I have hit a plateau! What do I do?

Oh boy. The plateau. Also known as frustration squared. Is there a dieter on the planet who has been spared the dreaded plateau? I doubt it. I know that on my way down I had a few plateaus, including one that lasted over 2 months.

I'm afraid I don't have any one-size-fits-all solutions to the plateau problem. Rather, I know a bunch of things that have helped various folks I've talked to, or have worked for me. It's worth trying one or more of them -- although I'd try one at a time, so that if something works for you, you'll know what it was!

But first, make sure it's really a plateau. First of all, how long have you been stalled? If it's just a week, don't sweat it. Your body is probably just playing catch-up. If you're female, where are you in your cycle? I don't know a whole lot of women who don't plateau in the last week before their period, or even go up a few pounds. It's just hormones; no big deal.

Also, pay attention to what size you are, as well as to what the scale says. We've all had the weight thing pounded into our heads to the point where the number on the scale is reality, no matter what all the other indicators are saying. I've known many people to say that while the number on the scale is staying the same, they're still losing inches -- and then all of a sudden, the scale will catch up, practically overnight. This is sometimes referred to as "the whoosh", or even "a visit from the Whoosh Fairy." So pay attention to inches, as well as to pounds. (Or to centimeters as well as kilos. You know what I mean.)

Then, make sure you're being honest with yourself. Are you really following the program you've chosen? If you're on a mini-binge type diet, like The Carbohydrate Addict's Diet, have you been stretching out your Reward Meal past the allotted hour? If you're on a Basic Low Carb Diet, like Atkins or Protein Power, have you been reading the label on everything that has one, and looking up things that don't? Be aware of hidden carbs -- nutrition labeling laws allow processors to list "0 grams" if there's 0.4 grams or less, and "less than 1 gram" if there's between 0.5 and 0.9. Those hidden carbs can add up!

Okay, so you really are sticking to your program, and it's been a few weeks, and your clothes aren't getting any looser, and you're starting to panic. What to do?

First, take stock of the progress you've made, and of the other benefits you've realized from your low carb diet. Do you have more energy? Fewer mood swings? Has your arthritis improved? Your triglycerides dropped? If this way of eating is making you healthier, then it's important to value that as well. I've actually had people say things to me like, "Well, my cholesterol's down, and my energy level is better, and maybe now I won't get the family diabetes -- but I'm not losing weight, so what's the point?" Hard to know what to say to something like that...

Now, the next thing to do is to change something, in a controlled, careful, and consistent manner, and to persist with the change long enough to know what effect it's having -- at least a week or two. What should you change? Here, in no particular order, are a bunch of possibilities:

* Try a different version of a low carb diet. If you've been on a Basic Low Carb Diet, try the mini-binge diet, or a diet that includes some modest quantities of low impact carbs, like my Careful Carb Diet. If you've been on a mini-binge diet, try a Basic Low Carb Diet. You get the picture.

* Eat the same quantity of food, but divide it up into smaller, more frequent feedings. This alone has, in some instances, been enough to cause weight loss. (This isn't allowed on a mini-binge diet, which depends on not eating between meals.)

* Drop dairy. Yep, it's hard, dairy is versatile and yummy, but I've known a fair number of people for whom this was the thing that did the trick.

* If you're on a Basic Low Carb Diet, try modifying it to a Cyclic Ketogenic Diet. Once every week to two weeks, have a carb-up day -- and then go straight back to your ketogenic diet the next day. Some people feel that this keeps their body from becoming adjusted to ketosis, and therefore encourages their weight loss. If you find it difficult to stop the carb-up and go back to your ketogenic plan, this may not be for you. Also not for you if you've found that your low carb diet dramatically improves your state of mind -- depression ain't fun, even if it's followed by weight loss.

* Try cutting out diet soda, Crystal Light, sugar free gelatin, etc. Roughly half of low carb dieters find that these interfere with their weight loss. Why this should be is a matter of controversy. Dr. Atkins blames aspartame, which, he says, interferes with fat burning on a cellular level. Others point out that citric acid, widely used to give tartness to these products, interferes with ketosis. Either way, it's worth cutting them out for a week or two to see whether you're in the group that loses far better without them.

* Eat more fat, and a bit less protein. If you've been eating vast amount of protein, more than, say, 100 g a day for an average sized woman or 125 g a day for a guy, cut it back a bit -- to maybe 75 g a day -- and fill in the extra calories with healthy fats.

* Eat less fat, and a bit more protein. Yes, I know this is the exact opposite of the advice just previous. Problem is, I've known folks who've had success one, and people who have had success with the other. Bodies differ. What can I say?

* Go paleo. Drop not only dairy, but soy, cashews, coffee, alcohol, vinegar, artificial sweeteners -- basically everything in your diet that wouldn't have been available to a caveman. As a consolation, you get a bit more fruit. This has worked very well for several people I've been in touch with. If you're looking for a guide, I recommend Ray Audette's Neanderthin. Worth reading!

* Up your exercise, or change it. If you're currently not getting any at all, adding just a 15 minute walk each day could make a big difference. If you're already exercising regularly, keep in mind this piece of info from my trainer friend BJ: After about 6 to 8 weeks, your body is accustomed to whatever work out you've been doing, and your returns will diminish. If you've been using a treadmill, try doing aerobics; if you've been doing aerobics, try circuit training instead. Mix it up.

* Related to exercising, breathe. I've been doing breathing exercises for the past year, and they've done very good things for my body. Fat only burns in the presence of oxygen. If you're exercising, deliberately "force" your breathing -- breathe deeper and harder than you think you need to -- in through the nose, out through the mouth, and concentrate on emptying your lungs completely, to make room for fresh air. I promise I'll do an article about the breathing exercises soon.

* Adjust your carb intake -- either down or up. I've talked with folks who had to drop their carbs all the way down to 15 g a day to lose, and I've also heard from folks who had better results when they bumped it up to 60 or 70 g.

* Count calories. Yes, I know it doesn't seem fair that you should have to pay attention to carbs and calories both, but I've heard from quite a few people for whom this was necessary. If you do decide to count calories, don't decide to cut back drastically. This can easily backfire on you -- your metabolism may well drop, which isn't the effect we're looking for, here. You may also end up hungry and miserable, which is a good way to end up quitting your diet altogether. How many calories do you need? Rule of thumb: 12-15 calories per day for every pound of what would be your healthy weight. Note: "Healthy weight" does not mean the weight which you wish that Nature had granted you, the weight that would make you a size 2. It means just that -- a reasonable, healthy weight for your body, even if that weight wouldn't make you look like Kate Moss.

* Take a look at your medications. The Pill can keep you from losing weight, as can estrogen replacement therapy. Did you know that meat producers give estrogens to cattle to make them put on fat and retain water? Works the same way with human females. Anti-depressants can make it hard to lose weight, as can antibiotics. You may want to explore alternatives.

And last but not least:

* Ask yourself if you really need to lose weight. Are you healthy? Energetic? Bloodwork looks good? Immune system strong? Knees and back don't ache? Reasonable, attractive size? If you're a size 10 or 8, and you're trying to get down to a 4, your body may be telling you that you're not supposed to be that small. My body seems to think I should be a size 12. I may eventually get down as small as a 10, but I doubt I'll ever be an 8, much less a 4. It is my observation that a low carbohydrate diet is very useful for fixing genuine obesity, and avoiding the dreadful medical problems that come with it, but is not well suited for becoming unhealthily thin. If your aim is to become fashionably anorexic looking, I can't help you.