Lisa, age 42, was in week 3 of my weight loss program. The first two weeks, Lisa dropped weight at about a pound a week, but this week, there was no change. All that work she did and no result. She looked like she was going to quit on the spot! What happened? Lisa was almost 90% compliant with her exercise and even though it was Chanukah, she felt as though she “deserved” a better outcome for all of her work. She was clearly frustrated and I feared Lisa would just quit and not give her program the chance to work for her in the way it could. When someone gets this result after being more than 80% compliant during the week, what could possibly be the cause of no drop in weight?
First and foremost is Portion Distortion. 
From the point of view of diet, the single biggest reason people don’t lose weight on their food plan is by not fully understanding the size of what one portion of any single food is. Think about it—if you are only eating portions that are 6-7% larger than what you should, by the end of the day, you might be eating an extra portion or two every single day. That will not lead to weight loss! So be careful and see a good registered dietician in order to learn how many portions of food, and what types you should be eating per day and what a portion really is.
Another area to explore has to do with how many times you eat per day and how late in the day 
you are eating. Eating small meals and snacks more often will boost metabolism and also even out your insulin secretions. If you eat too many of your calories late in the day and at night, you don’t use those calories through normal movement and activity. This can, in turn, cause small weight gain and not weight loss. So, make a curfew for yourself and try not to eat after 8 or 8:15 at night.
From the exercise and activity side of the equation, is your exercise routine intense enough? Exercising isn’t a stroll in the park. You should feel some slight exertion if you are walking, biking or swimming or doing any other aerobic program. It has to feel like an effort. Make sure you feel a little uncomfortable-each person according to their own level of fitness. And make sure you are doing your exercise long enough.
Don’t ignore muscle building! Even though you don’t use a ton of calories while you are doing these exercises, this is what gives us the long-term calorie burn. Along with eating more often, it will do a lot toward raising your basic metabolic rate. So you are burning more calories all the time.
Activity plays a part. Aside from formal exercise, are you walking from place to place instead of driving your car or taking a bus? Are you using stairs instead of elevators? Do you have an opportunity to garden or play some leisurely sports? Can you park your car a little further from your destination than you might normally do? Do some gardening! All of this adds up over the course of a year and lead to many additional kilos and pounds being taken off in the long term.
And then there are the other issues of weight loss aside from calories consumed and calories used. Are you sleeping well at night? If you aren’t getting enough sleep and quality sleep, it negatively affects your metabolism. Do you drink enough water each day? In addition to the other negative effects of dehydration, a slower metabolism is also a result. And finally, if you are stressed beyond normal limits, this will also cause your metabolism to lag.
There is one last thing to check out. Have a blood test to see how your thyroid function is doing. A slow thyroid, known as hypothyroid, will make weight loss a very frustrating experience. This is usually easily dealt with by an endocrinologist. Once thyroid function is brought to normal levels, you will probably see better results for all of your efforts. This situation is not very prevalent, but some type of thyroid issue does affect 12% of the population.
Patience!!!! Sometimes, it takes our bodies time to adjust and for everything we are doing to kick in. How long? Weeks or months! The older we are, the more pronounced this problem can become. Stick with your program and keep in mind that while weight loss might take 
time, the other health benefits you are getting from good eating and exercise are quite pronounced. Stay focused, eventually, it all kicks in.
Too much emphasis has been placed on weight loss alone. And to this extent, people have done some very unhealthy things just to lose weight while sacrificing their health. They go on radical diets that reduce calories too much so they don’t get proper nutrition. They eliminate entire categories of food and don’t get proper nutrition. They go on diets that cause loss of muscle and water more than fat weight. Some are left severely constipated and increase their risk of kidney stones and osteoporosis. Many can be protein deficient or vitamin deficient. Some people develop eating disorders in order to lose weight. WHEN WE CONCENTRATE ON OUR HEALTH, WEIGHT LOSS WILL FOLLOW! Keep the emphasis on healthy habits—eating properly and exercising, and everything else that is supposed to happen will follow.
Lisa might be frustrated for now, but focusing on the future benefits of her current investment of time and effort will reward her in so many ways. To sum up, we must make sure we are doing everything we are supposed to do in order to lose weight. Watch the portion distortion, make sure your exercise program is balanced and includes both aerobic and muscle building exercise. Sleep, water consumption, and managing your stress properly are also integral to successful weight loss. Don’t do things that are radical and harmful to your health in order to lose weight—they will only backfire on you and you will regain your weight anyway and may damage your health. It’s true that the number on the scale isn’t the only ingredient to good health, but it sure is a very important one.
Even if you don’t get to your goal weight, every kilogram you lose is health gained. Putting it all together for slow and steady weight loss will “add hours to your day, days to your year and years to your life.”
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