I hear it all the time: “But I’m doing everything right! Why am I not losing weight?”

If you’re one of these people, you know that the simple calories-in, calories-out formula doesn’t necessarily work for weight loss. There are a number of reasons why this might be the case.

Check Your Hormones

One of the most common causes of inability to lose weight (and the easiest to fix) is hypothyroidism. The thyroid regulates your metabolism, and if it’s sluggish, you’re going to have a hard time getting the weight off.

A related hormonal condition is adrenal fatigue. Your adrenals are the glands that help you to handle stress. When they’re overworked, sometimes they will tell your thyroid to slow down: too much cortisol (the stress hormone) encourages the thyroid to create more reverse T3, which will block the regular T3 receptors, making you look hypothyroid even if you are not.

Too much estrogen relative to progesterone, or estrogen dominance, can also make weight loss a challenge—one reason why menopause often leads to weight gain. (In menopause all the sex hormones decline; this can also mean low testosterone, the “male” sex hormone which encourages muscle mass production, thereby speeding up metabolism. So, estrogen dominance combined with low testosterone can be a perfect storm for weight gain in menopause.)

Check Your Carb Intake

I know, I know… you’re already doing this. Or at least you think you are, and maybe you really are! But the best way to find out for sure is to write down everything you eat for a week (keep a diet diary). Many people who tell me they eat really well find this to be an eye-opening exercise.

Another way to get a little more scientific about it is to make sure you’re in nutritional ketosis, meaning you’re burning fat instead of sugar (i.e. what you’ve stored instead of what you’ve just eaten). A cheap and easy way to keep track of this is to go get urine ketone strips at your local pharmacy. Urinate on the strips at the same time every day to make sure you’re in ketosis. If you’re not, it means you’re eating more carbs than you think you are. Add in extra medium chain fatty acids (such as coconut oil or full fat coconut milk), decrease your carbs even more, and make sure you’re keeping your protein levels moderate, as even protein can convert to glucose in the liver. Keep playing with the ratios until you’re in ketosis.

Shake Up Your Routine

Your body is incredibly adaptive and efficient. What that means is, if you do the same thing over and over again, your body will learn how to perform that activity with minimal effort (i.e. burning minimal calories). The best way to burst free of this phenomenon is to change up your routine.

Try consuming the same amount of calories over the period of a week… but vary the total from day to day significantly (one day under and another day over-consuming your recommended caloric intake, as long as the weekly total remains the same). Another great way to shake it up is to try intermittent fasting. Studies show this helps to improve insulin sensitivity, meaning you’ll use your glucose more efficiently. 

Likewise, with exercise: if you do the exercise bike at a particular speed every day at the same time, try the stair-stepper instead… or better yet, substitute strength training for a cardio day. Strength training will help you to build more muscle, which in turn will lead to a faster metabolism, even at rest. If you’re a runner, try interval training: walk for a few minutes, then jog for a few, then sprint full out for one, and then go back to walking.

No matter what variation you choose, if your body isn’t used to it, it won’t be nearly as calorically efficient at that task. This is a good way to push through a plateau.

If your problem is that you’re not monitoring your food intake or exercising at all, and are having a hard time creating positive habits, check out this article on motivation!

Get Enough Sleep

Most adults require 7-9 hours of sleep per night, and 8 is probably the average for most of us. If you’re getting less than 7 on a regular basis, that means your body is producing cortisol (the adrenal stress hormone, which will keep your blood sugar high) for more hours of the day than it should be. Sugar gets stored as triglycerides, which gets stored in adipose tissue (fat cells). This is probably the main reason why there’s an inverse correlation between hours of sleep and BMI.

If you’re not sleeping enough, or not sleeping well, this will also contribute to adrenal fatigue, which will contribute to a sluggish thyroid… and round and round we go.

The Upshot:

If you’re in a weight loss plateau, don’t despair (and don’t go on a binge diet!) Get your hormones checked, make sure you’re getting plenty of sleep, and shake up your workout and calorie intake routine. If all else fails, make sure you’re staying in nutritional ketosis.

Plateaus happen in every journey. Sometimes it just takes a little time to get past them.