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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Sensory-Based Nutrition Pilot Intervention for Women
Gravel, K., Deslauriers, A., Watiez, M., Dumont, M., Bouchard, A.-A. D., & Provencher, V. (2013) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2013.06.354 · Cited by 24
Repletion of TNFα or leptin in calorically restricted mice suppresses post-restriction hyperphagia
Hambly, C., Duncan, J. S., Archer, Z. A., Moar, K. M., Mercer, J. G., & Speakman, J. R. (2011) · Disease Models & Mechanisms · doi:10.1242/dmm.007781 · Cited by 25
“This leads them to cheat on their diets (Del Corral et al., 2011), terminate CR and ultimately regain any lost weight and fat: often called obesity rebound or catch-up fat (Crescenzo et al., 2003; Dulloo et al., 2006; Mann et al., 2007; Yepuri et al., 2011).”
Background
Comparing different boosters of planning interventions on changes in fat consumption in overweight and obese individuals: A randomized controlled trial
Scholz, U., Ochsner, S., & Łuszczyńska, A. (2012) · International Journal of Psychology · doi:10.1080/00207594.2012.661061 · Cited by 28
Eating behaviors in a male and female community sample: psychometric properties of the DEBQ
Andrés, A., Oda-Montecinos, C., & Saldaña, C. (2017) · Terapia psicológica · doi:10.4067/s0718-48082017000200141 · Cited by 25
“However, attempts to reduce body weight over an extended period of time seem difficult to maintain for most people, and most of the weight lost is usually regained (aphramor, 2010; chaput et al., 2009; Mann et al., 2007; saris & Harper, 2005).”
Background
Biology of obesity and weight regain
Rogge, M. M., & Gautam, B. (2017) · Journal of the American Association of Nurse Practitioners · doi:10.1002/2327-6924.12504 · Cited by 26
“Studies also suggest that weight plateaus occur approximately 10 weeks to 6 months into weight-loss programs (Franz et al., 2007; Sumithran et al., 2011) and that one- to twothirds of dieters regain more weight than was lost from the dietary intervention (Mann et al., 2007).”
Background
An Initial Investigation of Neural Changes in Overweight Adults with Food Cravings after Emotional Freedom Techniques
Stapleton, P., Buchan, C., MItchell, I., McGrath, Y., Gorton, P., & Carter, B. (2019) · OBM Integrative and Complementary Medicine · doi:10.21926/obm.icm.1901010 · Cited by 25
“likely to gain back more weight than they lost [14].”
Background
“I will fast … tomorrow”: Intentions to restrict eating and actual restriction in daily life and their person-level predictors
Reichenberger, J., Smyth, J. M., Kuppens, P., & Blechert, J. (2019) · Appetite · doi:10.1016/j.appet.2019.04.019 · Cited by 26
Dual and Triple Gut Peptide Agonists on the Horizon for the Treatment of Type 2 Diabetes and Obesity. An Overview of Preclinical and Clinical Data
Anastasiou, I. A., Argyrakopoulou, G., Dalamaga, Μ., & Kokkinos, A. D. (2025) · Current Obesity Reports · doi:10.1007/s13679-025-00623-1 · Cited by 28
“Unfortunately, many people living with obesity cannot lose weight over the long term with lifestyle changes (diet and physical activity) alone [3].”
Weight Disparities Between Female Same-Sex Romantic Partners and Weight Concerns
Markey, C. N., & Markey, P. M. (2013) · Psychology of Women Quarterly · doi:10.1177/0361684313484128 · Cited by 24
“However, as mentioned above, there is an imperfect relationship between weight status and weight concerns and the consequences of weight concerns can be the opposite of the desired goal of healthy weight management (Goodrick et al., 1996; Haines et al., 2007; Mann et al., 2007; Patton et al., 1990).”
BackgroundInfluential
Weight stigma, fat pedagogy and rediscovering the pleasures of movement: experiencing physical activity and fatness in a public health weight management programme
Wittels, P., & Mansfield, L. (2019) · Qualitative Research in Sport Exercise and Health · doi:10.1080/2159676x.2019.1695655 · Cited by 24
Healthy eating behaviors and self-control in scarcity: The protective effects of self-compassion
Fan, L., & Wang, Y. (2021) · Appetite · doi:10.1016/j.appet.2021.105860 · Cited by 25
A qualitative study of the determinants of dieting and non-dieting approaches in overweight/obese Australian adults
Leske, S., Strodl, E. S., & Hou, X. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-1086 · Cited by 24
“Unfortunately, there appears to be little support for the notion that dieting produces lasting weight loss or health benefits when attempted in isolation [24].”
Background
Not merely a question of self-control: The longitudinal effects of overeating behaviors, diet quality and physical activity on dieters' perceived diet success
Keller, C., & Hartmann, C. (2016) · Appetite · doi:10.1016/j.appet.2016.08.007 · Cited by 27
“The difficulties of dieters in achieving this goal (Fedoroff et al., 1997; Mann et al., 2007) has been explained with the goal conflict model (Stroebe, Mensink, Aarts, Schut, & Kruglanski, 2008; Stroebe et al.”
Influential
Elective surgery to save my life: rethinking the “choice” in bariatric surgery
Trainer, S., & Benjamin, T. R. (2016) · Journal of Advanced Nursing · doi:10.1111/jan.13193 · Cited by 24
Long-term treatment of severe obesity: are lifestyle interventions still an option?
