on the long term. Weight loss programs Weight loss programs involve lifestyle changes including diet modifications, physical activity and behavior therapy. This may involve eating smaller meals, cutting down on certain types of food and making a conscious effort to exercise more. These programs also enable people to connect with a group of others who are attempting to lose weight, in the hopes that participants will form mutually motivating and encouraging relationships. Since 2013, the United States guidelines recommend treating obesity as a disease and actively treat obese people for weight loss. A number of popular programs exist including Weight Watchers, Overeaters Anonymous and Jenny Craig. These appear to provide modest weight loss () over dieting on one's own () over a two-year period, similarly to non-commercial diets. As of 2005, there was insufficient scientific evidence to determine whether Internet-based programs produce effective weight loss. The Chinese government has introduced a number of "fat farms" where obese children go for reinforced exercise and has passed a law which requires students to exercise or play sports for an hour a day at school (see Obesity in China). In a structured setting with a trained therapist, these interventions produce an average weight loss of up to 8 kg in 6 months to 1 year, and 67% of people who lost greater than 10% of their body mass maintained or continued to lose weight one year later. There is a gradual weight regain after the first year of about 1 to 2 kg per year, but on the long-term this still results in weight loss. Attending group meetings for weight reduction programmes rather than receiving one-on-one support may increase the likelihood that obese people will lose weight. Those who participated in groups had more treatment time and were more likely to lose enough weight to improve their health. Study authors suggested that one explanation for the difference is that group participants spent more time with the clinician (or whoever delivered the programme) than those receiving one-on-one support. Comprehensive diet programs, providing counseling, targets for calorie intake and exercise, may be more efficient than dieting without guidance ("self-help"), although the evidence is very limited. Following comprehensive lifestyle modifications, the average maintained weight loss is more than or 3% of total body mass, and could be sustained for five years, and up to 20% of the individuals maintain a weight loss of at least 10%