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As a registered dietitian, I don't rush clients out of my office once they've achieve their weight-loss goal for a reason: I want to increase the odds they won't put the pounds back on.

To do so, I encourage them to continue checking in with me - often for years after reaching their weight target.

Research suggests that most of us can lose weight, but keeping it off is a far greater challenge. People in weight-loss programs typically lose 10 per cent of their initial weight, but then regain most of it - and sometimes more - within three to five years.

The real measure of success is how well you keep the weight off. The health benefits achieved from losing weight - reduced blood pressure, lowered cholesterol and improved blood sugar control - persist only as long as the weight loss in maintained.

Findings from a study published in last week's issue of the Journal of the American Medical Association support my strategy of staying in contact. Compared to people who received web-based or self-directed support, those who had monthly personal contact with a counsellor did a better job of maintaining their weight loss.

While many studies have evaluated strategies that help people lose weight, very few have tested methods that help sustain weight loss, especially past 18 months.

In the Weight Loss Maintenance trial, researchers from Duke University school of medicine compared strategies for sustaining weight loss for 30 months following a six-month weight-loss program.

In the largest randomized controlled trial on weight maintenance, 1,032 overweight or obese adults were assigned to one of three types of ongoing support: self-directed in which participants received minimal intervention; Internet-based in which participants were encouraged to log on regularly to a website; or personal contact with a dietitian. (Participants had lost an average of 8.5 kilograms or 18.7 lbs in the weight-loss phase.) Those who received personal guidance had telephone contact for five to 15 minutes each month, except for every fourth month when they had a 45 minute face-to-face meeting.

After 30 months of follow-up, all groups regained some of the lost weight, but those in the personal-contact group regained less. Although the difference in regained weight between the personal-contact group and the self-directed group was modest (8.8 pounds compared with 12.1), it was significant. Each kilogram (2.2 pounds) of weight loss is associated with a decrease of 1.0 to 2.4 mg Hg systolic blood pressure (the upper number in a blood-pressure reading) and a 16-per-cent reduction in the risk of developing Type 2 diabetes.

Participants assigned to the Web-based intervention regained an average of 11.5 pounds.

Personal contact probably helps weight maintenance because it offers tailored support and provides opportunities to and re-motivate people.

The fact that regaining weight is common suggests that a smaller-sized wardrobe, a lower cholesterol reading or an improved energy level are not enough to keep people on the straight and narrow.

If you're contemplating a weight-loss program - or you're in the process of shedding excess weight - knowing what steers people off course helps you determine strategies to avoid common blunders.

Maintaining contact with a nutritionist is one strategy that helps. Being accountable to someone keeps you motivated to stick with healthy eating and exercise habits.

But not everyone has access to the personal services of a dietitian. The good news: there are plenty of other strategies to help you succeed at permanent weight loss.

ENLIST SUPPORT

Ask for reinforcement from a family member, co-worker or friend, be it offering encouragement, preparing healthy meals or joining you at the gym. If you're motivated by meeting with people trying to achieve a similar goal, consider joining a support group such as Weight Watchers.

BE CONSISTENT

Stick to your eating plan on weekends. Research shows that people who don't give themselves a day or two off to cheat are 1.5 times more likely to keep the pounds off. Once you start giving yourself a few breaks on the weekend, you're more likely to ease off during the week. Eventually the breaks accumulate and show up on the bathroom scale.

WEIGH YOURSELF

Frequent weight monitoring is a critical factor in maintaining weight loss. The National Weight Control Registry, an ongoing study tracking the habits of more than 5,000 people who have lost weight and kept it off, reports that 75 per cent of participants weigh themselves at least once per week. Frequent weighing provides an early warning system and allows you to correct small increases quickly.

LIMIT SCREEN TIME

Spend a minimal amount of time in front of the television. In the NWCR, the majority of participants report watching less than 10 hours of TV per week. Another study revealed that people who watched more than four hours a week were twice as likely to regain weight as people who watched one hour or less. (Canadians spend, on average, 21.4 hours

a week watching TV.)

EXERCISE REGULARLY

Ninety-one per cent of successful maintainers in the NWCR report get one hour of scheduled exercise each day, often brisk walking. Other research has found that participating in a walking program - combined with diet counselling - lowers the odds of regaining weight.

DEAL WITH LAPSES

The key to long-term weight maintenance is nipping small weight gains in the bud. If a few pounds creep back on, take action to lose them: Keep a food diary for a few weeks, reduce your food portions or add an extra workout.

Leslie Beck, a Toronto-based dietitian at the Medcan Clinic, is on CTV's Canada AM every Wednesday. Her website is lesliebeck.com.