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

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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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“However, according to studies (Mann et al., 2007) temporary ﬁxes to old habits makes people to regain their weight.”
Background
A Conceptual Framework for the Expansion of Behavioral Interventions for Youth Obesity: A Family-Based Mindful Eating Approach
Dalen, J., Brody, J. L., Staples, J. K., & Sedillo, D. (2015) · Childhood Obesity · doi:10.1089/chi.2014.0150 · Cited by 42
“Indeed, dieting is now coming into question owing to long-term ineffectiveness and unfavorable physio- and psychological effects.(60,61) Instead, an emphasis on reducing overeating tendencies is increasingly being recommended as an alternative to dieting.”
Background
Weight Attitudes Predict Eating Competence among College Students
Clifford, D. E., Keeler, L. A., Gray, K. L., Steingrube, A., & Morris, M. N. (2010) · Family and Consumer Sciences Research Journal · doi:10.1111/j.1552-3934.2010.02056.x · Cited by 38
AHP-based multi-criteria decision-making approach for monitoring health management practices in smart healthcare system
Pant, S., Garg, P., Kumar, A., Ram, M., Sharma, H. K., Sharma, H. K., & Klochkov, Y. (2023) · International Journal of Systems Assurance Engineering and Management · doi:10.1007/s13198-023-01904-5 · Cited by 41
“Instead of opting for the wrong direction of losing or managing weights, one should go for the natural things, which may not provide any harm in the future (Mann et al. 2007).”
The fable of state self-control
Inzlicht, M., & Roberts, B. W. (2024) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2024.101848 · Cited by 40
“However, it also shows that most people relapse into old patterns in as little as a few months.”
Sociocultural influences on body dissatisfaction and dieting in Hong Kong girls
Lam, T., Lee, S. W., Fung, S. S. W., et al. (2008) · European Eating Disorders Review · doi:10.1002/erv.900 · Cited by 37
Maintaining healthy eating behaviour: experiences and perceptions of young adults
Allom, V., & Mullan, B. A. (2014) · Nutrition & Food Science · doi:10.1108/nfs-06-2013-0077 · Cited by 41
Why do diets fail? An exploration of dieters’ experiences using thematic analysis
Buchanan, K., & Sheffield, J. K. (2015) · Journal of Health Psychology · doi:10.1177/1359105315618000 · Cited by 37
“Email: kiera@cfih.com.au et al., 1991; Mann et al., 2007; Patton et al., 1999; Perri, 1998).”
Background
Not ‘Taking the Easy Way Out’: Reframing Bariatric Surgery from Low-effort Weight Loss to Hard Work
Trainer, S., Brewis, A., & Wutich, A. (2017) · Anthropology and Medicine · doi:10.1080/13648470.2016.1249339 · Cited by 37
“Although traditional diet and exercise tactics have been comprehensive failures at the population level, they remain the primary focus of weight-loss endeavors within the country (Dalley, Toffanin, and Pollet 2012; Mann et al. 2007; Pietil€ainen et al. 2012).”
Background
Mindfulness Reduces Reactivity to Food Cues: Underlying Mechanisms and Applications in Daily Life
Keesman, M., Aarts, H., Häfner, M., & Papies, E. K. (2017) · Current Addiction Reports · doi:10.1007/s40429-017-0134-2 · Cited by 41
The positive eating scale: relationship with objective health parameters and validity in Germany, the USA and India
Sproesser, G., Klusmann, V., Ruby, M. B., Arbit, N., Rozin, P. N., Schupp, H. T., & Renner, B. (2017) · Psychology and Health · doi:10.1080/08870446.2017.1336239 · Cited by 43
“However, research has shown that diets and restrained eating are often counterproductive and may enhance the risk for longterm weight gain and eating disorders (Mann et al., 2007; Neumark-Sztainer et al., 2006; Stice, Presnell, & Spangler, 2002; van Strien, Herman, & Verheijden, 2014).”
Background
Intuitive Eating
Barrada, J. R., Cativiela-Campos, B., van Strien, T., & Cebolla, A. (2018) · European Journal of Psychological Assessment · doi:10.1027/1015-5759/a000482 · Cited by 44
“We share the idea that a new glance is needed in the area of eating behavior and the relation between health and weight (Bacon & Aphramor, 2011; Mann et al., 2007).”
