Weight Loss

Losing Weight When You’re Over 250 lbs or Your BMI is Over 30

There are unique challenges to losing more than 40 pounds not faced by people with lesser weight-loss goals; Here are the key tips to moving that scale

Losing weight isn’t easy. Losing weight with diabetes comes with an additional set of obstacles. 

“There’s a big head-game that goes into losing weight when you’re struggling with a significant amount of extra weight,” explains Alexis Elliott, LCSW, LISW-CP, CDE, a health coach with specialties in diabetes, obesity, eating disorders, and nutrition.

Let’s take a closer look.

Weight-loss comes fast, at first…

“When a person has a significant amount of weight to lose, over 40 pounds, they’ll often see results very quickly from making just one or two changes in their life, said Elliott.

For example, a small change that could lead to fast weight-loss results in someone who is obese might be:

  • Quitting soda
  • Walking 20 minutes every day
  • Giving up your morning donut or muffin breakfast from Starbucks

Those seemingly little changes can be a big driver of weight-loss because while it’s “just soda,” that person may have been consuming 200 grams of sugar per day through soda. When you suddenly switch to water, you’re going to see big changes quickly.

You might lose 3 pounds per week for the first 6 weeks,” says Elliott, “and that’s very fast weight-loss but it’s realistic for someone whose BMI is over 30 or for someone who weighs over 250 pounds.”

And then, after a few months, the rapid weight-loss starts to slow down to a more realistic rate.

“When you’re used to seeing rapid changes on the scale, and then it stalls, it can leave you feeling very defeated and wanting to give up,” explains Elliott.

What to expect after the first two months

When you do get past that first phase of rapid weight-loss during the first two months, it’s important to remind yourself what long-term weight loss really looks like.

  • 3 pounds per week: during the first two months
  • 3 pounds every two weeks: during the third month
  • 1 pound every other week: after the first 12 weeks 

1 pound every other week can sound slow, but if you stick with it, that would add up to a 40-pound weight loss over the course of 6 months! That’s awesome! That’s a lot of weight,” says Elliott.

It’s easy to get stuck thinking it has to be faster to be real, but it’s crucial to remember that losing a large amount of weight is a long-term project. And the same habits that helped you lose weight are what will help you maintain that weight-loss, too.

7 Weight-loss tips to get the scale to budge

“The key to long-term weight-loss success is in continued small progress, the little daily victories that add up to bigger victory overtime,” says Elliott. “Even if you don’t see progress on the scale, you can’t let it trip you up from moving forward.”

Here are 7 tips to help you maintain your momentum and stick with it when you’ve got a lot of weight to lose.

  1. Do not weigh yourself too often 
  2. Use other methods of measuring your progress 
  3. Track your food every day for at least a few weeks
  4. Make sure your nutrition and weight-loss plan are realistic
  5. Ask yourself WHY you’re eating 
  6. Look at the stress/sleep-deprivation in your life 
  7. Look at your medications

Do not weigh yourself too often 

The scale does not measure your effort or your value or your worth. It doesn’t always give you the most accurate picture, either — especially if you’re weighing yourself daily. Your body has natural fluid fluctuations based on what you eat, your menstrual cycle, how much water you drank yesterday, etc. There’s too much victory vs. defeat when you use the scale as your primary method of measuring success. Instead: don’t weigh yourself every day. No more than once a week. Weighing yourself daily actually does way more harm than good. There are zero benefits.

Use other methods of measuring your progress 

Check-in once a month with measurements and looking at how your clothes fit. What size clothing do you fit in now compared to two months ago? What is your starting waist measurement then versus now? It might be only two pounds on the scale, but you lose 2 inches all over — that’s huge! And how is your energy? How is your cholesterol or your A1c? These things measure your progress far more than a scale can.

Track your food every day for at least a few weeks

Tracking your food is way more effective in helping you lose weight than obsessing over the scale. It’s so educational, and it’ll help you identify certain habits and choices you have that may be contributing to your weight struggle. Count how many times a day you’re eating packaged or processed foods. Even the protein bars. How much real food are you eating? How many servings of vegetables are you getting? Focus on the daily actions and behaviors — looking at the behaviors that influence the number on the scale rather than the actual number on the scale. 

Make sure your nutrition and weight-loss plan are realistic

It can’t be about perfection. That won’t last. If you’ve already done the ketogenic three times and can’t stick to it for more than two weeks, that tells you something. It’s too strict. Too extreme. Losing weight is a long-term project, so your plan needs to be something you can maintain long-term, too.

Ask yourself WHY you’re eating

We can get wrapped up in justifying our overindulgent choices like too much pizza or eating too many desserts. We make excuses like ‘Well, I walked today, so I earned this.’ We also tend to significantly overestimate how much activity we do, and underestimate how much we eat. We use food to reward ourselves for other good habits and then accidentally just feed the cycle of those less healthy behaviors. Play some detective work: What am I doing that’s helping or harming my success? 

Look at the stress/sleep-deprivation in your life

Sleep-deprivation and intense stress have such a big impact on your food cravings and your food choices — especially when it comes to craving refined sugars and processed foods. If you’re really struggling with weight-loss at the same time as dealing with a stressful life situation, you may need to put your energy into managing that stressor — or getting to bed earlier — rather than focusing on your weight. The long-term results will help you lose weight.” 

Look at your medications

There are so many medications that have a side-effect of weight gain, especially with antidepressants and even some diabetes medications. Talk to your doctor about the medications you’re taking and pinpoint which ones might be contributing to your weight-loss struggle rather than helping. And then, see if there is an alternative way of treating that issue if that medication is a problem for your weight management.”


Losing weight isn’t easy for anyone. It comes down to find a path that works for you along with inevitably facing your most self-destructive habits and tendencies around food and exercise. Instead of making weight-loss goals based on a number on the scale, consider making your daily measure of success about your habits and the overall balance you’re creating in your life through those new habits.

Ginger Vieira has lived with type 1 diabetes since 1999, along with Celiac, fibromyalgia, and hypothyroidism. She is the author of several books: When I Go Low (for kids!), Pregnancy with Type 1 Diabetes, Dealing with Diabetes Burnout, Emotional Eating with Diabetes, Your Diabetes Science Experiment. Ginger has created content for a variety of websites, including Diabetes Strong, Diathrive, MySugr, DiabetesMine, Healthline, and her YouTube Channel. Today, she is the Digital Content Manager for Beyond Type 1 & Beyond Type 2. Her background includes a B.S. in Professional Writing, certifications in cognitive coaching, Ashtanga yoga, and personal training with several records in drug-free powerlifting. She lives in Vermont with two kiddos, her handsome fella, and their amazing dog, Pedro.

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