Overweight and obesity is a medical issue that has constantly been on the rise, leading to non-communicable diseases like heart disease, diabetes, and high blood pressure. Weight loss, even only about 5 percent, can help in reducing the risk of developing these diseases. Many strategies can be applied to achieve weight loss, with the concept remaining the same; net calorie deficit should be achieved. When one starts a journey of calorie deficit, typically in the initial 6 months, weight loss will be rapid. This is as the body obtains energy from the glycogen storage, a type of carbohydrate stored in hydrated form, subsequently releasing water with it. This water loss causes quick weight loss. Weight loss then begins to slow down as the glycogen storage depletes and the body starts burning fat as an energy source.
超重和肥胖是一个不断上升，并导致心脏病、糖尿病和高血压等非传染性疾病的医学问题。减轻体重，即使只有约5%，也可以帮助降低患上这些疾病的风险。很多策略可以用来实现减肥，只要概念保持不变，即可以实现净热赤字。当一个人开始热量赤字之旅时，通常在最初的6个月内，体重会很快减轻。这是因为身体从糖原储存（一种以水合形式储存的碳水化合物）中获取能量，随后释放水分。这种水分流失会导致体重快速下降。随着糖原储存的耗尽，身体将开始燃烧脂肪作为能量来源，减慢体重下降的速度。
However, as the time passes, weight loss can slow down even more until it remains stagnant generally after 12 months, and in some cases, slight weight regain happens. This period is called the weight loss plateau. The possible causes of weight plateau are intermittent lack of adherence towards dietary intervention, downregulation of energy expenditure due to loss of metabolically active tissue which is the skeletal muscle, or metabolic adaptation to weight loss (also known as adaptive thermogenesis). Weight loss plateau can be frustrating and can cause loss of motivation to maintain the diet. This then may lead to weight regain as patients stop working on weight management. How do we overcome the plateau? There are a few methods that can be done:
然而，随着时间的推移，体重减轻的速度会进一步减慢，直至保持停滞状态，一般在12个月后。在某些情况下，体重会略微反弹。这段时期称为体重减轻平台期。体重停滞的可能原因是间歇性不坚持饮食干预，代谢活性组织（即骨骼肌）的损失导致能量消耗下调，或对体重减轻的代谢适应（也称为适应性产热）。减肥平台期会令人沮丧，并导致失去维持饮食的动力。当患者停止管理体重时，这可能会导致体重反弹。我们该如何克服减肥平台期呢？有几种方法可以做到：
1. Reassess calorie intake
重新评估卡路里摄入量
The most common reason for weight stagnation and regain is increase in calorie intake. Sometimes, extra calories from sources such as snacking, weekend getaways, night outs, alcohol, dressings, or slight but continuously increasing portion size can go unnoticed. This then leads to difficulty in reducing weight and subsequently weight plateau. To prevent this from happening, one should reassess the calorie intake by rechecking the portion size, reading nutrition labels, and making sure that the calorie counting is accurate.
体重停滞和反弹最常见的原因是卡路里摄入量的增加。有时候，我们会忽视来自零食、周末度假、夜间外出、酒精、调味品或轻微但持续增加的食量等来源的额外热量。这会导致减肥困难，并随后导致体重停滞。为了防止这种情况发生，我们应该通过重新检查食物的份量大小、阅读营养标签并准确的计算卡路里来重新评估卡路里摄入量。
2. Adequate protein
足够的蛋白质
Research has found that adequate protein intake along with calorie restriction helps in reduction of energy intake by improving appetite control and increasing satiety. It is also associated with weight loss and beneficial changes in body composition by decreasing fat mass while preserving fat-free mass. Therefore, a serving of around 20 to 30 grams of protein per meal (around 2 to 4 matchbox-sized flesh) or around 0.8 to 1 g/kg body weight/day should be consumed. Meanwhile, though there is currently not enough evidence on the negative effects of excessive protein consumption in healthy adults, it is better to consume in moderation. This is as some protein sources can be high in saturated fat, increasing risk of high cholesterol level. Excessive protein intake might also lead to excessive calorie intake, which is counterproductive for weight loss, and might increase the burden on the kidneys and liver to metabolize the protein.
