When it comes to maintaining weight loss, nothing works quite as well as the sympathetic ear of a human counsellor.

A new study finds that people who have lost weight are more likely to keep it off if they chat periodically with a counsellor rather than turning to a website that provides advice or getting no support at all.

The researchers speculate that it may be the aspect of being personally accountable to a human counsellor that motivates people to maintain healthy eating habits.

The study, published the Journal of the American Medical Association, looked 1,032 volunteers who had recently lost, on average, about 19 pounds each during a six-month weight loss program. They were randomly assigned to one of three groups:

  • The first group had monthly personal talks on diet and physical activity with trained weight-loss counsellors. The talks usually were by telephone but every four months people in the group had hour-long face-to-face meetings with counsellors.
  • The second group was given access to an interactive website with information and tools to track weight, keep food diaries and monitor exercise levels.
  • People in the third group were "self-directed" and worked to maintain weight loss largely on their own. They received printed information with diet and lifestyle recommendations at the beginning of the study and also met briefly with a trained counsellor once in the middle of the study.

By the study's end, two-and-a-half years later, most had regained some weight.

But the group who had personal contact with counsellors regained the least amount of weight -- an average of 8.8 pounds. The group using the website regained 11.5 pounds, doing little better than the people who were on their own, who regained 12.1 pounds.

Although the differences were modest, study co-author Dr. Lawrence Appel of the Johns Hopkins School of Medicine in Baltimore points out that even small changes in weight can have big effects on health.

"Keeping just a few pounds off can significantly affect your risk of getting high blood pressure or diabetes," he said in a statement.

He believes that having to answer to a counsellor kept the volunteers in the first group motivated. "Some dimensions of person-to-person contact are hard to duplicate with technology," he said.

Even with these findings, doctors aren't likely to recommend personal counsellors for everyone trying to keep weight off.

"There aren't enough dietitians and weight-loss counsellors in the world to maintain this kind of personal contact," Appel says.

Lead author Dr. Laura P. Svetkey, a professor of medicine at Duke University Medical Center in Durham, N.C. says the study does point to those techniques that work for long-term weight-loss.

"The takeaway message of this study for people wanting to keep weight off long-term is: adopt a healthy diet; focus on lifestyle changes you can sustain; reduce calorie intake; keep notes daily on how much you eat and exercise; set specific, realistic goals you can meet; seek encouragement from family, friends and co-workers to support your healthy choices; and remind yourself again and again of your original motivation and the health benefits of weight loss," she said.