Medicare's search for effective obesity treatments: Diets are not the answer.

Mann, Traci; Tomiyama, A. Janet; Westling, Erika; Lew, Ann-Marie; Samuels, Barbra; Chatman, Jason

doi:10.1037/0003-066x.62.3.220

Cited by 1,208Eating Disorders and BehaviorsObesity, Physical Activity, DietObesity and Health Practices

Medicare's search for effective obesity treatments: Diets are not the answer.

Mann, Traci, Tomiyama, A. Janet, Westling, Erika, Lew, Ann-Marie, Samuels, Barbra, Chatman, Jason·2007·American Psychologist

DOI 10.1037/0003-066x.62.3.220

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Abstract

The prevalence of obesity and its associated health problems have increased sharply in the past 2 decades. New revisions to Medicare policy will allow funding for obesity treatments of proven efficacy. The authors review studies of the long-term outcomes of calorie-restricting diets to assess whether dieting is an effective treatment for obesity. These studies show that one third to two thirds of dieters regain more weight than they lost on their diets, and these studies likely underestimate the extent to which dieting is counterproductive because of several methodological problems, all of which bias the studies toward showing successful weight loss maintenance. In addition, the studies do not provide consistent evidence that dieting results in significant health improvements, regardless of weight change. In sum, there is little support for the notion that diets lead to lasting weight loss or health benefits.

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Weight loss interventions may not be sustainable and potentially lead to greater risk in the long term.
“weight loss interventions may not be sustainable and potentially lead to greater risk in the long term [55,56,57,58,59].”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [56]
The sustainability of weight loss interventions has been questioned, and weight cycling has been identified as an independent risk factor for cardiovascular disease.
“the sustainability of weight loss interventions has been questioned [55,56,57], and weight cycling has been identified as an independent risk factor for cardiovascular disease [58,59]”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [56]

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“Third, the promotion of “healthy weight” as the key to health and well-being may instill a sense of learned helplessness in the majority of people who will be unable to attain these weight-based goals [1, 2, 5, 36].”
Long-Term Adherence to Health Behavior Change
Middleton, K. R., Anton, S. D., & Perri, M. G. (2013) · American Journal of Lifestyle Medicine · doi:10.1177/1559827613488867 · Cited by 499 · see citing works
Calorie Labeling And Food Choices: A First Look At The Effects On Low-Income People In New York City: Calorie information on menus appears to increase awareness of calorie content, but not necessarily the number of calories people purchase.
Elbel, B., Kersh, R., Brescoll, V. L., & Dixon, L. B. (2009) · Health Affairs · doi:10.1377/hlthaff.28.6.w1110 · Cited by 496 · see citing works
“Eating behavior is notoriously resistant to change.(39) A large body of research has shown that weight-loss interventions designed to educate people about healthful food choices are generally ineffective.”
Background
Causes of Emotional Eating and Matched Treatment of Obesity
van Strien, T. (2018) · Current Diabetes Reports · doi:10.1007/s11892-018-1000-x · Cited by 501 · see citing works
Why we eat what we eat. The Eating Motivation Survey (TEMS)
Renner, B., Sproesser, G., Strohbach, S., & Schupp, H. T. (2012) · Appetite · doi:10.1016/j.appet.2012.04.004 · Cited by 445 · see citing works
Training inhibitory control. A recipe for resisting sweet temptations
Houben, K., & Jansen, A. (2011) · Appetite · doi:10.1016/j.appet.2010.12.017 · Cited by 339 · see citing works
Healthy diet: Health impact, prevalence, correlates, and interventions
de Ridder, D. T. D., Kroese, F. M., Evers, C., Adriaanse, M. A., & Gillebaart, M. (2017) · Psychology and Health · doi:10.1080/08870446.2017.1316849 · Cited by 323 · see citing works
“The majority of dieters manage to lose some weight initially but regain the weight within two years, whereas only a small minority is able to maintain weight loss in the long term (Jeffery et al., 2000; Mann et al., 2007).”
Background
Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies
Barber, T. M., Hanson, P., Weickert, M. O., & Franks, S. (2019) · Clinical Medicine Insights: Reproductive Health · doi:10.1177/1179558119874042 · Cited by 411 · see citing works
Why most dieters fail but some succeed: A goal conflict model of eating behavior.
