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Behavioral treatment of obesity: thirty years and counting
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“Yet, participants in behavioral treatments, on average, fall far short of maintaining prescribed calorie and PA levels, and lose far less weight than would be expected given these prescriptions.2,3”
From The mind your health project: a randomized controlled trial of an innovative behavioral treatment for obesity (2013) · cites this paper as [3]
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“Although there is some controversy about the effectiveness of restricted eating (Rodin & Brownell, 1994), studies report that weight loss using current methods is poorly maintained in the long run (Wadden, Sternberg, Letizia, Stunkard, & Foster, 1989; Wilson, 1994) and studies that report higher maintenance rates show…”
A Text Message–Based Intervention for Weight Loss: Randomized Controlled Trial
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“Clinical and commercial weight loss programs can produce short-term weight loss, but a majority of adults regain about 40% of the lost weight in the first year and continue to regain [9].”
BackgroundObesity: Responding to the global epidemic.
Wadden, T. A., Brownell, K. D., & Foster, G. D. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.70.3.510 · Cited by 615
“A 20-week program induces an average loss of 8.5–9.0 kg (i.e., 9% of initial weight; Foreyt & Goodrick, 1993; Wadden & Foster, 2000; Wilson, 1994; Wing, 2002).”
BackgroundInfluentialPulmonary Complications of Obesity
Koenig, S. M. (2001) · The American Journal of the Medical Sciences · doi:10.1097/00000441-200104000-00006 · Cited by 521
Foster, G. D., Wadden, T. A., Vogt, R. A., & Brewer, G. (1997) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.65.1.79 · Cited by 460
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Obesity: What Mental Health Professionals Need to Know
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“Yet behavioral treatments have consistently achieved only modest outcomes, typically resulting in weight loss of 5% to 10% of initial body weight over 6 to 12 months, most of which time participants are receiving the active intervention (Brownell & Jeffery, 1987; Wilson, 1994).”
BackgroundForman, E. M., & Butryn, M. L. (2015) · Appetite · doi:10.1016/j.appet.2014.10.004 · Cited by 208
“…and, as a result, participants receiving behavioral treatment lose far less weight than is achieved by individuals in a controlled environment in which adherence to these same prescriptions is guaranteed (Brownell & Jeffery, 1987; Hall, 2010; Heymsfield et al., 2007; K. G. Wilson, 1994).”
Self‐Regulation of Energy Intake in the Prevention and Treatment of Obesity: Is It Feasible?
Lowe, M. R. (2003) · Obesity Research · doi:10.1038/oby.2003.223 · Cited by 201
“As Wilson (48) has suggested, the slow pace of progress in lifestyle change programs over the past several decades suggests that investing efforts to further refine such programs is unlikely to yield substantial benefits.”
BackgroundA qualitative study of GPs' views of treating obesity.
Epstein, L., & Ogden, J. (2005) · Europe PMC (PubMed Central) · Cited by 189
Forman, E. M., Butryn, M. L., Juarascio, A. S., Bradley, L. E., Lowe, M. R., Herbert, J. D., & Shaw, J. A. (2013) · Obesity · doi:10.1002/oby.20169 · Cited by 182
“ing prescribed calorie and PA levels, and lose far less weight than would be expected given these prescriptions.(2,3) Moreover, most ex-”
BackgroundEating disorders, obesity and addiction
Wilson, G. T. (2010) · European Eating Disorders Review · doi:10.1002/erv.1048 · Cited by 184
“The distinctive pattern of relapse that characterizes obesity treatment programs makes good behavioural sense (Wilson, 1994).”
BackgroundSelf-citationBraet, C. (2004) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsh054 · Cited by 169
The impact of obesity surgery and the paradox of control: A qualitative study
Ogden, J., Clementi, C., & Aylwin, S. J. B. (2006) · Psychology and Health · doi:10.1080/14768320500129064 · Cited by 152
“At three- and five-year follow ups, however, the data tend to show weight regain back to baseline weight (Brownell & Wadden, 1992; Wadden, 1993; Wilson, 1995).”