Background
SerpinA3N is a novel hypothalamic gene upregulated by a high-fat diet and leptin in mice
Sergi, D., Campbell, F., Grant, C., Morris, A. C., Bachmair, E., Koch, C. E., McLean, F. H., Muller, A., Hoggard, N., de Roos, B., et al. (2018) · Genes & Nutrition · doi:10.1186/s12263-018-0619-1 · Cited by 37
Compassion‐focused therapy for body weight shame: A mixed methods pilot trial
Carter, A., Gilbert, P., & Kirby, J. N. (2020) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2488 · Cited by 53
Self-Regulation, Motivation, and Psychosocial Factors in Weight Management
Teixeira, P. J., Mata, J., Williams, G. C., Gorin, A. A., & Lemieux, S. (2012) · Journal of Obesity · doi:10.1155/2012/582348 · Cited by 42
Combination therapy for obesity
Wilding, J. P. H. (2017) · Journal of Psychopharmacology · doi:10.1177/0269881117737401 · Cited by 37
“Lifestyle intervention with energy restriction, and an increase in physical activity supported by behaviour change, is considered the mainstay of treatment, but its efficacy is limited and few people with obesity are able to sustain clinically worthwhile weight loss in the long-term with lifestyle alone (Mann et al.,…”
Background
Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis
Wiebe, N., Lloyd, A. M., Crumley, E. T., & Tonelli, M. A. (2023) · Obesity Reviews · doi:10.1111/obr.13588 · Cited by 36
Relations of changes in self-regulatory efficacy and physical self-concept with improvements in body satisfaction in obese women initiating exercise with cognitive-behavioral support
Annesi, J. J. (2010) · Body Image · doi:10.1016/j.bodyim.2010.05.001 · Cited by 36
“People don't care as much about their health as they do about their looks”: Personal trainers as intermediaries between aesthetic and health-based discourses of exercise participation and weight management
Donaghue, N., & Allen, M. (2015) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2015.1016086 · Cited by 45
“The high rates of failure of weight loss attempts have lead some prominent anti-obesity researchers to seriously question the ethics of continuing to recommend weight loss programmes to obese clients (e.g. Brownell, 2010; Cooper et al., 2010; Mann et al., 2007; Rich & Evans, 2005).”
Background
Living large: the experiences of large-bodied women when accessing general practice services
Russell, N., & Carryer, J. (2013) · Journal of Primary Health Care · doi:10.1071/hc13199 · Cited by 42
Increased risk of diabetes development in individuals with weight cycling over 4 years: The Kangbuk Samsung Health study
Rhee, E., Cho, J. H., Kwon, H., Park, S. E., Park, C., Oh, K.-W., Park, H., & Lee, W. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.03.018 · Cited by 36
Efficacy of a mindful-eating programme to reduce emotional eating in patients suffering from overweight or obesity in primary care settings: a cluster-randomised trial protocol
Morillo‐Sarto, H., Barceló‐Soler, A., Herrera‐Mercadal, P., Pantilie, B., Navarro‐Gil, M., García‐Campayo, J., & Montero‐Marín, J. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-031327 · Cited by 40
Testing the effectiveness of a weight bias educational intervention among clinical psychology trainees
Brochu, P. M. (2020) · Journal of Applied Social Psychology · doi:10.1111/jasp.12653 · Cited by 36
‘A beautiful show of strength’: Weight loss and the fat activist self
Meleo-Erwin, Z. C. (2010) · Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine · doi:10.1177/1363459310361601 · Cited by 37
“In their meta-analysis of 14 long-term weight loss studies, Mann et al. (2007) posited that not only does dieting fail as a weight loss strategy, the majority of people who diet regain the lost weight plus more.”
BackgroundResultInfluential
Effect of Diet and Exercise Treatment for Obese Japanese Children on Abdominal Fat Distribution
Togashi, K., Masuda, H., & Iguchi, K. (2010) · Research in Sports Medicine · doi:10.1080/15438620903423924 · Cited by 36
“Since medical care costs for obesity are high, and the long-term effect of instructing obese persons in weight loss is reportedly not favorable (Mann et al. 2007), prevention and intervention at an early life stage are important.”