Stroebe, W., van Koningsbruggen, G. M., Papies, E. K., & Aarts, H. (2012) · Psychological Review · doi:10.1037/a0030849 · Cited by 318 · see citing works
Review Article Relationships between intuitive eating and health indicators: literature review
Dyke, N. V., & Drinkwater, E. J. (2013) · Public Health Nutrition · doi:10.1017/s1368980013002139 · Cited by 307 · see citing works
Executive functions and the self-regulation of eating behavior: A review
Dohle, S., Diel, K., & Hofmann, W. (2018) · Appetite · doi:10.1016/j.appet.2017.05.041 · Cited by 305 · see citing works
“Changing one’s eating behavior, however, is not easy: While millions of people diet, most of them ultimately gain weight (Burnette & Finkel, 2012; de Ridder, Adriaanse, Evers, & Verhoeven, 2014; Guerrieri, Stanczyk, Nederkoorn, & Jansen, 2012; Mann et al., 2007).”
Emotional Eating, Rather Than Lifestyle Behavior, Drives Weight Gain in a Prospective Study in 1562 Employees
Koenders, P. G., & van Strien, T. (2011) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0b013e31823078a2 · Cited by 297 · see citing works
Food insecurity as a driver of obesity in humans: The insurance hypothesis
Nettle, D., Andrews, C. P., & Melissa Bateson, B. (2016) · Behavioral and Brain Sciences · doi:10.1017/s0140525x16000947 · Cited by 300 · see citing works
Effects of non-invasive neurostimulation on craving: A meta-analysis
Jansen, J. M., Daams, J. G., Koeter, M. W. J., Veltman, D. J., van den Brink, W., & Goudriaan, A. E. (2013) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2013.07.009 · Cited by 284 · see citing works
“Furthermore, weight loss programmes are often ineffective for obese patients, as 33% to 66% of patients regain all weight that was lost, or gain even more (Bacon and Aphramor, 2011; Mann et al., 2007).”
Background
Weighed Down by Stigma: How Weight‐Based Social Identity Threat Contributes to Weight Gain and Poor Health
Hunger, J. M., Major, B., Blodorn, A., & Miller, C. T. (2015) · Social and Personality Psychology Compass · doi:10.1111/spc3.12172 · Cited by 332 · see citing works
“Although temporary weight loss may be achieved through such efforts, long term maintenance of weight loss is difficult if not impossible to achieve (Mann et al., 2007; Tomiyama, Alhstrom, & Mann, 2013).”
Nudge to nobesity I: Minor changes in accessibility decrease food intake
Rozin, P. N., Scott, S., Dingley, M., Urbanek, J. K., Jiang, H., & Kaltenbach, M. (2011) · Judgment and Decision Making · doi:10.1017/s1930297500001935 · Cited by 281 · see citing works
Stigma and the perpetuation of obesity
Brewis, A. (2014) · Social Science & Medicine · doi:10.1016/j.socscimed.2014.08.003 · Cited by 269 · see citing works
Dieting and weight cycling as risk factors for cardiometabolic diseases: Who is really at risk?
Montani, J. ‐., Schutz, Y., & Dulloo, A. G. (2015) · Obesity Reviews · doi:10.1111/obr.12251 · Cited by 257 · see citing works
A review of the effects of exercise on appetite regulation: an obesity perspective
Martins, C., Morgan, L., & Truby, H. (2008) · International Journal of Obesity · doi:10.1038/ijo.2008.98 · Cited by 254 · see citing works
Platemate
Noronha, J., Hysen, E., Zhang, H., & Gajos, K. Z. (2011) · ACM Symposium on User Interface Software and Technology (UIST) · doi:10.1145/2047196.2047198 · Cited by 247 · see citing works
“Seeking comprehensible and actionable advice, Americans spend over $40 billion each year on diets and selfhelp books [18], but achieve little success: the majority eventually regain any lost weight and more [13].”
Background
Child and adolescent fast-food choice and the influence of calorie labeling: a natural experiment
Elbel, B. D., Gyamfi, J., & Kersh, R. (2011) · International Journal of Obesity · doi:10.1038/ijo.2011.4 · Cited by 236 · see citing works
Goal priming and eating behavior: Enhancing self-regulation by environmental cues.
Papies, E. K., & Hamstra, P. (2010) · Health Psychology · doi:10.1037/a0019877 · Cited by 231 · see citing works
“Indeed, once they have stopped dieting, many dieters may even regain more weight than they initially lost (Mann et al., 2007).”
