Ch 23: Managing Weight Loss Plateaus and Maintaining Weight Loss Flashcards
Successful weight loss is a challenging endeavor for many. There are numerous obstacles to success; these barriers include
Physiological, psychological, and environmental factors.
Two major challenges that people face include:
Weight-loss plateaus and preventing weight regain
Only 17% of adults in the United States sustain a 10% weight loss after 1 year
A period of stalled progress of 1 month or longer.
Plateau
The amount of calories consumed compared to the amount of calories expended.
Energy Balance
Ways to kickstart a Plateau
Tracking Food, Moving More, Cutting Carbs, Increasing Hydration
The degree to which an individual sticks with a diet.
Dietary Adherence
Main reason for a weight-loss plateau
An increase in energy intake so that energy intake matches energy expenditure is the main reason
Key factor behind lack of weight loss
Online tools that can help give projected weight loss
National Institute of Diabetes and Digestive and Kidney Diseases Body Weight Planner
Obese people who have lost weight.
Reduced Obese
Causes of Dietary Adherence Lapses
Physiological
Psychological
Environmental
Physiological
Increase in Appetite
There is a biological drive to increase calorie intake by approximately 100 calories for every kilogram of weight loss
Psychological causes for weight loss plateau
Situational Barriers and Resisting Temptation
Stress-Related Eating
Decision Makingpeople surrounded with vending machines full of familiar, palatable foods will spontaneously overeat by up to 54% above their maintenance calories
Confusion
Perception of Choice
Difficulty with Meal and Snack Plan
Lower Palatability
Environmental causes for weight loss plateau
The abundance of hyperpalatable, energy-dense foods
–People will spontaneously overeat when surrounded with highly palatable food.
–People surrounded with vending machines full of familiar, palatable foods will spontaneously overeat by up to 54% above their maintenance calories
each clients how to construct their food environment so that highly palatable, energy-dense foods are not readily available.
Environmental causes for weight loss plateau
- Social and Cultural Contexts
- Cost
- Work-related issues
- Portion Sizes
- Family Support
What is the main reason for a weight loss plateau?
An increase in energy intake so energy intake matches energy expenditure.
Periods of body weight plateaus where a client practices maintenance of habits and becomes used to the new body weight.
Maintenance Practice
Plateaus Stair Step Progression
(Cognitive Reframing: Breaking through Weight Loss Plateau)
Build a proper mindset from the onset
It is important to educate client on the near certainty of plateaus (Normal part of weight loss journey)
“Maintenance Practice”
“Opportunities to test Program Sustainability)
Re-Establishing an Energy Deficit
Reducing energy intake, increasing energy expenditure, or by both
Decreasing energy intake can be done in at least one of three ways:
- Reduction in energy density of food choices (i.e., food with similar volume but less calories)
- Reduction in portion size
- Reduction in frequency of intake
Underreporting is a frequent problem
Increasing energy expenditure can be done in one of three ways:
Increasing formal exercise volume
Increasing non-exercise physical activity
Increasing recreational physical activity
Guidelines on how to choose to decrease calorie intake, increase energy expenditure, or do both
- If there is room to decrease calorie intake and a client’s self-reported hunger levels are not too high, then reducing calorie intake may be the best method.
- If there is room to decrease calorie intake but hunger levels are high, then an increase in activity may be a better option.
- If calorie intake is already low and the client is reporting accurately, then an increase in activity is preferable.
- If calorie intake is low but underreporting is suspected, then an increase in calorie intake (to improve adherence) or efforts to improve self-reporting accuracy combined with an increase in activity may be best.
- If there is not much room to increase formal exercise in the client’s daily schedule, then efforts to improve recreational activity or nonexercise activity (particularly in short bouts throughout the day) may work best.
A greater-than-expected decrease in energy expenditure due to weight loss.
Metabolic Adaptation
Manipulation of dietary components to improve satiety
One component that can be manipulated is the size of the energy deficit. While larger deficits may result in greater weight loss and possibly create more buy-in, they do so at the expense of greater hunger and possibly lower adherence
The quality and composition of the diet can also be modified to improve satiety
Associated with greater satiety
- Lower energy density, higher protein, and higher fiber intakes are all associated with greater satiety
- Reducing food variety and palatability can also help improve satiety
- Higher physical activity levels are associated with better adherence
- Modified foods (such as artificially sweetened foods) can enhance adherence through the substitution of lower-calorie versions of a person’s preferred foods