I work with many patients who feel like they are doing everything to lose weight and still don’t see the scale budge. After taking a closer look into their diet, I have come up with some reasons why you may not be losing weight like you think you should:

1. The little things are adding up

Extra calories add up fast once you start to dig in and take a deeper look into your diet. Having a taste here or there, adding extra condiments, drinking your calories, having an extra portion of food at meals, and mindless snacking can all add up. For steady weight loss (usually 1-2 lbs/week) this would be about a 500 to 1,000 calorie deficit per day. It becomes very easy to eat above your calorie deficit goal, and many times these small chunks of calories here and there add up to hundreds of calories sometimes. So just be mindful and truthful with yourself. 

2. You may already be healthy

Some people live an active lifestyle, have already on added sugars and junk foods, eat plenty of fruits and vegetables and still don’t see the scale budge. Maybe you don’t need to lose weight? Many people are technically overweight and are very healthy. One example is that elderly people are actually at a healthy weight and have lower mortality when their BMI is between 25 and 29. Another example is there are people who may be thin, but metabolically are unhealthy. I recommend not just looking at weight but also looking at other indicators of health such as cholesterol levels, blood pressure, visceral fat (fat that increases cardiovascular disease risk), glucose tolerance tests, etc. Weight is NOT the only indicator for health. There is a lot of grey area in this topic, but talk to your physician if weight loss is necessary based on your circumstances.

3. Be patient

If you just started making lifestyle changes recently, give the scale time to show your weight loss efforts. One of my favorite podcasts on Sigma Nutrition Radio has an episode called “The Poor, Misunderstood Calorie” that dives deep into this topic. Essentially, there is a lot of factors that affect weight and I recommend look at trends over time rather than obsess of fluctuations on a daily basis. Usually weighing yourself once per week is good enough to see trends. (However, if you have heart failure I would recommend daily weights to assess fluid retention status, but that topic is for another time)

4. Medical condition

If you have been diligent with your diet and truly feel like something is wrong, bring it up to your doctor. There are certain diagnosis or medications that affect weight and it can feel like an uphill battle if you try to restrict your diet with no changes in weight. Some conditions include hypothyroidism and PCOS, and some medications can cause weight gain as well.