Background
High trait self-control predicts positive health behaviors and success in weight loss
Will Crescioni, A., Ehrlinger, J., Alquist, J. L., Conlon, K. E., Baumeister, R. F., Schatschneider, C., & Dutton, G. R. (2011) · Journal of Health Psychology · doi:10.1177/1359105310390247 · Cited by 225 · see citing works
“While many overweight and obese individuals attempt to lose weight (Carrol, 2005), people often have only limited success in achieving and maintaining weight loss (Mann et al., 2007).”
Background
Nudge to nobesity II: Menu positions influence food orders
Dayan, E., & Bar‐Hillel, M. (2011) · Judgment and Decision Making · doi:10.1017/s1930297500001947 · Cited by 223 · see citing works
Mechanisms underlying the weight loss effects of RYGB and SG: similar, yet different
Pucci, A. B. F., & Batterham, R. L. (2018) · Journal of Endocrinological Investigation · doi:10.1007/s40618-018-0892-2 · Cited by 222 · see citing works
“3 and contribute to the high rate of weight recidivism observed following lifestyle intervention weight management programmes [57].”
Background
The Psychological Weight of Weight Stigma
Major, B., Eliezer, D., & Rieck, H. (2012) · Social Psychological and Personality Science · doi:10.1177/1948550611434400 · Cited by 220 · see citing works
Intuitive eating in young adults. Who is doing it, and how is it related to disordered eating behaviors?
Denny, K. N., Loth, K. A., Eisenberg, M. E., & Neumark‐Sztainer, D. (2012) · Appetite · doi:10.1016/j.appet.2012.09.029 · Cited by 218 · see citing works
“Furthermore, dieters may experience large weight fluctuations (Mann et al., 2007), emotional distress (Hawks, Madanat, & Christley, 2008; Rubinstein, 2006; Theim, 2007), depression (Cachelin & Regan, 2006; Gillen, Markey, & Markey, 2012), and are at risk for the development of eating disorders…”
Background
A systematic review of the relationship between eating, weight and inhibitory control using the stop signal task
Bartholdy, S., Dalton, B., O’Daly, O., Campbell, I. C., & Schmidt, U. H. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.02.010 · Cited by 215 · see citing works
“Restrained eaters frequently report unsuccessful dieting and their efforts at restraint are often accompanied by periods of overeating, particularly when they are disinhibited (Hofmann et al., 2014; Mann et al., 2007).”
Background
Dietary restraint: What’s the harm? A review of the relationship between dietary restraint, weight trajectory and the development of eating pathology
Schaumberg, K., Anderson, D. A., Anderson, L. M., Reilly, E. E., & Gorrell, S. (2016) · Clinical Obesity · doi:10.1111/cob.12134 · Cited by 210 · see citing works
“Recently, a review of dietary restraint-related concepts claimed that ‘dieting is not the answer’ to problems related to overweight and obesity (62), citing that weight gain commonly follows attempts to reduce energy intake.”
Background
Using stop signals to inhibit chronic dieters’ responses toward palatable foods
Veling, H., Aarts, H., & Papies, E. K. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.08.005 · Cited by 207 · see citing works
“Dieting has been found to be a rather ineffective weight maintenance and weight reduction strategy (Elfhag & Rössner, 2005; Jeffery et al., 2000; Mann et al., 2007).”
Background
A Review of Interventions that Promote Eating by Internal Cues.
Schaefer, J. T., & Magnuson, A. B. (2014) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2013.12.024 · Cited by 206 · see citing works
“Researchers are now raising attention to the serious ethical concern with recommending diets for weight loss due to long-term ineffectiveness and adverse effects.(3,16) As a result, much attention has been brought to a health-centered nondiet approach, commonly referred to as intuitive eating.”
Background
Pathways from dieting to weight regain, to obesity and to the metabolic syndrome: An overview
Dulloo, A. G., & Montani, J. ‐. (2015) · Obesity Reviews · doi:10.1111/obr.12250 · Cited by 202 · see citing works
“increased anxiety and depression), deficits in certain aspects of cognitive performance, in a variety of increased morbidities that includes type 2 diabetes, hypertension, cancer, diminished bone density and risks for bone fracture, inflammation and even increased mortality (3).”
