When things start to plateau during a fat loss phase, my go-to is to add a planned refeed (a day where we intentionally look to increase intake, such as double the current amount of daily carbohydrates) for a number of reasons. Firstly, it allows for the client to avoid 'diet fatigue' without feeling like they are straying of program or 'cheating'. Second, the occasional refeed can help avoid metabolic down regulation (the burning of less calories to perform daily physiological functions) or the body working to achieve homeostasis on a lower caloric amount, which keeps the body in caloric deficit. Finally, the additional calories can help refuel glycogen stores in the muscle which will provide higher levels of energy leading to more productive sessions where more calories are burnt during training and in the recovery period. The planned refeeds can also have a positive impact on mood, feelings of well being and overall levels of motivation to continue to fat loss program - all of which greatly increases the likelihood of success.
When patients hit weight loss plateaus, one unconventional strategy I use is to go deeper than just diet and exercise. I start by running functional labs and fasting labs to see what's really going on physiologically. From there, I layer in the Metabolic Approach to Health's 10 Terrain framework, which helps me understand the bigger picture of what's keeping their body stuck. I look at the epigenetic terrain, blood sugar regulation and metabolism, environmental toxin load and detoxification capacity, immune function, microbiome balance, angiogenesis and circulation, hormone health, levels of inflammation, mental and emotional well-being, and stress and nervous system regulation. For some patients, the terrain that needs attention is the epigenome or microbiome, while for others it's more about hormones, immune balance, or toxic exposures. Once we know which terrains are at play, we can make much more precise shifts—sometimes that means reducing high-intensity exercise for someone with adrenal burnout, or focusing on detoxification strategies when toxins are driving inflammation. This works because many plateaus are less about calories in/calories out and more about hidden imbalances across these terrains. When we identify and address the root cause through testing and terrain mapping, the body naturally starts moving again.