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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“Although many overweight people are able to lose weight in this way, several meta-analyses of randomised controlled trials (RCTs) show a large proportion of these people are unable to maintain this weight loss [13–15] and may regain more weight than they lose [16].”
Physiological consequences of transient hyperleptinemia during discrete developmental periods on body weight in mice
Skowronski, A. A., LeDuc, C. A., Foo, K. S., Goffer, Y., Burnett, L. C., Egli, D. M., & Leibel, R. L. (2020) · Science Translational Medicine · doi:10.1126/scitranslmed.aax6629 · Cited by 18
“The mechanistic bases for such effects (including genetic susceptibility) are difficult to disarticulate experimentally, but these distinctions are critical to developing preventive measures for obesity (13, 14).”
Background
The Self-Control of Eating
Mann, T. L., & Ward, A. C. (2024) · Annual Review of Psychology · doi:10.1146/annurev-psych-012424-035404 · Cited by 18
Self-citation
The first dimeric indole-diterpenoids from a marine-derived Penicillium sp. fungus and their potential for anti-obesity drugs
Du, H.-F., Li, L., Zhang, Y., et al. (2024) · Marine Life Science & Technology · doi:10.1007/s42995-024-00253-x · Cited by 17
“Lifestyle changes require sustained effort, and surgery, while effective, is reserved for severe cases due to risks (Mann et al. 2007).”
Satiety. Not the problem, nor a solution. Comment on ‘Satiety. No way to slim’
Smeets, P. A. M., & van der Laan, L. N. (2011) · Appetite · doi:10.1016/j.appet.2010.12.026 · Cited by 17
Psychosocial Aspects of Obesity in Adults with Psoriasis: A Systematic Review
Pavlova, N. T., Kioskli, K., Smith, C. H., Picariello, F., Rayner, L., & Moss-Morris, R. E. (2021) · Skin Health and Disease · doi:10.1002/ski2.33 · Cited by 17
Comparison of body perceptions between obese primary care patients and physicians: Implications for practice
Pulvers, K. M., Kaur, H., Nollen, N. L., Greiner, K. A., Befort, C. A., Hall, S., Born, W. K., Fitzgibbon, M., & Ahluwalia, J. S. (2008) · Patient Education and Counseling · doi:10.1016/j.pec.2008.04.002 · Cited by 18
“Yet, because we know clinically that patient perception of problem-severity often precedes behavior change [42–44], particularly with difficult changes such as weight loss [45], we believe that body figure size and recognition of a weight problem are connected.”
Background
Annual variation in Internet keyword searches: Linking dieting interest to obesity and negative health outcomes
Markey, P. M., & Markey, C. N. (2012) · Journal of Health Psychology · doi:10.1177/1359105312445080 · Cited by 17
“These negative effects of weight cycling led Mann et al. (2007), in their seminal review of the dieting literature, to stress the importance of continued research examining the potential outcomes of weight cycling.”
Background
Generalization of theory-based predictions for improved nutrition to adults with morbid obesity: Implications of initiating exercise
Annesi, J. J., & Tennant, G. A. (2013) · International Journal of Clinical and Health Psychology · doi:10.1016/s1697-2600(14)70031-6 · Cited by 21
Online Delivery of Emotional Freedom Techniques for Food Cravings and Weight Management: 2-Year Follow-Up
Stapleton, P., Lilley-Hale, E., Mackintosh, G., & Sparenburg, E. (2019) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2019.0309 · Cited by 17
“7,8 Behavioral treatments for long-term weight loss suggest that interventions should last at least 12 months, but adherence appears hindered by commitment and ﬁnancial expense.”
An investigation of the neural mechanisms underlying the efficacy of the adjustable gastric band
Stefanidis, A., Forrest, N., Brown, W. A., Dixon, J. B., O’Brien, P. B., Kampe, J., & Oldfield, B. J. (2015) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2015.11.020 · Cited by 17
Obesity in primary care: evidence for advising weight constancy rather than weight loss in unsuccessful dieters
Pryke, R., & Docherty, A. (2008) · British Journal of General Practice · doi:10.3399/bjgp08x277023 · Cited by 17
“If an individual’s 5–10% weight-loss goal ceases, evidence shows that more weight is regained than was initially lost.(6) In view of the disheartening finding in April 2007, from a major review of 31 long-term weightreduction studies, that dieting is a consistent predictor of future weight gain,(6) this article explor…”
Background
Effects of Treatment Differences on Psychosocial Predictors of Exercise and Improved Eating in Obese, Middle-Age Adults
Annesi, J. J. (2013) · Journal of Physical Activity and Health · doi:10.1123/jpah.10.7.1024 · Cited by 17
Emotional Freedom Techniques in the Treatment of Unhealthy Eating Behaviors and Related Psychological Constructs in Adolescents: A Randomized Controlled Pilot Trial
Stapleton, P., Chatwin, H., William, M., Hutton, A., Pain, A. W., Porter, B., & Sheldon, T. (2015) · EXPLORE · doi:10.1016/j.explore.2015.12.001 · Cited by 17
“Meta analysis and follow-up studies indicate that any gains from prevention and intervention programs are generally not maintained (Mann et al., 2007), which suggests the need for more holistic interventions that also take into account other variables, including psychological constructs (Goodspeed…”
Background
Belief in Free Will: Implications for Practice and Policy
Zheng, Y., van Osselaer, S. M. J., & Alba, J. W. (2016) · Journal of Marketing Research · doi:10.1509/jmr.15.0452 · Cited by 18
“Whereas both the development of—and remedy for—obesity are intuitively linked in the lay mind to willpower, scientific evidence increasingly supports physiological, hereditary, developmental, and environmental causation (Brownell and Gold 2012; Kessler 2009; King 2013; Lee and Blackshaw 2014; Linden 2011; Mann et al.…”
Background
Understanding the prevalence and correlates of implicit theories of weight in the United States: Insights from a nationally representative sample
Auster‐Gussman, L. A., & Rothman, A. J. (2017) · Psychology and Health · doi:10.1080/08870446.2017.1373112 · Cited by 18
Self-perceived overweight, weight loss attempts, and weight gain: Evidence from two large, longitudinal cohorts.