Background
Low calorie dieting increases cortisol
Tomiyama, A. J., Mann, T., Vinas, D., Hunger, J. M., DeJager, J., & Taylor, S. E. (2010) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181d9523c · Cited by 203 · see citing works
A systematic review of the psychosocial correlates of intuitive eating among adult women
Bruce, L. J., & Ricciardelli, L. A. (2015) · Appetite · doi:10.1016/j.appet.2015.10.012 · Cited by 198 · see citing works
The Fat studies reader
Rothblum, E. D., & Solovay, S. (2010) · Choice Reviews Online · doi:10.5860/choice.47-3885 · Cited by 196 · see citing works
Implicit Theories of Body Weight: Entity Beliefs Can Weigh You Down
Burnette, J. L. (2010) · Personality and Social Psychology Bulletin · doi:10.1177/0146167209359768 · Cited by 193 · see citing works
Obesity, Health at Every Size, and Public Health Policy
Bombak, A. E. (2013) · American Journal of Public Health · doi:10.2105/ajph.2013.301486 · Cited by 200 · see citing works
Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial
Mason, A. E., Epel, E. S., Kristeller, J. L., Moran, P. J., Dallman, M. F., Lustig, R. H., Acree, M. C., Bacchetti, P., Laraia, B. A., Hecht, F. M., et al. (2015) · Journal of Behavioral Medicine · doi:10.1007/s10865-015-9692-8 · Cited by 195 · see citing works
“…Department of Pediatrics, UCSF, San Francisco, CA, USA 5 Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA 6 UC Berkeley School of Public Health, Berkeley, CA, USA yet these improvements tend to be lost during longer-term follow-up (Byrne et al., 2003; Mann et al., 2007).”
Background
Intuitive eating longitudinally predicts better psychological health and lower use of disordered eating behaviors: findings from EAT 2010–2018
Hazzard, V. M., Telke, S. E., Simone, M., Anderson, L. M., Larson, N., & Neumark‐Sztainer, D. (2020) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-020-00852-4 · Cited by 206 · see citing works
Dieting and the self‐control of eating in everyday environments: An experience sampling study
Hofmann, W., Adriaanse, M. A., Vohs, K. D., & Baumeister, R. F. (2013) · British Journal of Health Psychology · doi:10.1111/bjhp.12053 · Cited by 187 · see citing works
“These difficulties were expected to result in a non-significant overall relationship between dietary restraint and weight loss, as other work has found (Mann et al., 2007; Tiggemann, 1994).”
BackgroundResult
Popular Nutrition-Related Mobile Apps: A Feature Assessment
Franco, R. Z., Fallaize, R., Lovegrove, J. A., & Hwang, F. (2016) · JMIR mhealth and uhealth · doi:10.2196/mhealth.5846 · Cited by 187 · see citing works
“However, if used without professional recommendation, this may mislead the users to begin unhealthy diets or trigger an eating disorder [11,12].”
Eating style, overeating and weight gain. A prospective 2-year follow-up study in a representative Dutch sample
van Strien, T., Peter Herman, C., & Verheijden, M. W. (2012) · Appetite · doi:10.1016/j.appet.2012.08.009 · Cited by 186 · see citing works
European Headache Federation guideline on idiopathic intracranial hypertension
Hoffmann, J., Mollan, S. P., Paemeleire, K., Lampl, C., Jensen, R., & Sinclair, A. J. (2018) · The Journal of Headache and Pain · doi:10.1186/s10194-018-0919-2 · Cited by 186 · see citing works
An Evidence‐Based Rationale for Adopting Weight‐Inclusive Health Policy
Hunger, J. M., Smith, J. P., & Tomiyama, A. J. (2020) · Social Issues and Policy Review · doi:10.1111/sipr.12062 · Cited by 188 · see citing works
“Prospective diet studies with no control group fare even worse—one third to two thirds of dieters in those studies gain back more weight than they lose initially on the diet (Mann et al., 2007).”
BackgroundInfluentialSelf-citation
Targeting impulsive processes of eating behavior via the internet. Effects on body weight
Veling, H., van Koningsbruggen, G. M., Aarts, H., & Stroebe, W. (2014) · Appetite · doi:10.1016/j.appet.2014.03.014 · Cited by 177 · see citing works
“However, there is a large literature showing that dieting intentions are often not effective for regulating one’s consumption behavior (Elfhag & Rössner, 2005; Jeffery et al., 2000; Mann et al., 2007).”
