Stuck At The Same Weight? US Doctor Explains Why Diet And Exercise Alone Don't Always Work

Dr Thomas Paloschi, a US-based longevity physician, lists seven reasons you are not losing weight

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If weight loss progress has stalled, it is worth looking at the bigger picture
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Summary is AI-generated, newsroom-reviewed
  • Experts list seven reasons why diet and exercise alone do not always work
  • Poor sleep increases calorie intake by about 300 kcal per day and affects hunger
  • Ultra-processed foods disrupt hunger regulation and metabolism, causing weight gain
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Hitting a weight loss plateau can feel frustrating, especially when you are sticking to a healthy diet and staying consistent with exercise. Many people assume that eating less and moving more should always lead to steady results, but the human body does not work that simply. Several hidden factors can slow or even stall progress. Understanding why this happens is the first step toward making progress and finding a more effective approach to weight management.

Dr Thomas Paloschi lists down the reasons you are not losing weight. In a post shared on Instagram, he writes, "Weight regulation is influenced by far more than diet and exercise alone. If progress has stalled, it is worth looking at the bigger picture: sleep quality, insulin resistance, food quality, ultra-processed food intake, daily movement outside the gym, medications, hormone shifts such as PCOS or menopause and overall metabolic health."

Reasons You Are Stuck In A Weight Loss Plateau
1. You may be moving less without noticing

You might unknowingly reduce your overall energy expenditure outside of workouts by being less active in daily life. This includes regular activities like walking, standing and spontaneous movement.

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2. Sleep loss

Poor sleep can affect your hunger, food cravings and even your food intake. "A systematic review found that sleep restriction increases daily calorie intake by about 300 kcal/day on average," he adds.

3. Ultra-processed food

Ultra-processed foods can stall weight loss and trigger plateaus by interfering with how your body regulates hunger, metabolism and fat storage. Dr Thomas discusses a controlled trial where people ate about 500 more kcal/day on an ultra-processed diet. In 14 days, they gained about 0.9 kg, while the unprocessed phase led to weight loss.

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4. Insulin resistance
Insulin resistance changes how the body stores and uses energy. It is often linked to visceral fat, fatty liver, high triglycerides and poorer glucose control.

5. PCOS and Menopause

Polycystic Ovary Syndrome is strongly linked to insulin resistance. In Menopause, lower estrogen often shifts fat storage toward the abdomen. That is why the same strategy that worked earlier in life may stop working later.

6. Medications

Some medications can make fat loss harder, including certain antidepressants, antipsychotics, glucocorticoids, insulin, some diabetes drugs and blood pressure medications.

7. Mitochondria are relevant

Mitochondria help cells produce energy efficiently. When mitochondrial function is impaired, metabolic health may suffer. This is often linked to insulin resistance and poorer energy regulation.

Do not reduce fat loss to calories and exercise alone. When progress stalls, the issue is often deeper: sleep, hormones, insulin resistance, satiety, medications and metabolic adaptation. "Sometimes the answer is not pushing harder. It is correcting the biology that is holding you back," the doctor concludes.

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