Background
Effects of GLP-1 receptor agonists on the degree of liver fibrosis and CRP in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: A systematic review and meta-analysis
Fang, L., Li, J., Zeng, H., & Liu, J. (2024) · Primary Care Diabetes · doi:10.1016/j.pcd.2024.03.005 · Cited by 34
Emotional Eating and Obesity
Jáuregui‐Lobera, I., & Martínez, M. M. (2020) · IntechOpen eBooks · doi:10.5772/intechopen.91734 · Cited by 36
Developing dimensions for a multicomponent multidisciplinary approach to obesity management: a qualitative study
Cochrane, A. J., Dick, B., King, N. A., Hills, A. P., & Kavanagh, D. J. (2017) · BMC Public Health · doi:10.1186/s12889-017-4834-2 · Cited by 35
“The practice of reducing patients to a diagnostic classification and applying a pre-formulated weight-loss practice has not translated into positive weight management outcomes [49, 50].”
Background
A direct tissue-grafting approach to increasing endogenous brown fat
Blumenfeld, N. R., Kang, H. J., Fenzl, A., Song, Z., Chung, J., Singh, R., Johnson, R., Karakeçili, A. G., FERANIL, J. B., Rossen, N. S., et al. (2018) · Scientific Reports · doi:10.1038/s41598-018-25866-y · Cited by 35
When weight management lasts. Lower perceived rule complexity increases adherence
Mata, J., Todd, P. M., & Lippke, S. (2009) · Appetite · doi:10.1016/j.appet.2009.09.004 · Cited by 35
“The underlying assumption is that staying longer on a healthful weight loss or weight management program increases the likelihood of controlling weight or achieving generally better health: short-term diets do not generate lasting effects (Mann et al., 2007), while successful weight management programs involve long-la…”
Food for Thought: A Randomised Controlled Trial of Emotional Freedom Techniques and Cognitive Behavioural Therapy in the Treatment of Food Cravings
Stapleton, P., Bannatyne, A. J., Urzi, K., Porter, B., & Sheldon, T. (2016) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12070 · Cited by 35
Neural correlates of restrained eaters’ high susceptibility to food cues: An fMRI study
Wang, Y., Dong, D., Todd, J., Du, J., Yang, Z., Lu, H., & Chen, H. (2016) · Neuroscience Letters · doi:10.1016/j.neulet.2016.08.017 · Cited by 34
Does self‐compassion help to deal with dietary lapses among overweight and obese adults who pursue weight‐loss goals?
Thøgersen‐Ntoumani, C., Dodos, L. A., Stenling, A., & Ntoumanis, N. (2020) · British Journal of Health Psychology · doi:10.1111/bjhp.12499 · Cited by 35
Changes in Self-Efficacy for Exercise and Improved Nutrition Fostered by Increased Self-Regulation Among Adults With Obesity
Annesi, J. J., Johnson, P. H., & McEwen, K. L. (2015) · The Journal of Primary Prevention · doi:10.1007/s10935-015-0398-z · Cited by 38
“Behavioral (non-surgical and non-pharmaceutical) treatments designed to reduce excessive body weight have overwhelmingly demonstrated poor results (Mann et al., 2007).”
BackgroundMethod
Behaviorally Supported Exercise Predicts Weight Loss in Obese Adults Through Improvements in Mood, Self-Efficacy, and Self-Regulation, Rather Than by Caloric Expenditure
Annesi, J. J. (2011) · The Permanente Journal · doi:10.7812/tpp/10-153 · Cited by 34
Improving Prediction of Binge Episodes by Modelling Chronicity of Dietary Restriction
Holmes, M., Fuller‐Tyszkiewicz, M., Skouteris, H., & Broadbent, J. (2014) · European Eating Disorders Review · doi:10.1002/erv.2315 · Cited by 33
The Effects of Multisystemic Therapy on Family Support for Weight Loss Among Obese African-American Adolescents: Findings From a Randomized Controlled Trial
Ellis, D. A., Janisse, H. C., Naar‐King, S., MacDonell, K. K., Jen, K.-L. C., Cunningham, P. B., & Marshall, S. P. (2010) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e3181e35337 · Cited by 33

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 › Medicine › Public Health, Environmental and Occupational Health › 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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