Background
Cognitive Function After Bariatric Surgery: Evidence for Improvement 3 Years After Surgery
Alosco, M. L., Galioto, R., Spitznagel, M. B., Strain, G., Devlin, M., Cohen, R., Crosby, R. D., Mitchell, J. E., & Gunstad, J. (2014) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2013.05.018 · Cited by 172 · see citing works
“obese people.(8,9) Bariatric surgery is associated with lower mortality and morbidity risk, decreased hospitalizations, and reduced need for medications.”
Does dieting make you fat? A twin study
Pietiläinen, K. H., Saarni, S. E., Kaprio, J., & Rissanen, A. (2012) · International Journal of Obesity · doi:10.1038/ijo.2011.160 · Cited by 173 · see citing works
Effects of Bariatric Surgery on Human Small Artery Function
Aghamohammadzadeh, R., Greenstein, A. S., Yadav, R., Jeziorska, M., Hama, S., Soltani, F., Pemberton, P., Ammori, B. J., Malik, R. A., Soran, H., et al. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.04.027 · Cited by 169 · see citing works
“Effective and sustained dieting does lead, without doubt, to significant weight loss, but unfortunately the weight loss is not sustained (20).”
Background
A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial
Mensinger, J. L., Calogero, R. M., Stranges, S., & Tylka, T. L. (2016) · Appetite · doi:10.1016/j.appet.2016.06.006 · Cited by 169 · see citing works
“Dieting has also been shown to be ineffective for sustaining lost weight in the long-term (Fildes et al., 2015; Kraschnewski et al., 2010; Mann et al., 2007), and, it increases the health risks associated with weight-cycling (Montani, Schutz, & Dulloo, 2015).”
The effect of viewing ultra-fit images on college women's body dissatisfaction
Homan, K. J., McHugh, E., Wells, D. S., Watson, C., & King, C. (2011) · Body Image · doi:10.1016/j.bodyim.2011.07.006 · Cited by 165 · see citing works
"They all work...when you stick to them": A qualitative investigation of dieting, weight loss, and physical exercise, in obese individuals
Thomas, S. L., Hyde, J., Karunaratne, A. S., Kausman, R., & Komesaroff, P. A. (2008) · Nutrition Journal · doi:10.1186/1475-2891-7-34 · Cited by 162 · see citing works
“We also acknowledge that fad diets are not the solution to weight loss [2], and that we need to consider a number of short and long term strategies to facilitate the social change needed to enable individuals, families and communities to live healthy lifestyles [3].”
The Role of Diet and Nutrient Composition in Nonalcoholic Fatty Liver Disease
McCarthy, E. M., & Rinella, M. E. (2012) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jada.2011.10.007 · Cited by 162 · see citing works
“Althoughthedataare incomplete,mostevidencesuggests that the vastmajority of peoplewho loseweight regain it during the subsequent months or years (70,71).”
Vegetarian diets and childhood obesity prevention
Sabaté, J., & Wien, M. (2010) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2010.28701f · Cited by 161 · see citing works
“In light of the consensus that obesity is a significant public health concern and that the majority of weight loss interventions have been unsuccessful in the long term (13), a closer exploration of vegetarian diets that are beneficial in the primary prevention of obesity is warranted.”
Background
Using stop signals to reduce impulsive choices for palatable unhealthy foods
Veling, H., Aarts, H., & Stroebe, W. (2012) · British Journal of Health Psychology · doi:10.1111/j.2044-8287.2012.02092.x · Cited by 156 · see citing works
Healthy Cognition: Processes of Self-Regulatory Success in Restrained Eating
Papies, E. K., Stroebe, W., & Aarts, H. (2008) · Personality and Social Psychology Bulletin · doi:10.1177/0146167208320063 · Cited by 159 · see citing works
“Only a small minority of dieters are able to reduce their body weight in the long term while the majority at least regain the weight initially lost through dieting (Jeffery et al., 2000; Mann et al., 2007).”
Background
What’s Wrong With the ‘War on Obesity?’ A Narrative Review of the Weight-Centered Health Paradigm and Development of the 3C Framework to Build Critical Competency for a Paradigm Shift
O’Hara, L., & Taylor, J. (2018) · SAGE Open · doi:10.1177/2158244018772888 · Cited by 170 · see citing works
“Between one third and two thirds of people who lose a substantial amount of weight on a dietary-based weight loss program will regain all the lost weight and more within 5 years (Mann et al., 2007).”