Petroni, M. L., Caletti, M. T., Calugi, S., Grave, R. D., & Marchesini, G. (2017) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2017.1386551 · Cited by 25
“[29], that may be summarized as: (a) large attrition rate (between 12% and 88%), progressively higher with longer”
Background
Increased Maternal Prenatal Adiposity, Inflammation, and Lower Omega-3 Fatty Acid Levels Influence Child Negative Affect
Gustafsson, H., Holton, K. F., Anderson, A. N., Nousen, E. K., Sullivan, C. A., Loftis, J. M., Nigg, J. T., & Sullivan, E. L. (2019) · Frontiers in Neuroscience · doi:10.3389/fnins.2019.01035 · Cited by 24
The use of virtual visits for obesity pharmacotherapy in patients with overweight or obesity compared with in‐person encounters
Griebeler, M. L., Butsch, W. S., Rodriguez, P., Lomeli, L., Kampert, M., Makin, V., Alwahab, U. A., Borukh, E., Daigle, E., Bena, J., et al. (2022) · Obesity · doi:10.1002/oby.23548 · Cited by 25
Health at Every Size and Acceptance and Commitment Therapy for Obese, Depressed Women: Treatment Development and Clinical Application
Berman, M. I., Morton, S. N., & Hegel, M. T. (2016) · Clinical Social Work Journal · doi:10.1007/s10615-015-0565-y · Cited by 23
Long-term follow-up after weight management in obese cats
Deagle, G., Holden, S. L., Biourge, V., Morris, P. J., & German, A. J. (2014) · Journal of Nutritional Science · doi:10.1017/jns.2014.36 · Cited by 29
“42; Royal Canin) (3) a high-protein diet (Obesity Management S/O, Royal Canin).”
BackgroundInfluential
The Ethical and Public Health Importance of Unintended Consequences: the Case of Behavioral Weight Loss Interventions
Devine, C. M., & Barnhill, A. (2017) · Public Health Ethics · doi:10.1093/phe/phx026 · Cited by 23
Patient initiation and maintenance of GLP-1 RAs for treatment of obesity: a narrative review and practical considerations for primary care providers
Fitch, A., & Ingersoll, A. B. (2020) · Postgraduate Medicine · doi:10.1080/00325481.2020.1845534 · Cited by 25
“It is noteworthy that real-world evidence also demonstrates that IBT does not provide lasting or significant weight reduction in individuals with obesity [63,64], compared with randomized clinical trials such as Look AHEAD [25].”
Result
Intuitive and mindful eating to improve physiological health parameters: a short narrative review of intervention studies
Hayashi, L. C., Benasi, G., St‐Onge, M., & Aggarwal, B. (2021) · Journal of Complementary and Integrative Medicine · doi:10.1515/jcim-2021-0294 · Cited by 28
An Overview of Treatments for Obesity in a Population with Mental Illness
Taylor, V. H., Stonehocker, B., Steele, M., & Sharma, A. M. (2012) · The Canadian Journal of Psychiatry · doi:10.1177/070674371205700104 · Cited by 22
Time to Abandon the Notion of Personal Choice in Dietary Counseling for Obesity?
Appelhans, B. M., Whited, M. C., Schneider, K. L., & Pagoto, S. (2011) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2011.05.014 · Cited by 24
Reciprocal Effects of Exercise and Nutrition Treatment-Induced Weight Loss with Improved Body Image and Physical Self-Concept
Annesi, J. J., & Porter, K. J. (2013) · Behavioral Medicine · doi:10.1080/08964289.2013.856284 · Cited by 23
“Although interventions based on social cognitive theory, incorporating cognitive-behavioral methods, have had better success than informational approaches,(2) there remains a minimal understanding of the interrelationships of treatment, psychosocial factors, and weight loss.(1,2) Almost universally, behavioral weight-…”
Background
Slimming starters. Intake of a diet-congruent food reduces meal intake in active dieters
Buckland, N. J., Finlayson, G., & Hetherington, M. M. (2013) · Appetite · doi:10.1016/j.appet.2013.09.026 · Cited by 23
Overweight and obesity: Effectiveness of interventions in adults
Puente, J. M. G., & Martínez-Marcos, M. (2018) · Enfermería Clínica (English Edition) · doi:10.1016/j.enfcle.2017.06.004 · Cited by 23
‘No one is as invested in your continued good health as you should be:’ an exploration of the post‐surgical relationships between weight‐loss surgery patients and their home bariatric clinics
Meleo-Erwin, Z. C. (2018) · Sociology of Health & Illness · doi:10.1111/1467-9566.12823 · Cited by 23
Weight Regain and Health‐related Quality of Life in Postmenopausal Women
Yankura, D. J., Conroy, M. B., Hess, R., Gabriel, K. P., Kuller, L. H., & Kriska, A. M. (2008) · Obesity · doi:10.1038/oby.2008.345 · Cited by 23
High definition transcranial pink noise stimulation of anterior cingulate cortex on food craving: An explorative study
Leong, S. L., De Ridder, D., Vanneste, S., Sutherland, W., Ross, S., & Manning, P. (2018) · Appetite · doi:10.1016/j.appet.2017.10.034 · Cited by 22
“Efforts to curb the obesity epidemic have not had significant wide-spread success (Mann et al., 2007).”
Background

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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