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Evaluation of a modified cognitive-behavioural programme for weight management
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The maintenance of treatment effects in the long-term management of obesity.
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Psychological aspects of weight maintenance and relapse in obesity
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The role of dieting in binge eating disorder
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Long-term follow-up of a cognitive behavioral treatment program for obese children
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Adding cognitive therapy to dietetic treatment is associated with less relapse in obesity
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“The pattern of findings clearly shows that the usual weight regain after behavior treatment [12–14] did occur in participants treated by the exercise dietetic treatment, but not in those who received the cognitive dietetic treatment.”
BackgroundAcceptance and change in the treatment of eating disorders and obesity
Wilson, G. T. (1996) · Behavior Therapy · doi:10.1016/s0005-7894(96)80025-6 · Cited by 114
Self-citationGoldstein, S. P., Evans, B. C., Flack, D., Juarascio, A., Manasse, S., Zhang, F., & Forman, E. M. (2017) · International Journal of Behavioral Medicine · doi:10.1007/s12529-016-9627-y · Cited by 112
“the source of calories that lead to weight regain [23].”
van Strien, T., de Laar, F. A. V., van Leeuwe, J. F. J., Lucassen, P. L., van den Hoogen, H. J. M., Rutten, G. E. H. M., & van Weel, C. (2007) · Health Psychology · doi:10.1037/0278-6133.26.1.105 · Cited by 107
Forman, E. M., Goldstein, S. P., Crochiere, R. J., Butryn, M. L., Juarascio, A. S., Zhang, F., & Foster, G. D. (2019) · Translational Behavioral Medicine · doi:10.1093/tbm/ibz137 · Cited by 94
Awareness and prevention of bias against fat clients in psychotherapy.
Davis-Coelho, K., Waltz, J. A., & Davis-Coelho, B. (2000) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.31.6.682 · Cited by 99
Forman, E. M., Schumacher, L. M., Crosby, R. D., Manasse, S. M., Goldstein, S. P., Butryn, M. L., Wyckoff, E. P., & Thomas, J. G. (2017) · Annals of Behavioral Medicine · doi:10.1007/s12160-017-9897-x · Cited by 106
Nauta, H., Hospers, H. J., Kok, G., & Jansen, A. T. M. (2000) · Behavior Therapy · doi:10.1016/s0005-7894(00)80024-6 · Cited by 98
“Despite encouraging results in the short term, there remains a continuing failure to achieve long-term maintenance of weight: After 1 year almost all participants return to their baseline weights, regardless of the length or method of the initial treatment (Perri, Nezu, Patti, & McCann, 1989; Wilson, 1994).”
BackgroundFollow‐up results of different treatment programs for obese children
Braet, C., Winckel, M. V., & Leeuwen, K. G. V. (1997) · Acta Paediatrica · doi:10.1111/j.1651-2227.1997.tb09030.x · Cited by 97
Braet, C., Tanghe, A., Bode, P. D., Franckx, H., & Winckel, M. V. (2003) · European Journal of Pediatrics · doi:10.1007/s00431-003-1155-5 · Cited by 89
“Whereas adult obesity is known to be resistant to treatment [ 33 ], intervention programmes for children show more promising results [5, 11, 10, 22].”
Forman, E. M., Goldstein, S. P., Zhang, F., Evans, B. C., Manasse, S. M., Butryn, M. L., Juarascio, A. S., Abichandani, P., Martin, G. J., & Foster, G. D. (2019) · Translational Behavioral Medicine · doi:10.1093/tbm/iby016 · Cited by 77
Worksite Intervention for Weight Control: A Review of the Literature
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“The rising prevalence of obesity is generally attributed to greater nutritional accessibility and more sedentary lifestyles, but many aspects of the condition remain enigmatic, and effective treatment continues to prove elusive [1].”
