You’re eating healthier, moving more, and sticking to what should be a solid calorie deficit—so why aren’t the scales budging? If you’re frustrated because you’re not losing weight on a calorie deficit, you’re not alone. Many of our patients at Vivo Pharmacy come to us with this exact concern.

Weight loss isn’t always as simple as “calories in versus calories out.” While a calorie deficit is a key part of the equation, there are several reasons why your body might not respond in the way you expect. Here, we’ll break down seven common explanations and what you can do about them.

1. You’re Not in as Much of a Deficit as You Think

The most common reason for stalled weight loss is inaccurate tracking. It’s surprisingly easy to underestimate portion sizes or forget to count hidden calories in sauces, drinks, or snacks.

Even healthy foods can be calorie-dense, and food labelling isn’t always precise. Additionally, fitness trackers often overestimate how many calories you burn through exercise, leading to a false sense of “earned” indulgence.

What you can do:

Try tracking your food intake more carefully for a week using a digital app or food diary. Measure portions and review packaged food labels closely. Sometimes, small adjustments make a big difference.

2. Your Body Has Adapted to a Lower Calorie Intake

Your body is incredibly smart. When you restrict calories over time, it responds by slowing down your metabolism to conserve energy—a process called adaptive thermogenesis.

This means you may no longer be in a true calorie deficit, even if you’re eating the same amount as before. This is especially common in people who have lost weight previously or are consuming very low calorie diets.

What you can do:

Try incorporating recovery weeks, adjust your calorie intake slightly upward to reset, or speak to a professional about metabolic testing or support through weight loss medication.

3. Hormonal Imbalances Are Interfering

If you’re doing everything right and still not seeing results, it’s worth considering whether a hormonal issue might be affecting your weight. Conditions like underactive thyroid (hypothyroidism), polycystic ovary syndrome (PCOS), or insulin resistance can make it harder to lose weight—even in a deficit.

Hormones such as cortisol (the stress hormone) and oestrogen can also affect appetite regulation, metabolism, and fat storage.

What you can do:

At Vivo Pharmacy, we offer consultations and can refer you for private blood testing or recommend a GP review if hormonal concerns are suspected.

4. You’re Losing Fat but Gaining Water or Muscle

The number on the scales doesn’t always tell the whole story. If you’ve started exercising more—particularly resistance or strength training—you may be building muscle while losing fat. Additionally, water retention caused by inflammation, menstruation, increased sodium intake, or poor sleep can temporarily mask fat loss.

What you can do:

Use additional progress measures like waist circumference, how your clothes fit, or progress photos. Give it a few weeks before jumping to conclusions.

5. Stress Is Affecting Your Progress

Stress can wreak havoc on your body’s ability to lose weight. High levels of cortisol not only stimulate appetite—particularly for sugary or fatty foods—but also contribute to fat storage, especially around the midsection.

Stress can also disrupt sleep, reduce motivation to exercise, and increase emotional or mindless eating.

What you can do:

Incorporate stress-reducing practices like walking, stretching, mindfulness, or journaling. Prioritise quality sleep and limit caffeine and screen time in the evenings.

6. You’re Not Getting Enough Sleep

Sleep deprivation affects your body’s hunger and satiety hormones, ghrelin and leptin, making you feel hungrier and less satisfied after eating. It also increases cravings for high-calorie foods and reduces your energy for physical activity.

Regularly getting fewer than 6–7 hours of quality sleep could significantly undermine your weight loss efforts—even if your diet is spot on.

What you can do:

Aim for 7–9 hours of consistent sleep per night. Create a bedtime routine, reduce blue light exposure before bed, and avoid large meals or alcohol in the late evening.

7. You May Benefit from Medical Support

For some individuals—especially those who are overweight or obese—lifestyle changes alone may not be enough. If you’ve genuinely maintained a calorie deficit for several months without results, it may be time to consider clinical weight loss options.

At Vivo Pharmacy, we offer private weight loss consultations, and can discuss options such as:

• –> Wegovy (semaglutide)

• –> Mounjaro (tirzepatide)

• –> Xenical (orlistat)

These treatments are designed to support weight loss when paired with healthy lifestyle changes, and may be appropriate if you meet the medical criteria.

What you can do:

Book a consultation with us to review your progress, discuss any underlying concerns, and explore whether medical treatment is right for you.

Get Back on Track

If you’re not losing weight on a calorie deficit, don’t lose hope. Weight loss is complex, and success often requires patience, consistency, and a tailored approach. Your body may be doing more than the scales reveal—and with the right support, you can get back on track.

If you’d like to explore weight loss support, metabolic health reviews, or prescription treatment options, our team at Vivo Pharmacy is here to help. Reach out to book your private consultation today and take the next step toward long-term success.

This blog was written on behalf of Vivo Pharmacy by Pharmacy Mentor.