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What weight loss looks like over months

Weight usually falls fastest in the first weeks, then slows and levels off after some months. As weight falls, appetite rises and the body spends less energy.

KiloCare Team · · 5 min read · How we write and review

An open diary with a pen on an oak wall shelf in soft morning light.

A 2018 review on keeping weight off found that weight comes off fastest at the start of a programme, then stalls after several months. It calls this pattern near-universal, across many kinds of programme.[1]

The usual shape of weight loss in programmes, from a 2018 review
  1. At the start, weight falls fastest.[1]
  2. Over the months after, the body spends less energy and appetite rises.[1]
  3. After several months, weight stalls.[1]
  4. After that, weight slowly comes back.[1]

The first weeks

Weight usually falls fastest in the first weeks, and part of that early drop is water.

The body keeps a store of carbohydrate, called glycogen. In 2 small studies, each gram of glycogen was stored with about 3 grams of water.[2][3]

  • When you eat much less, this store runs down, and its water goes with it. A 1992 study measured this in 11 people after 4 days on a very low-calorie diet.[4]
  • In a small 1976 US study, 6 adults with obesity ate 800 kcal (calories) a day for 10 days. On an ordinary mix of foods, over a third of the weight they lost was water, and more than half when carbohydrate was very low.[5] That was a very low-calorie diet in a small, old study. It cannot tell you how much of your own loss is water.

When you eat more carbohydrate again, glycogen and its water come back. The scale can then rise from glycogen and water alone.[2]

India's dietary guidelines advise slow and steady weight loss. They warn that extreme approaches to weight loss can harm health.[6]

Why it slows

As weight falls, the body spends less energy and appetite rises, so weight loss slows.

A slowdown is not a failure of willpower.[1] The old rule says each calorie cut keeps taking weight off at the same rate. The 2018 review calls this rule wrong, because the body spends less energy as weight falls.[1]

The review's authors think the rise in appetite does more to slow weight loss than the drop in spending.[1]

  • The review cites estimates that, for each kilogram lost, the body spends about 20 to 30 kcal a day less.[1]
  • In the same estimates, appetite rises by about 100 kcal a day more for each kilogram lost.[1]
  • After losing 5 kg, that is about 500 kcal a day more appetite, by our arithmetic.

Appetite is controlled by parts of the brain that work below awareness. So portions can slowly grow over time without anyone noticing.[1]

In US studies reviewed in 2010, people with and without obesity who kept off 10% or more of their weight spent about 20 to 25% less energy a day. A smaller body needs less energy, but that did not explain all of the drop.[7] The lower spending was still there in people who had kept the weight off for 6 months to 7 years.[7]

Is a small loss worth it?

In a large US trial of adults with type 2 diabetes, losing 5% to under 10% in the first year went with better blood sugar and blood pressure, but the programme did not lower heart attacks or strokes.[8][9]

People who lost 5% to under 10% of their weight in the first year were more likely than people whose weight stayed the same to have better blood sugar, blood pressure and some blood fats.[8] Nobody was assigned to lose these amounts, so this shows a link only, and the authors say it may not apply to people without diabetes.[8]

When the trial stopped, after about 9.6 years, its lifestyle programme had not reduced heart attacks, strokes or other heart and blood vessel events.[9]

What helps the weight stay off

A 2018 review found that ongoing contact with health professionals, or a group, helps people keep weight off better than programmes that end after a short time.

  • The Endocrine Society of India advises staying in touch with your doctor after the first weight loss.[12] Where resources are limited, it suggests a follow-up visit every 3 months if possible.[12]
  • The 2018 review notes that US obesity guidelines ask for weight-maintenance programmes that last at least 1 year.[1]
  • The US National Weight Control Registry follows adults who have kept off a large weight loss. In a 2005 report, its members said they stay active, keep track of their weight and eat in a steady pattern through the week.[10] They joined after they had already kept weight off, so the registry cannot show that these habits caused their success.
  • A 10-year study, published in 2014, followed 2,886 registry members with an average age of 48. Those who became less active, or weighed themselves less often, tended to regain more.[11] That is an association. It does not prove that weighing less often causes weight to return.

After you reach your goal weight covers the care that should carry on once you get there.

If you keep a note of your weight, take it when you next see your doctor. Ask them to look at the trend over months with you. You can also measure your waist: how to measure your waist shows the steps.

When to check with a doctor:

  • Anyone who takes medicine for diabetes should check with their doctor before changing how much they eat. The same applies to blood pressure medicine.
  • If your doctor has asked you to weigh yourself every day, keep doing that and tell them about a quick gain or swollen ankles.
  • If counting or weighing makes you anxious, or you often skip meals to control your weight, talk to a doctor.
  • If you lose weight you were not trying to lose, see a doctor.

