“I’ve hit a weight loss plateau and I don’t know why.”
We hear some version of this all the time at High Country Wellness.
Maybe you’ve already lost weight, but now you’re struggling with the last 5, 10, or 15 pounds. Maybe you’re taking a GLP-1 and were seeing steady progress until suddenly…the scale stopped moving. Or maybe the things that worked for you five or ten years ago simply aren’t working anymore.
It’s frustrating. And it’s very easy to assume the answer is to eat less, exercise more, or push harder. But a weight loss plateau doesn’t necessarily mean you’re doing something wrong. Your body changes as you lose weight, your energy needs can change, your hunger, daily movement, muscle mass, hormones, sleep, stress, nutrition, and exercise habits can all affect what happens next.
And for women entering perimenopause or menopause and men experiencing changes in testosterone, there may be another layer to consider.
So before you slash your calories, add another workout, or assume your GLP-1 has “stopped working,” here are some of the things we look at with our patients.
First: Why Do Weight Loss Plateaus Happen?
A true weight loss plateau is a period when your weight stops decreasing despite continuing the habits or treatment that previously resulted in weight loss.
And plateaus are normal!!!
As you lose weight, your body generally requires less energy than it did at a higher body weight. There can also be changes in appetite, energy expenditure and spontaneous daily movement. This is sometimes referred to as metabolic adaptation.
That doesn’t mean your metabolism is “broken.” It means the same strategy that worked at the beginning of your weight loss journey may need to be reevaluated as your body changes.
There’s another piece we think is important: the scale isn’t the only measure of progress.
At High Country Wellness, we care about body composition, not just body weight.
Someone can lose body fat, build or preserve muscle and improve their metabolic health without seeing a dramatic change on the scale. That’s one reason we use body composition scans as part of our medical weight loss programs.
The goal isn’t to make you weigh less necessarily. We want to help you lose fat while protecting the muscle that supports your strength, metabolism and long-term health.
What If You’re Taking a GLP-1 and Stop Losing Weight?
This is an especially common concern among patients using GLP-1 medications for medical weight loss. GLP-1s can be incredibly helpful tools, but they aren’t magic, and hitting a plateau doesn’t automatically mean your dose needs to go up.
Medication is only one piece of the picture. If your progress has slowed, we may look at your nutrition, protein intake, muscle mass, strength training, daily activity, sleep, stress, alcohol intake, hormones, metabolic health and how your body is responding to treatment.
Sometimes there are underlying metabolic issues that need time and attention as well. If someone comes to us with significant insulin resistance or other metabolic dysfunction, for example, there may be important improvements happening internally before the scale reflects the progress they expect to see.
This is also why individualized medical weight loss care matters. Your treatment should be based on what your body is doing, not an arbitrary dosing schedule you found online.
1. Look at Your Nutrition, Especially Protein
I know, I know. You have probably heard “eat more protein” approximately one million trillion times. But there’s a reason we keep talking about it, really!
Protein is particularly important during weight loss because we don’t want all of the weight you lose to come from lean tissue. We want to preserve, and ideally build, muscle while reducing body fat.
Protein can also help with satiety, making meals more satisfying and helping you stay fuller longer.
And if you’re taking a GLP-1 and your appetite has significantly decreased, getting enough protein can become even more important. Eating less isn’t necessarily the goal if the foods you are eating aren’t giving your body what it needs.
How Much Protein Do You Need?
Your ideal protein intake depends on your body size, health, activity level, goals and other individual factors.
We usually recommend .8g-1g of protein per lb of body weight.
But rather than obsessing over a perfect number, one of the simplest places to start is making sure you’re intentionally including a quality source of protein throughout your day.
Easy Ways to Eat More Protein
You don’t need to completely overhaul your diet. Try building meals around a protein source first. Keep easy options around for busy days: Greek yogurt, cottage cheese, eggs, rotisserie chicken, tuna, lean meat, beans, edamame or whatever works for your preferences.
You can also:
Add chickpeas or beans to salads and bowls.
Use Greek yogurt in place of sour cream.
Keep hard-boiled eggs, cottage cheese or jerky available for quick snacks.
Find a protein shake or bar you enjoy.
Add protein powder to a morning smoothie.
Prep a protein source ahead of time so dinner doesn’t start from zero.
It doesn’t have to be fancy!
2. Look at the Type of Exercise You’re Doing
More exercise does not automatically mean better results.