BackgroundCombining Behavioral and Pharmacological Treatments for Obesity
Phelan, S., & Wadden, T. A. (2002) · Obesity Research · doi:10.1038/oby.2002.77 · Cited by 73
“As others have suggested (27), it may be asking too much for overweight individuals to exert continuous control in the face of unremitting biological factors and an environment that supplies an abundance of ready-made high-calorie, high-fat foods, as well as a multitude of energy-saving devices.”
BackgroundForman, E. M., Kerrigan, S. G., Butryn, M. L., Juarascio, A. S., Manasse, S. M., Ontañón, S., Dallal, D. H., Crochiere, R. J., & Moskow, D. M. (2018) · Journal of Behavioral Medicine · doi:10.1007/s10865-018-9964-1 · Cited by 70
“, in-person or telephone coaching) is provided and is sustained long-term (Anderson et al., 1999; Kramer et al., 1989; Wadden et al., 1989; Wilson, 1994; Wilson & Brownell, 2002).”
Prospective relation of dieting behaviors to weight change in a community sample of adolescents
Stice, E. M. (1998) · Behavior Therapy · doi:10.1016/s0005-7894(98)80007-5 · Cited by 67
Fortnightly review: Cognitive behaviour therapy–clinical applications
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One-year follow-up effects of two obesity treatments on psychological well-being and weight
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“Behavioural treatments for obese people who focus on weight loss generally succeed in the short term, but are often not very effective in maintaining weight loss in the long term (e.g. Bennett, 1986; Garner & Wooley, 1991; Wadden, 1993; Wilson, 1994).”
BackgroundWeight‐specific Health‐related Quality of Life in Adolescents With Extreme Obesity
Modi, A. C., Loux, T., Bell, S. K., Harmon, C. M., Inge, T. H., & Zeller, M. H. (2008) · Obesity · doi:10.1038/oby.2008.347 · Cited by 66
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Mindfulness and eating behaviour styles in morbidly obese males and females
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“The long term ineffectiveness of weight control treatment is a fundamental problem of behavioural interventions for obesity (Wilson, 1994).”
BackgroundExplanatory Models of Overweight Among African American, Euro-American, and Mexican American Women
Allan, J. D. (1998) · Western Journal of Nursing Research · doi:10.1177/019394599802000104 · Cited by 56
Li, K. K., Powell, N. B., Riley, R. W., Zonato, A. I., Gervacio, L., & Guilleminault, C. (2000) · The Laryngoscope · doi:10.1097/00005537-200006000-00019 · Cited by 53
“Furthermore, regardless of the method of dietary alteration, there is a high degree of relapse after weight loss.(24,25) More importantly, From the Stanford University Sleep Disorders and Research Center, Stanford, California.”
MethodMaintenance of weight loss after obesity treatment: is continuous support necessary?
Leibbrand, R., & Fichter, M. M. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00099-7 · Cited by 52
Ogden, J., & Sidhu, S. (2006) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2006.04.017 · Cited by 50
“Although some individuals lose weight with this approach an analysis of the effectiveness of behaviourally based treatments suggests that at 3 and 5 year follow ups most show weight regain back to baseline weight (1,2,3).”
BackgroundOgden, J., Karim, L., Choudry, A., & Brown, K. A. (2006) · Health Education Research · doi:10.1093/her/cyl090 · Cited by 50
The Lived Experience of Choosing Bariatric Surgery to Lose Weight
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“…and have lost weight on weight reduction programs regain the lost weight back within 5 years (Fabricatore & Wadden, 2003; Institute of Medicine, 1995; National Institutes of Health Technology Assessment Conference Panel, 1993; Wadden, Sternberg, Letizia, Stunkard, & Foster, 1989; Wilson, 1994).”
BackgroundBehavioral treatment of childhood obesity: Theoretical and practical implications.
