The sleep piece resonates hard with me. I'm a nurse doing 12-hour night shifts and my weight loss has been slower than most people I see posting here. I average about 5 hours of broken sleep on work days. I wonder how much that's holding me back.

Sleep deprivation is enormously underappreciated as a factor in weight management. There are studies showing that people in a caloric deficit who sleep 5.5 hours lose 55% less fat and 60% more lean mass compared to those sleeping 8.5 hours — same caloric intake. Shift workers consistently show higher rates of obesity, metabolic syndrome, and cardiovascular disease, and disrupted circadian rhythm is a major contributor.

I know you can't always control your schedule, but even small improvements — blackout curtains, consistent wake times on days off, limiting caffeine 8+ hours before sleep — can help.

Looking at the OP's numbers from a trends perspective: the "plateau" from week 14-19 actually shows a slight downward trend if you plot it. 222 → 219 over 5 weeks is about 0.6 lbs/week. That's not zero — it's just much slower than the 2.3-3.0 lbs/week she was losing before.

Psychologically, going from 3 lbs/week to 0.6 lbs/week feels like a plateau even though progress is technically still happening. This is why I always recommend plotting a 7-day moving average rather than looking at individual weigh-ins. Daily weight fluctuations of 2-4 lbs are completely normal due to water, sodium, and digestive contents.