Study: Check with counselor monthly to keep weight off

( USA TODAY )- Dieters keep more weight off if they have to report to a nutrition counselor every month, according to the largest study on strategies to prevent regaining weight.

Researchers at Duke University and three other institutions recruited 1,685 adults who weighed an average of 213 pounds and had high blood pressure or high cholesterol or both.About 38% were African-Americans, who were recruited because they are often under-represented in weight-loss studies yet frequently suffer from weight-related health issues.

Participants followed the Dietary Approaches to Stop Hypertension (DASH) diet for six months, eating fruits, vegetables, whole grains and low-fat dairy products. They also were encouraged to do 180 minutes a week of moderate exercise. Most chose to walk briskly.

More than 1,000 of the participants lost between nine and 66 pounds in six months and were included in the second phase of the study. Average loss was 19 pounds.

The dieters were divided into three groups. Some were left to their own devices; others had a monthly phone conversation or office visit with a behavioral/nutrition counselor; and some had access to an interactive website.

Findings reported in Wednesday's Journal of the American Medical Association:

•After 2 1/2 years, people in the personal contact group lost and kept off an average of nine pounds; the web interactive group, seven; the self-directed group, six.

• 71% of participants weighed less at the end of the study.

• 42% kept off at least nine pounds.

"Even small amounts of weight loss have beneficial effects on blood pressure and cholesterol and reduce the risk of diabetes," says lead author Laura Svetkey, a professor of medicine at Duke University. "This study tells me that people can sustain weight loss."

Svetkey says more research needs to be done combining the elements of interactive technology and personal contact to get "a bigger impact on long-term weight-loss maintenance."

The study is "good news for people trying to manage their weight," says Gary Foster of the Center for Obesity Research and Education at Temple University in Philadelphia. "Historically there have been many studies that say it's difficult or impossible to keep weight off, but this shows it is possible."

Being in contact with a counselor provides a "reality check," he says.

"Some people think a small deviation from their plan spells disaster, but the counselor can tell them that they can easily recover. Other people may have the don't-worry-be-happy approach after they gain five pounds, and the counselor can tell that they need to take small weight gains seriously," says Foster, who is president of the Obesity Society, an organization of weight-loss researchers and professionals.

When it comes to paying for nutrition or behavioral counseling, most consumers have to reach into their own pockets, he says.

The bottom line: "Long-term weight control requires chronic vigilance."

Brown University's Rena Wing, who has studied this topic, says people who keep off lost pounds usually weigh themselves daily, exercise 60 to 90 minutes a day, eat breakfast and remain vigilant about not regaining.