If you’re frustrated with your weight, it’s tempting to start piling on cardio or adding workout after workout, but we don’t want you exercising simply to burn off what you ate. We want to build muscle.
Why Strength Training Matters for Weight Loss
Resistance training helps preserve and build lean muscle while you’re losing weight. That’s especially important when you’re using a GLP-1 because significant weight loss can include both fat mass and lean mass.
Think squats, lunges, rows, presses, deadlifts, resistance bands, machines or bodyweight exercises. And no, you don’t have to become a bodybuilder.
For many people, 2–3 full-body resistance-training sessions each week can be a realistic place to start. The goal is progressive overload: gradually challenging your muscles more over time as you get stronger.
Strength Training During Perimenopause and Menopause
This becomes especially important for women as they enter perimenopause and menopause. Hormonal changes during midlife can coincide with changes in body composition, muscle and bone health. Resistance training gives us a powerful tool for maintaining strength, preserving lean tissue and supporting healthy aging.
And no, lifting weights is not automatically going to make you “bulky.” For most women, that’s not how it works. If anything, the strong, lean, “toned” appearance many women tell us they want requires muscle.
And Men: This Applies to You Too
Men experiencing low testosterone symptoms may notice changes in strength, muscle mass, motivation, energy and body composition.
If you’re working harder in the gym but struggling to build or maintain muscle, or noticing more abdominal fat despite your efforts, it may be worth looking beyond calories and workouts. That’s one reason we evaluate both metabolic and hormone health when appropriate rather than treating every weight concern exactly the same way.
3. Don’t Ignore Stress and Sleep
You cannot talk about sustainable weight loss without talking about what happens during the other 23 hours of your day. Chronic stress can affect sleep, appetite, food choices and how much energy you have to move and exercise. Poor sleep can make that cycle even harder.
Think about what happens after a terrible night of sleep.
You’re exhausted. You skip your morning walk. You want something quick for lunch. You’re hungrier by mid-afternoon. Your workout sounds miserable. By 8 p.m., you just want to sit on the couch and snack.
One bad night isn’t going to ruin your progress, but when poor sleep and high stress become your normal, all of those small effects can add up. This is also where hormone health may enter the conversation.
A woman waking up repeatedly because of hot flashes or night sweats has a different problem to solve than someone who needs a better bedtime routine. A man dealing with low energy, poor sleep and other symptoms alongside low testosterone deserves a more complete evaluation than “try harder.”
Context matters.
4. Be Honest About Alcohol (Without Giving Up Fun in Life)
We’re not going to tell you that you can never have a drink again. We live in the High Country. There are breweries, wineries, restaurants, football games, holidays and dinners with friends. You should be able to enjoy your life.
But if you’ve hit a plateau, alcohol is worth looking at (honestly).
Alcohol adds calories quickly, particularly with craft beer, sugary cocktails and multiple drinks over the course of an evening. It can also affect sleep and may make it harder to make the food and movement choices you intended to make the next day.
It’s often a cascade effect rather than just the calories in one drink. That doesn’t mean you need to cut it out completely.
Try:
Swapping an IPA for a lighter beer or seltzer sometimes.
Choosing soda water and lime instead of sugary mixers.
Using lower-sugar mixers.
Eating a balanced meal before drinking.
Deciding ahead of time how many drinks you want.
Alternating alcoholic drinks with water.
The goal is never restriction, it’s just about being more aware and making simple swaps!
5. Look at How Much You Move Outside of Your Workouts
You went to your workout class twice this week. Great. But what happened during the rest of the week?
One part of energy expenditure that often gets overlooked is non-exercise activity: all the movement you do that isn’t a formal workout.
Walking the dog, gardening, cleaning the house, taking the stairs, playing with your kids or grandkids, walking around downtown Boone, getting up from your desk between meetings.
All of it counts.
And as people lose weight or eat fewer calories, spontaneous movement can sometimes decrease without them realizing it. You’re tired, so you sit more. You don’t take the extra walk. You park closer. You spend a little more time on the couch. You don’t need another brutal workout, you may just need to move more throughout your normal day!
6. Consider Whether Your Hormones Are Part of the Picture
This is where weight loss advice can get overly simplistic.
Weight loss still involves energy balance, but that doesn’t mean every person struggling with their weight has the exact same circumstances.
