tax sugary drinks.

Stop junk food sponsorship of sports events.

Have proper labelling of food.

Subsidise fresh, wholesome food.

Ban sugary food in schools hospitals and workplaces.

Put in cycle paths, street lighting, pavements and redesign towns to make walking attractive.

Have stairs, showers and secure bike parks in offices.

Limit fast food advertising especially to children.

Give proper meal breaks in the workplace.

Put calories/carbs on drinks as well as food.

Food production and service changes:

Reduce portion sizes.

Stop check out sweets and goodies marketed to children.

Stop buy one get one free promotions.

Cut salt, sugar and fat in manufactured foods.

Get food manufacturers to produce more genuinely healthy products.

Decrease plate sizes at buffets.

Actually, I don’t have any gripe with these.  I would simply say that my idea of good food is meat/fish/eggs/cheese/nuts/veg and some fruit with butter, cream, olive, coconut and avocado oil NOT starch, fruit juice, industrial fats. I would also prioritise weight /resistance training over cardio because it make you burn more calories, makes you stronger, doesn’t wear out your joints, and reduces osteoporosis better than cardio.

As you can see the obesity problem and therefore solution is multi-factorial. There are things we can do ourselves, but there  is a much wider framework regarding political will, town planning, working hours and facilities, food manufacturing and advertising, food costing, and education by health services, schools and the media.

We can’t go back to the so called “Good Old Days” like this attractive, affluent, family circa 1949. Will the government get so fed up with the devastating health bill that that they will take some of the steps outlined in Sarah’s book? Or will corporate interests, the low fat/high starch dogma and the high working hours culture win out?