Prevalence of Orthorexia nervosa among college students based on Bratman's test and associated tendencies
Bundros, J., Clifford, D. E., Silliman, K., & Morris, M. N. (2016) · Appetite · doi:10.1016/j.appet.2016.02.144 · Cited by 157 · see citing works
Augmented Reality: A Brand New Challenge for the Assessment and Treatment of Psychological Disorders
Giglioli, I. A. C., Pallavicini, F., Pedroli, E., Serino, S., & Riva, G. (2015) · Computational and Mathematical Methods in Medicine · doi:10.1155/2015/862942 · Cited by 150 · see citing works
“However, not all patients benefit from this treatment and, according to Jefferey et al. (2000) [55] and Mann et al. (2007) [56], some patients do not improve after treatment and others relapse in the long term.”
Background
All-Cause Mortality Risk of Metabolically Healthy Obese Individuals in NHANES III
Durward, C. M., Hartman, T. J., & Nickols‐Richardson, S. M. (2012) · Journal of Obesity · doi:10.1155/2012/460321 · Cited by 149 · see citing works
“Arguments against aggressively pursuing weight loss in MHO individuals include the chance of harm [38], ineffectiveness of weightloss interventions over the long term [44], and adverse effects of weight cycling [45, 46].”
Background
A closed-loop synthetic gene circuit for the treatment of diet-induced obesity in mice
Roessger, K., Hamri, G. C., & Fussenegger, M. (2013) · Nature Communications · doi:10.1038/ncomms3825 · Cited by 146 · see citing works
Bringing the Laboratory and Clinic to the Community: Mobile Technologies for Health Promotion and Disease Prevention
Kaplan, R. M., & Stone, A. A. (2013) · Annual Review of Psychology · doi:10.1146/annurev-psych-113011-143736 · Cited by 144 · see citing works
The role of glucagon‐like peptide‐1 impairment in obesity and potential therapeutic implications
Madsbad, S. (2014) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.12119 · Cited by 146 · see citing works
“However, long-term weight loss is often difficult to achieve, and maintain, through diet and exercise alone [9], and the treatment options available to aid or maintain weight loss in obese individuals are scarce.”
Background
Is intuitive eating the same as flexible dietary control? Their links to each other and well-being could provide an answer
Tylka, T. L., Calogero, R. M., & Daníelsdóttir, S. (2015) · Appetite · doi:10.1016/j.appet.2015.07.004 · Cited by 144 · see citing works
“In general, eating restraint does not lead to long-term weight reduction, a trend that is especially noticeable within methodologically sound studies (Mann et al., 2007).”
Background
Impact of Non-Diet Approaches on Attitudes, Behaviors, and Health Outcomes: A Systematic Review
Clifford, D. E., Ozier, A. D., Bundros, J., Moore, J. L., Kreiser, A., & Morris, M. N. (2015) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2014.12.002 · Cited by 144 · see citing works
Food Addiction: Implications for the Diagnosis and Treatment of Overeating
Adams, R. C., Sedgmond, J., Maizey, L., Chambers, C., & Lawrence, N. (2019) · Nutrients · doi:10.3390/nu11092086 · Cited by 143 · see citing works
“Critically, even those who have undergone weight loss treatment often fail to lose weight or gain weight following intervention [46,48,50,51].”
Background
Effects of health at every size® interventions on health‐related outcomes of people with overweight and obesity: a systematic review
Ulian, M. D., Aburad, L., Oliveira, M. S. D. S., Poppe, A., Sabatini, F., Pérez, I., Gualano, B., Benatti, F. B., Pinto, A. J., Roble, O. J., et al. (2018) · Obesity Reviews · doi:10.1111/obr.12749 · Cited by 142 · see citing works
The Importance of Energy Balance
Hill, J. O., Wyatt, H. R., & Peters, J. C. (2010) · touchREVIEWS in Endocrinology · doi:10.17925/ee.2013.09.02.111 · Cited by 141 · see citing works
A cognitive-behavioral mindfulness group therapy intervention for the treatment of binge eating in bariatric surgery patients
Leahey, T. M., Crowther, J. H., & Irwin, S. R. (2008) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2008.01.004 · Cited by 127 · see citing works
“Treatments for obesity, such as behavior therapy, lowcalorie diets, exercise programs, and psychopharmacology, often produce only moderate, temporary effects (Mann et al., 2007; Wadden, 1993).”
