Sudden Weight Plateau

Question
Hi Laurie, thanks for taking my question.

I am a relatively healthy 44 year old woman. I am 5'4" and weigh 210lbs. Between April and September I lost 30 pounds.

In June I was diagnosed with hypothyroidism and put on .025mg/day of Levothroxine. No change in rate of weight loss.

In October I was diagnosed with PCOS and put on Metformin. I am now on 1000mg/day of Metformin. Rate of weight loss has changed. I have been unable to lose any weight since being put on the Metformin. I抳e been on it almost six weeks.

My diet change beginning in April was more of a lifestyle change. I stopped eating all processed food. I eat mostly low glycemic foods, lean proteins and a lot of fruits and vegetables. I抳e been trying to eat less meat, and more vegetable proteins, such as quinoa, beans and things like egg whites (obviously not a vegetable lol). I stay away from soy because my husband is deathly allergic to it so I don抰 allow it in the house. I make all my meals and never have fast food. We eat dinner out maybe twice a month.

I cannot exercise because I have a knee injury which requires surgery. I will be having surgery next year. I have limited mobility and cannot walk up or down stairs. Squatting or bending my knee at all is very painful.

So, nothing in my diet has really changed except for the addition of medications. I can抰 figure out how to get off this plateau. It抯 devastating to me. I抦 in pretty good health. My last physical was great and my blood work in August was really good (normal fasting blood sugar, cholesterol 160).

I take supplements, some of which are a good multivitamin, fish oil, and probiotics.

What can I do to start losing weight again? It抯 been six weeks of eating really well and not losing any weight.

Answer
Hello Isabelle,

Congratulations on losing 30 pounds, and on doing it the right way!
It's great that the weight came off so fast without "dieting". Rather, you changed to healthy eating habits.

It would seem that the thyroid medication would have boosted your weight loss and it's surprising you were able to lose so well when you were hypothyroid.

I'm not educated in the effects Metformin or PCOS have on metabolism and/or weight loss, so I cannot speak to those.

A couple of things do come to mind:

1) Perhaps your thyroid prescription needs some 'tweaking'. Often people are started on a dose and then have follow-up blood tests and exams. Is there a chance your doctor wants to see you again regarding the dosage, and possibly will increase it?

2) Often when people stop losing weight, the reason is that they have changed their diet, but it's just sort of snuck up on them. You rationalize you are still eating the healthy way that helped you lose weight, but allowing yourself a 'treat' now and then because you've been doing so well! Often these treats add up to enough to keep you from losing weight.
I would suggest keeping a food diary for a week, and then checking back in to see if you are  really eating as well as you think you are.

3) You are eating a healthy diet, and you are not gaining weight. What is there to be devastated about! If you aren't suffering and starving and depriving yourself, then just enjoy your newfound healthy eating habits :)

4) And one last idea: If you were eating, for example 1900 calories a day and losing weight when you weighed 240 pounds, keep in mind that you don't burn as many calories now that you weigh 30 pounds less. You might have to reduce your calories a bit, or perhaps find an exercise that you can do to burn a few hundred calories a day. Perhaps a seated rowing machine would work for you, or upper arm exercises. There are special programs to exercise when people require remaining seated. Your best bet would be to ask your physician to refer you to a specialized exercise program for your condition.

Keep up the good work and your plateau may just take care of itself in time :)

Laurie

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