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.