Background
Path analysis of exercise treatment-induced changes in psychological factors leading to weight loss
Annesi, J. J., & Marti, C. N. (2011) · Psychology and Health · doi:10.1080/08870446.2010.534167 · Cited by 131 · see citing works
“As individuals conclude a predictable phase of weight loss (often 4–6 months after initiating reduced calorie eating; Jeffery et al., 2000; Mann et al., 2007), the ensuing plateau may cause psychological distress that challenges one’s confidence (as naturally occurring reinforcers such as social approval, lower weight…”
BackgroundInfluential
Restrained eating and BMI: A longitudinal study among adolescents.
Snoek, H. M., van Strien, T., Janssens, J., & Engels, R. C. M. E. (2008) · Health Psychology · doi:10.1037/0278-6133.27.6.753 · Cited by 130 · see citing works
Pathological overeating: emerging evidence for a compulsivity construct
Moore, C. F., Sabino, V., Koob, G. F., & Cottone, P. (2017) · Neuropsychopharmacology · doi:10.1038/npp.2016.269 · Cited by 126 · see citing works
“…negative affect and, in turn, hypothesized to drive compulsive eating through a negative reinforcement mechanism, abstaining from calorie-dense food also often implicates caloric restriction, which has wellknown effects on rebound binge eating and weight gain (Stice et al, 2008; Mann et al, 2007).”
Using health primes to reduce unhealthy snack purchases among overweight consumers in a grocery store
Papies, E. K., Potjes, I., Keesman, M., Schwinghammer, S. A., & van Koningsbruggen, G. M. (2013) · International Journal of Obesity · doi:10.1038/ijo.2013.136 · Cited by 129 · see citing works
Diabetes: Have We Got It All Wrong?
Corkey, B. E. (2012) · Diabetes Care · doi:10.2337/dc12-0825 · Cited by 130 · see citing works
“In a review of studies of the long-term outcomes of diets to determine if dieting is an effective therapy for obesity, it was found that one-third to two-thirds of dieters regain more weight than they lost on their diets (8).”
Background
Reduced reward-driven eating accounts for the impact of a mindfulness-based diet and exercise intervention on weight loss: Data from the SHINE randomized controlled trial
Mason, A. E., Epel, E. S., Aschbacher, K., Lustig, R. H., Acree, M., Kristeller, J., Cohn, M., Dallman, M., Moran, P. J., Bacchetti, P., et al. (2016) · Appetite · doi:10.1016/j.appet.2016.02.009 · Cited by 125 · see citing works
“Daubenmier@ Lifestyle interventions using diet and exercise are first-line treatments for obesity; however, these interventions tend to result in poor long-termweight loss (Barte et al., 2010; Mann et al., 2007; Wadden, Butryn, & Byrne, 2004; Wu, Gao, Chen, & Van Dam, 2009).”
Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management
Thoolen, B. J., Ridder, D. D., Bensing, J., Gorter, K., & Rutten, G. (2009) · Psychology & Health · doi:10.1080/08870440701864504 · Cited by 127 · see citing works
“The weight loss at nine month follow-up is heartening; but recent studies suggest that a longer follow-up is necessary to examine if patients truly are able to maintain their weight loss (Mann et al., 2007).”
Background
A Cognitive Profile of Obesity and Its Translation into New Interventions
Jansen, A. T. M., Houben, K., & Roefs, A. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01807 · Cited by 128 · see citing works
Stigma in Practice: Barriers to Health for Fat Women
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“The evidence that prescribing weight loss does not work has been available for many years now (Miller, 1999; Howard et al., 2006; Mann et al., 2007).”
Background
Health-At-Every-Size and Eating Behaviors: 1-Year Follow-Up Results of a Size Acceptance Intervention
Provencher, V., Bégin, C., Tremblay, A., Mongeau, L., Corneau, L., Dodin, S., Boivin, S., & Lemieux, S. (2009) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2009.08.017 · Cited by 126 · see citing works
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“Against the backdrop of the obesity epidemic and the inability of most individuals to sustain weight loss induced by calorie-restricted diets [1], alternative dietary approaches to achieve shortand long-term weight loss have become of increasing scientific interest [2].”
