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Join host Chase Hendrickson, MD, from Vanderbilt University Medical Center, in a discussion about a recent study in The Journal of Clinical Endocrinology & Metabolism that reports on the benefits of older weight-loss medications in a population of women with polycystic ovary syndrome (PCOS). Much of the attention today in obesity medicine focuses on GLP-1 receptor agonists. However, these medications are not treatment options for many of our patients, so we thought this paper asked important questions that we would want to know the answers to. Dr. Hendrickson talks with Na Shen, MD, from the University of California, Los Angeles, and guest expert Stanley G. Korenman, MD, also from UCLA. The article featured this month, by Bandeira Marchesan et al, was first published in JCEM in September 2024: “Topiramate Added to Metformin for Obesity Control in Women With Polycystic Ovary Syndrome.” Show notes can be found at https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series/efl060 — podcast home page: https://www.endocrine.org/journals/endocrine-feedback-loop-podcast-series

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"Could This Be Alzheimer’s Game-Changer? $COYA CEO Reveals GLP-1 Breakthroughs" Nature Magazine has recently covered GLP-1 receptor agonists (GLP-1RAs) in depth, particularly in a January 2025 article in Nature Medicine titled "Mapping the effectiveness and risks of GLP-1 receptor agonists." This study analyzed a massive dataset from the U.S. Department of Veterans Affairs, looking at over 215,000 people with diabetes who started GLP-1RAs compared to those on other diabetes meds. The findings are pretty striking for cognitive health: folks taking GLP-1 drugs showed a reduced risk of neurocognitive conditions, including dementia and Alzheimer’s disease. Specifically, the study found a lower incidence of these disorders compared to people on traditional diabetes treatments like sulfonylureas or DPP4 inhibitors. It’s not just a small dip either—the data suggests a meaningful protective effect on the brain. Coya Therapeutics CEO Arun Swaminathan updates the listeners on where ($COYA Impact Stock) is positioned with their treatments concerning the data presented so far and some new initiatives that $COYA feels the science makes the choice easy. Coya's anti-inflammatory therapy, in conjunction with a GLP1 product, could have a more impactful positive response than one of the therapies as a stand-alone. Produced with CyberLink PowerDirector

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Understanding the Keto Plateau Phenomenon

The ketogenic diet has gained immense popularity for its perceived benefits, including weight loss, enhanced energy levels, and improved mental clarity. Many individuals find that the initial stages of this diet yield rapid results, which can be both motivating and exciting. However, one common challenge that many people encounter during their keto journey is the dreaded plateau. This plateau refers to a stage where weight loss stalls, despite adherence to the low-carb, high-fat dietary regimen. Understanding the underlying causes of a keto plateau is vital for individuals eager to break through and continue their weight loss journey.

A keto plateau can be disheartening for individuals who have been committed to their diet and lifestyle changes. When the scale doesn’t budge after weeks or even months of hard work, it can lead to frustration and a sense of defeat. Factors contributing to this plateaus can be varied and include metabolic adaptations, inflammation, stress levels, and even water retention. Recognizing that a stall in weight loss is common can provide some solace, but it is also essential to take proactive measures to reignite weight loss efforts.

In this article, we will explore five quick and effective strategies to help individuals who find themselves stuck in a keto plateau. These strategies include adjustments to macronutrient intake, incorporating intermittent fasting, tweaking physical activity levels, increasing hydration, and managing stress. By understanding and applying these methods, individuals can boost their progress and re-engage with their health goals. Armed with knowledge and practical tips, overcoming a keto plateau can be achieved with determination and the right approach.

Adjusting Your Macronutrient Ratio

One of the primary reasons individuals experience a plateau on the ketogenic diet is a mismatch in macronutrient ratios. The keto diet emphasizes a high-fat, moderate-protein, and low-carb intake. However, as some individuals adapt to this diet over time, they may inadvertently increase their carbohydrate intake or decrease their fat consumption. This alteration can lead to a state in which the body shifts out of ketosis, resulting in stalled weight loss. Therefore, analyzing and reevaluating one’s macronutrient intake is crucial.

To effectively break through a plateau, consider tracking your macronutrient consumption using a food diary or a dietary app. Ensure that you are keeping your carbohydrate intake below the recommended threshold of 20 to 50 grams per day, as exceeding this can hinder ketosis. Additionally, assess your fat intake; many individuals need to consume around 65 to 75 percent of their daily calories from fats. If your ratios are not aligned with these guidelines, recalibrating your meals can help re-enter the state of ketosis and stimulate fat loss.

Experimenting with different types of fats can also have a significant impact on your keto journey. Including a variety of sources such as avocados, nuts, seeds, olive oil, and coconut oil can not only enhance flavor but also provide essential nutrients that support overall health. By adjusting macronutrient ranges and ensuring they align with keto principles, individuals may find themselves able to break through their plateau and regain momentum in their weight loss journey.

Incorporating Intermittent Fasting

Intermittent fasting (IF) is another approach that can prove beneficial for those facing a plateau on the ketogenic diet. IF involves cycling between periods of eating and fasting, which can enhance metabolic flexibility and improve insulin sensitivity. There are several popular methods of intermittent fasting, such as the 16/8 method, which involves fasting for 16 hours and eating during an 8-hour window, or the 5:2 approach, where individuals eat normally for five days and restrict calorie intake to approximately 500-600 calories on two non-consecutive days.