研究发现，通过改善食欲和增加饱腹感来获取充足的蛋白质摄入及限制卡路里有助于减少能量摄入。它还可以通过减少脂肪量，同时保持无脂肪量来减轻体重并改变身体成分。因此，每餐应摄入约20至30克的蛋白质（约2至4个火柴盒大小的果肉）或约0.8至1克/公斤体重/天。同时，虽然目前还没有充足的证据表明过量地摄入蛋白质会对健康的成年人造成负面影响，但还是适量地摄入为好。这是因为一些蛋白质来源可能含有大量饱和脂肪，会增加患高胆固醇的风险。过量蛋白质的摄入也可能导致过量卡路里的摄入。这对减肥是适得其反的，并可能增加肾脏和肝脏代谢蛋白质的负担。
3. Physical activity
体力活动
While dietary changes are important, physical activity also plays a role in weight management. Physical activity can boost body metabolism, inducing weight loss. At least 150 minutes of moderate or 75 minutes of vigorous exercise per week or a combination of both can assist in weight reduction. Strength and resistance exercise on the other hand, can lead to an increase in muscle mass, which will also increase metabolism. Incorporating physical activity in daily routines such as parking further from the workplace, using stairs instead of escalators or elevators can help keep one physically active. Before starting any physical activity and exercise regime, patients with obesity should get clearance on their health and physical conditions to ensure that they are able to safely perform the activities.
虽然改变饮食习惯很重要，但体力活动在体重管理中也发挥着作用。体力活动可以促进身体新陈代谢，包括减肥。每周至少进行150分钟的中度运动或45分钟的剧烈运动或两者综合有助于减肥。另一方面，力量和阻力训练可以增加肌肉质量，从而增加新陈代谢。将体力活动融入日常生活，例如将车停在距离工作场所较远的地方，使用楼梯而不是自动扶梯或电梯，可以帮助我们保持身体活跃。在开始任何体力活动和锻炼计划之前，肥胖患者应该先了解自己的健康和身体状况，以确保他们能够安全地进行这些活动。
4. Try new things
尝试新事物
Some people might think that certain dietary methods such as precise calorie calculation are difficult to follow and are not suitable to be applied in the long term. In this case, one can try other dietary modifications such as quarter-quarter half plate and intermittent fasting. Aside from that, the body can efficiently adjust to physical activity in order to burn less energy while doing the same activities after a while. Therefore, one should gradually increase the intensity, duration or frequency of physical activity and include various types of exercise such as aerobic, strength and resistance exercise to accelerate energy burn.
有些人可能认为某些饮食方法，如精准计算卡路里，难以遵循且不适合长期实施。在这种情况下，他们可以尝试其他饮食调整，如四分之一餐盘饮食法和间歇性禁食。除此之外，身体可以有效地适应体力活动，以便在一段时间过后进行相同的活动时，燃烧更少的能量。因此，我们应改逐渐增加体力活动的强度、持续时间或频率，并包括各种类型的运动，如有氧运动、力量和阻力运动，以加速能量燃烧。
5. Improve motivation
提高积极性
When one has been on a diet and lifestyle changes for a period of time, it can be taxing physically and mentally, making it difficult to retain the changes. Therefore, bringing back motivation in order to continue the journey is important. One should think about the reasons as to why they need to lose weight in the first place, including health, self-confidence et cetera. Obtaining support from family, friends and health professionals may also help.
当一个人在一段时间内节食和改变生活方式时，身心会造成压力，导致他很难维持一些改变。因此，恢复动力以继续前行是很重要的。他首先应该思考自己需要减肥的理由，包括健康、自信等等。获得家人、朋友及健康专家的支持也可能会有所帮助。
It is normal to experience a plateau in weight loss journey. Even if there are no changes to weight, there might be changes to body composition such as increased muscle mass and reduced body fat. Before making any dietary and lifestyle changes, one should set a realistic and sustainable weight loss goal, for instance around 2 to 4 kg per month instead of 10 kg per month. Self-monitoring should be continued with regards to dietary intake, physical activity, and weight changes as it is proven to have a positive relationship with weight management outcome.
在减肥过程中经历一段停滞期是正常的。即使体重没变化，身体成分也可能会发生变化，例如肌肉质量的增加及体脂的减少。在改变饮食和生活方式之前，我们应该设定一个现实且可持续的减肥计划，例如每月减重2至4公斤，而不是每月减重10公斤。我们应该继续自我监测饮食摄入量、身体活动和体重变化，因为这已被证实与体重管理结果呈正相关。
