Rapid loss at 5+ pounds weekly raises risks of gallstones, muscle loss, sagging skin, and possible metabolic slowdown, though some tolerate it initially when very heavy. Most contributors recommend capping at 1-2 pounds per week or 1% of body weight, paired with high protein and lifting to protect lean mass. Medical monitoring is advised because issues like liver strain or heart problems can appear without obvious symptoms. Starting weight and whether loss is mostly water early on affect how concerning the pace feels.
What this discussion establishesSome view aggressive early loss as acceptable when starting very heavy or using medication, while others insist any pace over 2 pounds weekly is unsafe long-term regardless of starting size.
Still openWhether the metabolic slowdown seen in extreme cases applies to moderate rapid loss, and the precise point at which individual monitoring becomes necessary.
Nothing here is advice.
People have told me since I was young that dropping pounds too quickly might harm your health. I figure 10 pounds weekly is excessive, but where's the line between rapid and risky? Or maybe it's not damaging over time as claimed. Right now I've shed 26 pounds at about 5.6 pounds each week and feel better than I have in a long time.
Dropping weight at that speed raises chances of gallstones, hair loss, and losing muscle.
Hair loss doesn't worry me since I'm already bald, but gallstones are something I'd rather avoid.
Rapid loss also makes loose skin more likely because the skin doesn't have enough time to tighten as the fat underneath disappears.
I chose to aim for 1% body weight lost each week. Going at 1.25 to 1.5% showed more problems, so 1% felt like a workable target. After 29 weeks I'm still on track to finish in 16 weeks with little lean mass lost and hopefully no gallbladder trouble.
That percentage comparison is really useful. I might use the same approach.
Gallbladder problems from fast loss can be fatal. My mother went through that. I'd say no more than one or two pounds a week is reasonable, and five pounds weekly isn't safe over time.
Very fast loss can lower your resting metabolic rate for good. People from a major weight-loss study still showed a big drop in RMR years later even after regaining most of the weight.
The study noted a roughly 500-calorie lower RMR after six years even after accounting for age and body-composition changes. I'm wondering how well the age adjustment works across the 21-to-40 range they studied, since metabolism decline might accelerate differently as people get older.
Either way, a 500-calorie drop is meaningful and helps explain why losing weight gets harder with age.
The metabolic slowdown seems tied to large total loss rather than speed alone. Their method of predicting expected RMR from DEXA scans may not hold up well after major weight loss because those scans can misread body composition and the usual equations assume normal organ and muscle proportions that may no longer apply with excess skin.
Losing half a kilo to one kilo a week is the safer route for keeping it off. Faster loss often leads to rebound weight gain later.
The real issue is how much of that 5.6 pounds is muscle. Studies suggest you might lose around 3.3 pounds of fat and 2.3 pounds of muscle at that rate. Keeping loss to one or two pounds weekly, or up to 1% of body weight, plus eating at least 0.8 grams of protein per pound and lifting weights, helps protect muscle. Without those steps, up to 40% of the weight lost can be muscle.
It depends on your starting weight. Early weeks on these medications often show fast scale drops that are mostly water. The rate usually slows once that phase passes, so there's probably no need to worry yet.
Early water-weight loss is common, but when the scale slows many people cut calories too far and create a yo-yo cycle. Education on that point matters.
I'm hitting 180 grams of protein daily and lifting four days a week while eating around 1600 calories. I'm looking for ways to raise calories without dropping protein so the weekly loss moves closer to one pound. I began at 287 pounds, so while I'm still quite heavy I'm not at the highest end.
I started at 282 and switched medications a month later at 272. One pound a week would feel too slow for my goals. DEXA scans let me separate fat and lean loss so I can fine-tune the deficit more accurately than the usual 3500-calorie rule, and I've been averaging about an 1100-calorie daily deficit.
How much does each scan cost you?
What exactly are you eating to hit those numbers?
Mostly pre-packaged grilled chicken and cottage cheese, keeping carbs low. Sometimes a protein shake when I need extra protein.
I have to travel an hour to get them done. My fifth scan is in a couple weeks. Make sure you still eat some fat each day since it's calorie-dense and may help the gallbladder. Carbs can also improve mood if blood sugar dips, even if you're not diabetic.
From experience the pain is like childbirth. After my tenth child I had mine removed, though I later learned diet changes might have helped avoid surgery.
Whatever pace works for the individual is fine. Being very heavy carries its own risks, and if faster loss gets someone active and building better habits sooner, that can be worthwhile.
I had kidney stones in January, so anything that painful is something I'd like to avoid.
A shake made with raspberries, low-fat quark, oats, and protein powder works well for me. It blends easily, you can tweak the calories and protein, and it keeps you full.
I aim for 200 grams of protein daily and usually hit around 220. Lean ground beef or turkey, eggs and whites, high-protein Greek yogurt, and the occasional shake or bar add up quickly if you include some with every meal.
Mine works out to roughly two pounds a week, actually 2.2. I track everything in a spreadsheet.
I saved the thread to show people who insist their weekly loss isn't too high.
I went from 260 to 198 since mid-April and feel great, but recent labs showed elevated liver enzymes. Another check is happening after starting NAC and TUDCA. It might just be the liver adjusting to 60 pounds lost in ten weeks, or possibly gallstones affecting ducts.
I'm interested in how the percentages translate into daily decisions. Have you found a reliable way to adjust week to week or is it mainly for tracking?
It's straightforward: eat more or move less if the rate is too fast, and the opposite if it's too slow. The only surprise slowdown came from creatine in May. I adjusted by stopping it, adding a bit of another medication, and walking more, then caught back up within three weeks.
Anything over two pounds a week is seen as the point where gallbladder trouble becomes more likely, followed by muscle loss. Taking it slower helps preserve metabolism until you reach your goal.
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