Oprah Winfrey is one of the world’s most famous yo-yo dieters. She lost 67 pounds in 1988; by late 1990 she had regained most of that weight. In 1994 she was thin again — and she completed the Marine Corps Marathon. But by 2008 when she hit 200-plus pounds, she wrote in O Magazine that she felt really uncomfortable! Since then she’s lost 42 pounds and hopes to never have to try to lose weight again.

Down and up. Down and up. It’s a hard pattern to break, and one that millions of Americans experience annually. According to the Centers for Disease Control and Prevention, from 2013 to 2016 around 56% of women and 42% of men tried to lose weight. But research shows that in the first year after dieting, most folks regain 33% to 66% of the weight they lost, and almost all the weight is regained within five years. That’s hard on your spirit, your clothes budget … and your body!

Some studies have shown that yo-yo dieting increases your risk for heart disease and stroke, leads to added weight gain and raises your risk for a variety of health problems related to chronic inflammation. It can also lead to long-term loss of muscle mass if you don’t eat enough lean protein to fight it off. That makes you weaker and lowers your metabolism, making it easier to regain weight.

WHY MAINTAINING WEIGHT LOSS IS SO HARD

Extreme action (super food deprivation, precipitous weight loss, over-exercising) leads to an equal and opposite reaction (indulgence in comfort foods, sedentary behavior and a physiological reaction where the body thinks, “Yikes! I’m starving; feed me more!”). That causes weight rebound.

4 WAYS TO MAINTAIN WEIGHT LOSS

1. Learn a stress management technique and practice it daily. People who manage stress successfully lose weight without even trying. Meditation is useful for easing stress and focusing your determination.

2. Lose weight slowly (a half- to one pound a week) by changing your eating habits and increasing your activity level. That lets your body — your behavior patterns and metabolism — adjust so that you’re less likely to regain lost weight.

3. Change your relationship to food. There’s no ironclad diet that is the key to losing and keeping off excess weight. Moderation within some easy-to-follow guidelines does the trick.

>> Go for a plant-centered diet; eat lean animal protein and fish; enjoy healthy oils from nuts, olive oil; and choose fiber-rich foods like 100% whole grains and produce. But stay flexible. Enjoy your options.

>> Identify when you use food for emotional comfort. As you reach for that box of cookies, ask yourself, “Am I bored? Anxious? Sad?” Then make sure to have snack alternatives like nuts and pre-cut veggies around. Also try activities to ease those emotions: Take a walk, call a friend or write in a diary.

>> Learn to cook new dishes. Spend time reading through recipes online. Pick one a week that’s tasty and healthy. Make shopping a fun excursion. Get your kids and partner involved. Have a friend over to try your creation.

>> Do not eat after 6:30 p.m., eat your biggest meal at midday and have breakfast at least 13 hours after dinner.

4. Move more; build muscle mass.

>> It’s never too late to gain benefits from physical activity, so start with whatever makes you comfortable and build endurance slowly. Every week, try to increase your efforts by 10%. Do you walk for 20 minutes a day? Then go for 22 minutes. Your ultimate goal is 300 minutes of physical activity a week. With 22 minutes x 7 days a week = 154 — that’s more than halfway there!

>> Diversify your activities. Combine walking and aerobics with bouts of intense effort, strength building, agility and balance skills (yoga, jumping, Pilates). There are enough choices to find something that is enjoyable every day.

Once you have lost weight, adopt these guidelines and you’re on your way to a lifetime of better health and happiness.

Mehmet Oz, M.D., is host of “The Dr. Oz Show,” and Mike Roizen, M.D., is chief wellness officer and chairman of the Wellness Institute at Cleveland Clinic. Email questions to youdocsdaily@sharecare.com.