Background
Work or Fun? How Task Construal and Completion Influence Regulatory Behavior
Laran, J., & Janiszewski, C. A. (2010) · Journal of Consumer Research · doi:10.1086/656576 · Cited by 125 · see citing works
“This might explain why the average dieter is 11 pounds heavier than their prediet weight 5 years after successful weight loss (Mann et al. 2007).”
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“Because medical, behavioral, and nutritional weight loss management methods have a low success rate [3], weight”
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Self-Perception of Overweight and Obesity: A Review of Mental and Physical Health Outcomes
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“and people who attempt to lose weight will often end up gaining more weight than if they had not attempted weight loss.(61) Likewise, backfiring weight-loss attempts may promote unhealthy coping strate-”
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Reducing Calorie Intake May Not Help You Lose Body Weight
Benton, D., & Young, H. A. (2017) · Perspectives on Psychological Science · doi:10.1177/1745691617690878 · Cited by 112 · see citing works
“In fact an examination of the long-term consequences of lowcalorie diets found that between one third and two thirds of dieters regained more weight than they lost initially (Mann et al., 2007).”
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Smart food policy for healthy food labeling: Leading with taste, not healthiness, to shift consumption and enjoyment of healthy foods
Turnwald, B. P., & Crum, A. J. (2019) · Preventive Medicine · doi:10.1016/j.ypmed.2018.11.021 · Cited by 126 · see citing works
“, 2013; Metcalfe and Mischel, 1999), a challenging and often unsuccessful strategy in the moment of food choice (Hofmann et al., 2010; Mann et al., 2015; Mann et al., 2007), particularly for individuals trying to control their weight (Hofmann et al.”
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Mindful eating and common diet programs lower body weight similarly: Systematic review and meta‐analysis
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“Furthermore, there is evidence that repeated dietary interventions may adversely affect both physical and mental health.(5-9) More recently, mindful eating as an alternative weight management strategy has gained increasing attention.”
Background
As Pleasure Unfolds: Hedonic Responses to Tempting Food
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“…dieters, also referred to as restrained eaters (Herman & Polivy, 1980), are generally highly motivated to restrict food intake in order to control body weight, only a few succeed in losing weight and in maintaining weight losses over significant periods of time (Mann et al., 2007; Stroebe, 2008).”
Background
Eat for Life: A Work Site Feasibility Study of a Novel Mindfulness-Based Intuitive Eating Intervention
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“Second, diet programs focusing on caloric restriction are ineffective, as many of these programs produce only moderate, temporary weight loss and contribute to adverse health consequences associated with weight cycling.(18,19) A meta-analysis of 31 randomized controlled trials and long-term weight-loss studies found t…”
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Recognizing the Fundamental Right to be Fat: A Weight-Inclusive Approach to Size Acceptance and Healing From Sizeism
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Authors: Mann, T., Tomiyama, A. J., Westling, E., Lew, A.-M., Samuels, B., & Chatman, J.
Affiliations: University of California, Los Angeles (US)
ORCID: Mann, Traci
Tomiyama, A. Janet
Westling, Erika
Venue: American Psychologist
Publisher: American Psychological Association (APA)
Published: 2007
Volume: 62
Issue: 3
Pages: 220-233
ISSN: 0003-066X (ISSN-L)
1935-990X
DOI: 10.1037/0003-066x.62.3.220
OpenAlex: W2090491403
Semantic Scholar: 08fd329f4ec6d46d528ad437c1859d734af02396
Cited by: 1,208
References: 83
Citations by year: 2026: 36 · 2025: 46 · 2024: 73 · 2023: 53 · 2022: 61 · 2021: 98 · 2020: 69 · 2019: 66 · 2018: 86 · 2017: 93 · 2016: 73 · 2015: 70 · 2014: 71 · 2013: 68 · 2012: 69
FWCI: 44.41
Type: journal article
Language: en
Open access: closed
Locations: American Psychologist (publishedVersion)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institute of Mental Health (R01 63795)
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 › Health Professions › Pharmacy › Obesity and Health Practices
Keywords: obesity treatment, Medicare policy, weight regain, weight loss maintenance, long-term outcomes
MeSH terms: Diet Therapy, Medicare, Humans, Obesity, United States, Treatment Outcome

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Medicare's search for effective obesity treatments: Diets are not the answer.

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