For women, perimenopause and menopause can bring changes in estrogen and other hormones alongside changes in sleep, muscle mass, fat distribution, appetite, energy and body composition.
For men, low testosterone can occur alongside decreased muscle mass, increased body fat, low energy, reduced motivation, changes in sexual health and difficulty maintaining the strength they once had.
At High Country Wellness, we don’t necessarily separate a “weight problem” from everything else happening in your body. We look at your symptoms, labs, health history, body composition, lifestyle and goals together.
For some patients, that may mean medical weight loss alone. For others, it may mean combining weight management with hormone replacement therapy (HRT) or weight management with testosterone replacement therapy (TRT).
Before You Decide You Need to Try Harder…
Take a look at the full picture.
Are you eating enough protein?
Are you doing strength training?
Are you moving throughout the day?
How are you sleeping?
How much stress are you carrying?
Has alcohol slowly become a bigger part of the weekend than you realized?
Are you preserving muscle as you lose weight?
Have your hormones or metabolic health been properly evaluated?
And, perhaps most importantly, are you actually at a plateau, or are you relying entirely on the scale to tell you whether you’re making progress?
There isn’t a tea, supplement, workout, step count or “perfect” GLP-1 dose that’s going to magically solve a weight loss plateau. And sometimes, pushing harder is the wrong answer (yep, you heard us!!)
Weight Loss Help in Boone, NC
If you’re doing “all the right things” and still feel stuck, you don’t have to keep guessing.
At High Country Wellness in Boone, North Carolina, we work with women and men throughout the High Country who want to better understand what’s happening with their weight, metabolism and hormones.
Our approach includes comprehensive lab testing, GLP-1 medical weight loss treatment, body composition tracking, nutrition and lifestyle guidance, health coaching, hormone replacement therapy for women in perimenopause and menopause, and testosterone replacement therapy for men when clinically appropriate.
If you’ve hit a weight loss plateau or feel like your body has stopped responding to what used to work, schedule a Welcome Call with High Country Wellness. We’ll talk through what’s been going on, answer your questions and help you determine what the next step may look like.
Talk soon!
Stephanie Johnson, MN, APRN, FNP-C
Founder of High Country Wellness
FAQs
Why have I stopped losing weight on a GLP-1?
Weight loss can slow or plateau while taking a GLP-1 medication. As you lose weight, your body’s energy needs change, and factors like nutrition, muscle mass, daily movement, sleep, stress, alcohol intake, metabolic health, and hormones may also affect your progress. A plateau doesn’t automatically mean your medication isn’t working or that you need a higher dose. It’s a good time to look at the full picture with your provider.
How long does a weight loss plateau last?
There isn’t a set amount of time. Day-to-day and week-to-week weight fluctuations are normal, so a few days, or even a couple of weeks, without a change on the scale doesn’t necessarily mean you’ve hit a true plateau. We also look at body composition, measurements, strength, symptoms, and other markers of progress rather than relying on weight alone.
Should I increase my GLP-1 dose if I stop losing weight?
Not necessarily. A higher dose isn’t automatically the answer when weight loss slows. We as your provider would consider how you’re responding to your current dose, side effects, appetite, nutrition, body composition, activity level, and overall health before making medication adjustments. At High Country Wellness, GLP-1 dosing is individualized rather than increased just because you’ve reached a certain point in treatment.
Can perimenopause or menopause make it harder to lose weight?
Hormonal changes during perimenopause and menopause can affect body composition, fat distribution, muscle mass, sleep, and other factors related to weight management. That doesn’t mean weight gain is inevitable, but it may mean the strategies that worked earlier in your life need to change. For some women, addressing hormone symptoms alongside nutrition, strength training, and metabolic health may be an important part of the bigger picture.
Can low testosterone make it harder for men to lose fat?
Low testosterone can be associated with changes in muscle mass, body fat, energy, motivation, and overall body composition. However, difficulty losing weight alone doesn’t mean you have low testosterone. If weight or body-composition changes are happening alongside symptoms such as low energy, decreased libido, reduced strength, or loss of motivation, a clinical evaluation and appropriate lab testing can help determine what’s going on.
Why am I losing inches but not weight?
The number on the scale doesn’t tell you how much of your body is fat versus muscle. If you’re strength training, eating adequate protein, and losing body fat while maintaining or building lean muscle, your body composition can improve even when your weight changes very little. That’s why we use body composition measurements at High Country Wellness to look beyond the scale.