Wilson, G. T. (1994) · Health Psychology · doi:10.1037/0278-6133.13.5.371 · Cited by 48
Self-citationAllison, D. B., & Faith, M. S. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.64.3.513 · Cited by 47
“narrative reviews (e.g., Brownell, 1993; Garner & Wooley, 1992; Wilson, 1994) of the broader obesity treatment literature.”
BackgroundA wireless wellness monitor for personal weight management
Pärkkä, J., van Gils, M., Tuomisto, M. T., Lappalainen, R. I., & Korhonen, I. (2002) · IEEE International Conference on Information Technology and Applications in Biomedicine · doi:10.1109/itab.2000.892354 · Cited by 46
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Obesity Treatment: Examining the Premises
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The past, present, and future of behavioral obesity treatment
Chao, A. M., Moore, M., & Wadden, T. A. (2025) · International Journal of Obesity · doi:10.1038/s41366-024-01525-3 · Cited by 40
“These limitations, combined with a growing recognition of the need for direct modi fi cation of the biological mechanisms that regulate body weight, prompted several investigators to continue testing the integration of anti-obesity medications and behavioral treatment [63].”
Using ecological momentary assessment to better understand dietary lapse types
Goldstein, S. P., Dochat, C., Schumacher, L. M., Manasse, S. M., Crosby, R. D., Thomas, J. G., Butryn, M. L., & Forman, E. M. (2018) · Appetite · doi:10.1016/j.appet.2018.07.003 · Cited by 38
Behavior analytic contributions to public health and telehealth
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Behavioral Approaches to the Problems of Obesity
Faith, M. S., Fontaine, K. R., Cheskin, L. J., & Allison, D. B. (2000) · Behavior Modification · doi:10.1177/0145445500244001 · Cited by 37
“For the most part, such interventions have been increasingly successful in the short run but consistently disappointing in the long run (Garner & Wooley, 1991; Wadden et al., 1989; Wilson, 1994).”
BackgroundResultInfluentialObesity: Towards a System of Libertarian Paternalistic Public Health Interventions
Skipper, R. A. (2012) · Public Health Ethics · doi:10.1093/phe/phs020 · Cited by 34
Maintenance following a very-low-calorie diet.
Agras, W. S., Berkowitz, R. I., Arnow, B. A., Telch, C. F., Marnell, M. E., Henderson, J. B., Morris, Y., & Wilfley, D. E. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.64.3.610 · Cited by 34
“This study adds to the literature demonstrating the steady regain in weight following different types of weight loss programs despite the use of a variety of maintenance procedures ( Brownell, Marlatt, Lichtenstein, & Wilson, 1986 ; Perri et al., 1988 ; Wadden et al., 1994 ; Wilson, 1994 ). Page 5 of 7”
BackgroundResultCognitive-behavioural approaches and weight management: an overview
Liao, K. L. (2000) · The Journal of the Royal Society for the Promotion of Health · doi:10.1177/146642400012000114 · Cited by 32
Long‐Term Drug Treatment of Obesity in a Private Practice Setting
Atkinson, R. L., Blank, R. C., Schumacher, D., Dhurandhar, N. V., Ritch, D. L., Chan, E. S. Y., & Rieg, T. S. (1997) · Obesity Research · doi:10.1002/j.1550-8528.1997.tb00579.x · Cited by 32
MINI‐REVIEW Assessment of Body Image Disturbance in Obesity
Thompson, J. K., & Tantleff‐Dunn, S. (1998) · Obesity Research · doi:10.1002/j.1550-8528.1998.tb00366.x · Cited by 34
Appearance vs Health as Motivators for Weight Loss
Cheskin, L. J., & Donze, L. F. (2001) · JAMA · doi:10.1001/jama.286.17.2160-jms1107-4-1 · Cited by 31
Psychological profile to become and to stay obese
Braet, C. (2005) · International Journal of Obesity · doi:10.1038/sj.ijo.0803100 · Cited by 30
“Although externality is not yet explained by a good model, therapeutic techniques focusing on reducing the external responsiveness to food cues were very successful”
BackgroundUSE OF DRUGS IN THE TREATMENT OF OBESITY
Atkinson, R. L. (1997) · Annual Review of Nutrition · doi:10.1146/annurev.nutr.17.1.383 · Cited by 29
Ball, G. D. C., Mushquash, A. R., Keaschuk, R. A., Ambler, K. A., & Newton, A. S. (2017) · BMC Research Notes · doi:10.1186/s13104-016-2361-3 · Cited by 31
Role for a sense of self-worth in weight-loss treatments: helping patients develop self-efficacy.
