Overcoming Weight Loss Plateaus: Evidence-Based Nutritional and Behavioral Strategies—A Narrative Review

Abstract

A weight plateau is a common and clinically challenging occurrence in weight management, marked by stable body weight despite adherence to physical exercise and a diet low in calories. This phenomenon can hinder progress and motivation. While several theories exist regarding its cause, effective clinical interventions remain limited. This review explores evidence-based strategies to overcome weight plateaus in clinical practice, examines physiological and behavioral contributors, and synthesizes current approaches into a practical framework to guide healthcare providers in supporting patients through plateau phases. A narrative review was conducted using peer-reviewed literature sourced from PubMed, Google Scholar, Scopus, and Web of Science. The search included studies published between 2007 and 2024, using keywords such as “weight plateau,” “dietary intervention,” “physical activity,” “energy restriction,” and “clinical strategies.” Human studies, clinical trials, and systematic reviews were prioritized. Weight plateaus are multifactorial, involving metabolic adaptation, hormonal shifts, and behavioral fatigue. Effective strategies include adjusting macronutrient distribution, intermittent energy restriction, circadian-aligned meal timing, and combining aerobic and resistance training. Additional interventions include enhancing non-exercise activity thermogenesis (NEAT) and identifying underlying health issues. High-protein, ketogenic, and very low-calorie diets (VLCDs) might be applied selectively under supervision. While evidence supports individualized strategies, consensus on standardized protocols is lacking. This review supports individualized, multifaceted interventions and emphasizes the need for further research to establish evidence-based clinical guidelines.