Medical disclaimer: This article is general information. It does not replace advice from your doctor about your own health.

Common questions

Part of the early drop is water. The body stores carbohydrate as glycogen, held with water, and uses some of it up when you eat much less. Later, the body spends less energy and appetite rises, so weight loss slows.

Yes. A 2018 review describes weight that falls fastest at first and stalls after several months as the usual pattern in weight programmes. Look at the trend over months with your doctor.

A 2018 review found that ongoing contact with health professionals, or a group, helps people keep weight off better than programmes that end early. People in a US registry who kept weight off reported staying active and keeping track of their weight.

Sources

  1. Hall KD, Kahan S. Maintenance of Lost Weight and Long-Term Management of Obesity. Med Clin North Am. 2018;102(1):183-197. doi:10.1016/j.mcna.2017.08.012. PMID: 29156185. Available from: pmc.ncbi.nlm.nih.govCited atExplaining the weight plateauExplaining the weight plateauExplaining the weight plateauExplaining the weight plateauExplaining the weight plateauPhysiological responses to weight lossPhysiological responses to weight lossExplaining the weight plateauExplaining the weight plateauExplaining the weight plateauExplaining the weight plateauLong term benefits require long term attention
  2. Chan ST, Johnson AW, Moore MH, Kapadia CR, Dudley HA. Early weight gain and glycogen-obligated water during nutritional rehabilitation. Hum Nutr Clin Nutr. 1982;36(3):223-32. PMID: 6811511. Available from: pubmed.ncbi.nlm.nih.govCited atAbstractAbstract
  3. Fernández-Elías VE, Ortega JF, Nelson RK, Mora-Rodriguez R. Relationship between muscle water and glycogen recovery after prolonged exercise in the heat in humans. Eur J Appl Physiol. 2015;115(9):1919-26. doi:10.1007/s00421-015-3175-z. PMID: 25911631. Available from: pubmed.ncbi.nlm.nih.govCited atAbstract
  4. Kreitzman SN, Coxon AY, Szaz KF. Glycogen storage: illusions of easy weight loss, excessive weight regain, and distortions in estimates of body composition. Am J Clin Nutr. 1992;56(1 Suppl):292S-293S. doi:10.1093/ajcn/56.1.292S. PMID: 1615908. Available from: pubmed.ncbi.nlm.nih.govCited atAbstract
  5. Yang MU, Van Itallie TB. Composition of weight lost during short-term weight reduction. Metabolic responses of obese subjects to starvation and low-calorie ketogenic and nonketogenic diets. J Clin Invest. 1976;58(3):722-30. doi:10.1172/JCI108519. PMID: 956398. Available from: jci.orgCited atAbstract
  6. ICMR-NIN Expert Committee. Dietary Guidelines for Indians - 2024. Hyderabad: ICMR-National Institute of Nutrition; 2024. Available from: nin.res.inCited atp. 68, Guideline 9
  7. Rosenbaum M, Leibel RL. Adaptive thermogenesis in humans. Int J Obes (Lond). 2010;34 Suppl 1(0 1):S47-55. doi:10.1038/ijo.2010.184. PMID: 20935667. Available from: pmc.ncbi.nlm.nih.govCited atEnergy expenditureEnergy expenditure
  8. Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481-6. doi:10.2337/dc10-2415. PMID: 21593294. Available from: pmc.ncbi.nlm.nih.govCited atAbstractAbstractDiscussion
  9. Look AHEAD Research Group, Wing RR, Bolin P, Brancati FL, Bray GA, Clark JM, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369(2):145-54. doi:10.1056/NEJMoa1212914. PMID: 23796131. Available from: pubmed.ncbi.nlm.nih.govCited atAbstractAbstract
  10. Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr. 2005;82(1 Suppl):222S-225S. doi:10.1093/ajcn/82.1.222S. PMID: 16002825. Available from: pubmed.ncbi.nlm.nih.govCited atAbstract
  11. Thomas JG, Bond DS, Phelan S, Hill JO, Wing RR. Weight-loss maintenance for 10 years in the National Weight Control Registry. Am J Prev Med. 2014;46(1):17-23. doi:10.1016/j.amepre.2013.08.019. PMID: 24355667. Available from: pubmed.ncbi.nlm.nih.govCited atAbstract
  12. Madhu SV, Kapoor N, Das S, Raizada N, Kalra S, Endocrine Society of India. ESI Clinical Practice Guidelines for the Evaluation and Management of Obesity In India. Indian J Endocrinol Metab. 2022;26(4):295-318. doi:10.4103/2230-8210.356236. PMID: 36185955. Available from: pmc.ncbi.nlm.nih.govCited atRecommendation 9.3Recommendation 9.3 (L)