Robinson, E., Sutin, A. R., & Daly, M. (2018) · Health Psychology · doi:10.1037/hea0000659 · Cited by 18
“, 2000) and could be associated with ‘yoyo’ dieting (Mann et al., 2007).”
Background
Associations between intuitive eating, overall diet quality, and physical health indicators: Results of the PREDISE study
Sire, T., Carbonneau, N., Lemieux, S., & Carbonneau, É. (2025) · Appetite · doi:10.1016/j.appet.2025.107904 · Cited by 16
Predictors of diet failure: A multifactorial cognitive and behavioural model
Buchanan, K., Sheffield, J. K., & Tan, W. H. (2017) · Journal of Health Psychology · doi:10.1177/1359105316689605 · Cited by 16
Food Consciousness Intervention Improves Interoceptive Sensitivity and Expression of Exteroception in Women
Palazzo, C. C., Leghi, B. E., & Garcia, R. W. D. (2022) · Nutrients · doi:10.3390/nu14030450 · Cited by 19
“Traditional strategies to control body weight, involving dietary restrictions and counting calories, have been considered to be ineffective in the medium and long terms [1].”
Background
How Formerly Overweight and Obese Individuals Negotiate Disclosure of Their Weight Loss
Romo, L. K. (2016) · Health Communication · doi:10.1080/10410236.2015.1045790 · Cited by 16
Self-guided Change: The most common form of long-term, maintained health behavior change
Bishop, F. M. (2018) · Health Psychology Open · doi:10.1177/2055102917751576 · Cited by 18
“Most overeaters do not lose weight and keep it off; approximately 80 percent regain the weight they have lost and many gain more, that is, (Kraschnewski et al., 2010; Mann et al., 2007).”
Background
Intuitive eating, objective weight status and physical indicators of health
Keirns, N. G., & Hawkins, M. A. W. (2019) · Obesity Science & Practice · doi:10.1002/osp4.359 · Cited by 19
Efeitos psicológicos e metabólicos da restrição alimentar no transtorno de compulsão alimentar
Soihet, J., & Silva, A. D. (2019) · Nutrição Brasil · doi:10.33233/nb.v18i1.2563 · Cited by 21
Exercise Amounts and Short- to Long-Term Weight Loss: Psychological Implications for Behavioral Treatments of Obesity
Annesi, J. J. (2020) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2020.1799917 · Cited by 17
“, behavioral treatments) remain ineffective beyond the very short term, with little sign of improving (Dombrowski et al., 2014; Loveman et al., 2011; Mann et al., 2007; Svetkey et al., 2008).”
BackgroundResultInfluential
Weight Bias in Obstetrics
Gibbins, K. J., Abel, D. E., Carletti, A. A., Morrison, T., Sullivan, E. L., & Marshall, N. (2023) · Current Obstetrics and Gynecology Reports · doi:10.1007/s13669-023-00348-9 · Cited by 19
“For those who lose weight intentionally, only 13–20% maintain that weight loss at five years out, and many regain more weight than originally lost [52, 53].”
Background
The Rise and Fall of Self-Control
van Koningsbruggen, G. M., Stroebe, W., & Aarts, H. (2012) · Social Psychological and Personality Science · doi:10.1177/1948550612471061 · Cited by 16
“Although dieters often manage to lose weight in the beginning, most fail in maintaining their weight loss (Mann et al., 2007).”
Background
When does behavior follow intent? Relationships between trait level dietary restraint and daily eating behaviors
Rodgers, R. F., Fuller‐Tyszkiewicz, M., Holmes, M., Skouteris, H., & Broadbent, J. (2017) · Appetite · doi:10.1016/j.appet.2017.09.030 · Cited by 16
Sobrepeso y obesidad: eficacia de las intervenciones en adultos
Puente, J. M. G., & Martínez-Marcos, M. (2017) · Enfermería Clínica · doi:10.1016/j.enfcli.2017.06.005 · Cited by 27
Words with weight: The construction of obesity in eating disorders research
Gotovac, S., LaMarre, A., & Lafreniere, K. D. (2018) · Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine · doi:10.1177/1363459318785706 · Cited by 17
“…that “adolescent obesity is associated with serious health problems” (Stice et al., 2002: 131), “levels of obesity are increasing throughout the world” (Mann et al., 2007: 220), and “obesity is a significant health problem among Black women of all socioeconomic strata” (Wilfley et al., 1996: 377);…”
Background
Reach and Adoption of a Randomized Weight Loss Maintenance Trial in Rural African Americans of Faith: The WORD (Wholeness, Oneness, Righteousness, Deliverance)
Yeary, K. H. K., Moore, P. C., Gauss, C. H., Cornell, C. E., Prewitt, T. E., Shakya, S., Turner, J. R., Scarbrough, C. B., Porter, G. C., & Estabrooks, P. A. (2018) · American Journal of Health Promotion · doi:10.1177/0890117118805065 · Cited by 16

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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