Arthritis Today

How to Wisely Choose a Weight Loss Program

There’s no shortage of weight-loss programs from which to choose. Here, diet experts share their advice on making good choices.


Deciding the time has come to lose weight – whether it’s for your your joints, cardiovascular health or your 25th high school reunion – presents yet another choice: How are you going to do it? Structured weight-loss programs may be the best means to achieve your goals.

For people with arthritis, weight loss can take a literal load of your joints. According to research published in the Journal of Rheumatology, being even 10 pounds overweight increase forces on the knee by up to 60 pounds with each step.

Studies have also shown that people who are more than 30 pounds overweight have significantly less pain from knee osteoarthritis after dropping most of their excess weight. The connection between pain relief and weight loss in people with arthritis who have less weight to lose isn’t as well studied, but experts believe that even lower amounts of weight loss can reduce pain and anti-inflammatory use.

According to the National Weight Control Registry, a database of 10,000-plus individuals who have lost 30 pounds or more and kept the weight off for at least a year, about half of these weight loss winners did it on their own and about half participated in a structured program.

“Often, if people can find a way to exercise regularly and to cut back significantly on calories, they can accomplish great things on their own,” says Howard Eisenson, MD, director of Duke University’s Diet and Fitness Center, Durham, NC.

Some people, however – particularly those with more than 25 pounds to lose or those who feel “stuck” after a few diet failures – may more easily reach their goals with the extra accountability, support and organization that comes with a structured weight-loss program, Eisenson says. 

They may also lose more weight and keep it off longer than do-it-yourself dieters 2003 study published in the Journal of the American Medical Association found that people who took part in a structured program maintained a loss of 9.5 to 11 pounds at the end of one year, while those who lost weight solo were about 3 pounds below their starting weight after a year. After two years they also maintained a greater degree of weight loss – 6.5 pounds versus 0.5 pounds – than their go-it-alone counterparts.

There are hundreds of options when it comes to selecting a structured program, from MD-supervised programs to group-oriented settings to meal replacement plans, and few of these are cheap. Here, Dr. Eisenson and Adrienne Youdim, MD, medical director of Cedars-Sinai Weight Loss Center, Los Angeles, offer some insight into what to look – and what to void – when choosing a weight-loss program.  

Look for:

  • A balanced approach to weight loss – one that addresses and emphasizes healthier eating habits, increased physical activity and behavioral strategies and modifications to promote lasting change.
  • A program whose staff have appropriate professional education, credentials and experience. This includes registered dietitians, personal trainers certified by professional organization such as the American College of Sports Medicine, and MDs and other health professionals with specialized training in bariatric medicine or weight management.
  • A plan personalized to your individual needs. This kind of tailored approach, Dr. Eisenson says, requires a thorough assessment of your current health status as well as a thoughtful evaluation of your needs, goals, resources and physical and emotional challenges. 
  • Flexibility. Extreme plans that severely restrict, eliminate or demonize food groups can sometimes help you lose weight quickly, but are difficult to impossible to maintain and can lead to regaining the weight, says Dr. Youdim.
  • A program that offers ongoing professional follow up and long-term support. Staff should also be able and willing to answer all your questions before you enroll and provide you with opportunities to talk with people who have gone through the program.


  • Programs that over-promise, says Dr. Eisenson. “While ALL weight-loss programs can provide some extraordinary success stories, it is important to understand what kind of results are typical. If a behaviorally based weight-loss program can consistently help people lose approximately 10 percent of body weight, they are doing well,” he says.
  • Programs dependent on what Dr. Eisenson calls “gimmicks.” This includes, he says, an emphasis on dietary supplements or oral or injectable weight-loss agents or medications. “These are often expensive, of very limited or unproven value and sometimes of questionable safety.” He notes that these caveats don’t include programs that feature balanced meal replacements, such as shakes and bars, which studies have shown are helpful short- and medium-term weight-loss tools.
  • Plans that promote extensive and expensive lab studies and other diagnostic testing, such as full body imaging scans to measure body fat, which can be determined adequately with simple, inexpensive methods, such as measuring waist circumference or calculating body mass index. If you’re not sure whether a test is appropriate, ask your doctor is there is scientific evidence to supports its use outside of research studies.
  • Programs that promise rapid weight loss without supervision by a health care professional who understands the potential health and safety concerns this can create. “A person may need to change the type or dosage of their medications, for example,” says Dr. Youdim. “You need to know that someone is evaluating these issues and is qualified to manage them.”