Cochrane, G. (2008) · PubMed Central · Cited by 30
Garaulet, M., Pérez‐Llamas, F., Zamora, S., & Tébar, F. J. (1999) · Journal of Human Nutrition and Dietetics · doi:10.1046/j.1365-277x.1999.00163.x · Cited by 27
Grilo, C. M. (1994) · Biomedicine & Pharmacotherapy · doi:10.1016/0753-3322(94)90101-5 · Cited by 28
Leveraging applied behavior analysis research and practice in the service of public health
Normand, M. P., Dallery, J., & Slanzi, C. M. (2021) · Journal of Applied Behavior Analysis · doi:10.1002/jaba.832 · Cited by 26
Forman, E. M., Berry, M. P., Butryn, M. L., Hagerman, C. J., Huang, Z., Juarascio, A. S., LaFata, E. M., Ontañón, S., Tilford, J. M., & Zhang, F. (2023) · Contemporary Clinical Trials · doi:10.1016/j.cct.2022.107029 · Cited by 24
ASSESSMENT AND TREATMENT OF BINGE-EATING DISORDER
Devlin, M. J. (1996) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70380-4 · Cited by 24
What Characterizes Successful Weight Maintainers?
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Personal Theories of Hunger and Eating1
Assanand, S., Pinel, J. P. J., & Lehman, D. R. (1998) · Journal of Applied Social Psychology · doi:10.1111/j.1559-1816.1998.tb01664.x · Cited by 23
Manasse, S. M., Crochiere, R. J., Dallal, D. H., Lieber, E. W., Schumacher, L. M., Crosby, R. D., Butryn, M. L., & Forman, E. M. (2018) · Appetite · doi:10.1016/j.appet.2018.04.025 · Cited by 22
Treatment of Obese Children: A New Rationale
Braet, C. (1999) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104599004004013 · Cited by 21
“Wilson (1994a) pointed out that the understanding of the mechanisms which cause, or at least maintain obesity, should determine what treatment is to be adopted.”
BackgroundInfluentialIs weight loss a realistic goal of treatment in type 2 diabetes?
Clark, M. (2004) · Patient Education and Counseling · doi:10.1016/j.pec.2003.07.008 · Cited by 20
“Finally, it is widely acknowledged that the obese diabetic patient poses a formidable therapeutic challenge [12,43,76] and recent reviews document the failure of all obesity treatment approaches, behavioural, dietetic or pharmacological, to achieve significant and long-lasting weight loss [10–13].”
BackgroundResultInfluentialThe role of weight management in the health of women
Jeor, S. T. S. (1993) · Journal of the American Dietetic Association · doi:10.1016/0002-8223(93)92039-z · Cited by 20
Comparing Large Language Model AI and Human-Generated Coaching Messages for Behavioral Weight Loss
Huang, Z., Berry, M. P., Chwyl, C., Hsieh, G., Wei, J., & Forman, E. M. (2025) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-025-00491-5 · Cited by 22
“Still, a recent study by our research group reveals these messages often suffer from repetitiveness, impersonal tones, and redundant content, partly because they rely on a rule-based approach, where predefined rules lead to predictable content.”