When combined with a ketogenic diet, intermittent fasting can help to accelerate fat loss by enabling the body to tap into its fat reserves more efficiently. During fasting periods, the body undergoes several metabolic changes, including a rise in human growth hormone (HGH) levels and a decrease in insulin levels. These changes can facilitate increased fat burning and encourage ketosis, offering a new method for those who hit a plateau to revitalize their progress.

While implementing intermittent fasting, it is crucial to remain mindful of the quality of foods consumed during eating windows. Focusing on nutrient-dense, low-carb foods ensures that the body is receiving the necessary vitamins and minerals to thrive. Moreover, individuals should listen to their bodies and prioritize hydration, as electrolytes are vital during fasting phases. By introducing intermittent fasting, individuals may find a powerful tool to support their weight loss goals and overcome a keto plateau.

Revamping Your Exercise Routine

Physical activity plays an integral role in promoting weight loss and overall health. For those facing a plateau on the ketogenic diet, revisiting their exercise routine can provide the necessary boost to jumpstart fat loss again. Over time, the body can adapt to a specific workout regimen, which may lead to diminishing returns in weight loss efforts. As a result, pursuing variety in activities and intensity can be instrumental in breaking through a plateau.

Incorporating high-intensity interval training (HIIT) has been shown to be particularly effective for those on a ketogenic diet. HIIT workouts involve short bursts of intense activity followed by periods of rest or lower-intensity exercise. This training method not only burns calories efficiently but also enhances cardiovascular health and boosts metabolic rate, even after the workout has concluded. By including HIIT workouts in your routine, you can stimulate fat loss while also improving fitness levels.

Additionally, integrating strength training is essential for promoting lean muscle mass, which can contribute to increased metabolism. Muscle burns more calories at rest compared to fat, making it advantageous for weight loss. Consider implementing resistance training sessions several times a week to enhance overall body composition. Whether through weights, resistance bands, or bodyweight exercises, increasing muscle engagement can lead to sustained fat loss over time.

Prioritizing Hydration and Electrolyte Balance

Hydration is a critical aspect of any dietary approach, and it is particularly important for those following a ketogenic diet. As individuals transition into ketosis, the body undergoes changes that can increase diuresis or fluid loss. This can create a situation where individuals may experience dehydration and an imbalance of electrolytes, which in turn can lead to fatigue, irritability, and even weight loss stalls. Ensuring adequate fluid intake and supplementing with electrolytes can help individuals overcome these hurdles.

In addition to drinking sufficient water throughout the day, consider including electrolyte-rich foods in your meals. Foods such as leafy greens, avocados, seeds, and nuts are excellent sources of magnesium, potassium, and sodium, which can help support electrolyte balance. Furthermore, many people may benefit from electrolyte supplements, especially during the initial phases of the keto diet or after intense exercise sessions.Ultimate Keto Guide Magnetic Cheat Sheets For Easy Weight Loss

Monitoring hydration levels can also offer insights into your overall well-being. Signs of dehydration such as headaches, dizziness, or fatigue can indicate that it’s time to increase fluid intake. It is important to recognize that maintaining proper hydration and electrolyte balance can enhance energy levels, physical performance, and metabolic function. Consequently, prioritizing fluids can reinvigorate your keto journey and help to overcome any plateaus.

Managing Stress Effectively

Lastly, stress management is a crucial but often overlooked factor that can contribute to weight loss plateaus in individuals on a ketogenic diet. Chronic stress leads to elevated cortisol levels, a hormone that can promote fat storage, particularly in the abdominal area. When trying to lose weight, managing stress through various techniques can play an essential role in breaking through plateaus.

Incorporating mindfulness practices such as meditation, yoga, or deep breathing exercises can help individuals cope with daily stressors. These practices not only promote relaxation but also help to improve overall mental health and well-being. Additionally, ensuring adequate sleep is another fundamental aspect; poor sleep can exacerbate stress and hormonal imbalances, ultimately hindering weight loss efforts.

Finding enjoyable leisure activities can also mitigate stress levels. Engaging in hobbies, spending time with loved ones, or pursuing creative endeavors can help shift focus away from the pressures of daily life, fostering a more positive mindset. By addressing stress proactively, individuals can create a healthier environment for weight loss to take place, helping to dislodge stagnation during their ketogenic journey.

Common Questions and Summary

As individuals navigate their keto journey, questions may arise regarding plateaus and how to address them. It’s essential to understand that hitting a plateau is normal, and it doesn’t signify failure. Stubborn weight loss stalls can occur due to numerous factors, including metabolic adaptations, lifestyle choices, and hormonal responses. However, implementing the strategies discussed in this article can significantly enhance the chances of overcoming these hurdles.

First, taking the time to assess and readjust macronutrient ratios can yield substantial impacts. Ensuring low-carb intake and sufficient healthy fats plays a crucial role in maintaining ketosis. Secondly, incorporating intermittent fasting can encourage fat utilization while minimizing calorie consumption during eating periods. Revamping exercise routines by adding varied activities, particularly HIIT and strength workouts, is another excellent method to stimulate fat loss.

Furthermore, prioritizing hydration and ensuring electrolyte balance is pivotal in promoting overall health and metabolic function. Lastly, effective stress management techniques can help individuals navigate emotional challenges associated with dieting, allowing them to focus on their health journey positively. Armed with this information, readers are encouraged to tackle the keto plateau head-on, embracing each process changes to achieve their desired outcomes.

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