Integrating cognitive behavioural therapy into dietetic practice: a challenge for dietitians
Rapoport (1998) · Journal of Human Nutrition and Dietetics · doi:10.1046/j.1365-277x.1998.00102.x · Cited by 19
Reasonable Weights: Determinants, Definitions and Directions
Foster, G. D. (1995) · Springer eBooks · doi:10.1007/978-1-4615-1901-0_4 · Cited by 19
Butryn, M. L., Kerrigan, S. G., Arigo, D., Raggio, G. A., & Forman, E. M. (2016) · Behavioral Medicine · doi:10.1080/08964289.2016.1170663 · Cited by 21
Bardus, M., Hamadeh, G. N., Hayek, B., & Kherfan, R. A. (2018) · JMIR Research Protocols · doi:10.2196/resprot.9793 · Cited by 19
Verbiest, I., Michels, N., Tanghe, A., & Braet, C. (2021) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2021.07.020 · Cited by 23
Goldstein, S. P., Brick, L. A. D., Thomas, J. G., & Forman, E. M. (2020) · Translational Behavioral Medicine · doi:10.1093/tbm/ibaa097 · Cited by 16
Behavioral and Psychological Predictors of Treatment Outcome in Obesity
Wilson, G. T. (1995) · Springer eBooks · doi:10.1007/978-1-4615-1901-0_24 · Cited by 16
Self-citationMeers, M. R. (2013) · OhioLink ETD Center (Ohio Library and Information Network) · Cited by 14
Behavioral and Cognitive‐Behavioral Psychotherapy
Craighead, W. E., & Craighead, L. W. (2003) · Handbook of Psychology · doi:10.1002/0471264385.wei0811 · Cited by 14
Janssen, L. K., Duif, I., Speckens, A. E. M., van Loon, I., Wegman, J., de Vries, J. H. M., Cools, R., & Aarts, E. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1115727 · Cited by 11
“Although weight control and diet interventions are often successful in producing significant weight loss on the short term, they often fail to produce longterm weight maintenance (73).”
BackgroundThe Impact of Personality Traits on the Success of a Multimodal Obesity Treatment
Lahmann, C., Henrich, G., Henningsen, P., Baessler, A., Fischer, M. J., Loew, T. H., Tritt, K., & Pieh, C. (2011) · Behavioral Medicine · doi:10.1080/08964289.2011.635169 · Cited by 11
“4 , 5 Weight regain is believed to be a combination of a physiological drive to return one's body weight to the previous “settling point” 6 and/or the failure to maintain a less obeseogenic lifestyle and eating behaviors.”
BackgroundGreater mindful eating practice is associated with better reversal learning
Janssen, L. K., Duif, I., van Loon, I., de Vries, J. H. M., Speckens, A. E. M., Cools, R., & Aarts, E. (2018) · Scientific Reports · doi:10.1038/s41598-018-24001-1 · Cited by 9
James, L. C., Folen, R. A., & Earles, J. E. (2001) · Military Psychology · doi:10.1207/s15327876mp1303_4 · Cited by 11
“Other researchers also have documented the successful use of cognitive–behavioral treatment approaches with this population (Fairburn, 1995; Fairburn & Wilson, 1993; Vitousek & Orimoto, 1993).”
Background
Metadata
- Authors
- Wilson, G. T.
- Affiliations
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Wilson, G.Terence
- ORCID
- Wilson, G.Terence
- Venue
- Advances in Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 1994-01
- Volume
- 16
- Issue
- 1
- Pages
- 31-75
- ISSN
- 0146-6402 (ISSN-L)
- OpenAlex
- W2115017918
- Cited by
- 159
- References
- 169
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 4 · 2019: 1 · 2018: 7 · 2017: 4 · 2016: 2 · 2015: 1 · 2014: 3 · 2013: 7 · 2012: 4
- FWCI
- 12.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Advances in Behaviour Research and Therapy (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
- Keywords
- obesity, behavior therapy, weight loss, relapse, weight maintenance, very low calorie diet, cognitive behavioral therapy, binge eating, dietary habits, obesity phenotypes, body weight regulation
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