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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Wright, R. R., Nelson, R., Garcia, S., & Butler, A. (2020) · The Journal of Primary Prevention · doi:10.1007/s10935-020-00605-0 · Cited by 15
RMR-Related MAP2K6 Gene Variation on the Risk of Overweight/Obesity in Children: A 3-Year Panel Study
Lee, M., Lee, Y., Kang, I., Shin, J., & Sorn, S. R. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11020091 · Cited by 12
“Some studies have suggested that dietary variation in protein, carbohydrate, and low GI have attenuated RMR and body composition, but dietary effects on the metabolic rates are still controversial [38,39].”
Background
Focusing on weight is not the answer to America's obesity epidemic.
Tomiyama, A. J., & Mann, T. L. (2008) · American Psychologist · doi:10.1037/0003-066x.63.3.203 · Cited by 12
“No one denies the benefits of exercise, for which Mann et al. (2007) are strong advocates.”
BackgroundSelf-citation
Carry-Over of Self-Regulation for Physical Activity to Self-Regulating Eating in Women With Morbid Obesity
Annesi, J. J., Porter, K. J., & Johnson, P. H. (2015) · Women & Health · doi:10.1080/03630242.2014.996727 · Cited by 12
“Thus, despite decades of attempts at revising behavioral interventions, the predictable cycle of initial weight loss, plateau, and near complete regain of weight persists (Jeffery et al. 2000; Mann et al. 2007).”
BackgroundInfluential
Nutritional Treatment of Obesity
Shewmake, R. A., & Huntington, M. K. (2009) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2009.01.010 · Cited by 12
Cross-sectional and longitudinal associations between self-esteem and BMI depends on baseline BMI category in a population-based study
Robert, M., Allès, B., Gisch, U. A., Shankland, R., Herçberg, S., Touvier, M., Leys, C., & Péneau, S. (2024) · BMC Public Health · doi:10.1186/s12889-024-17755-z · Cited by 11
“This potential interpretation should be nuanced by the fact that restrictive diet on the long term lead to long term weight gain [56].”
Background
Quantitative analysis of the caloric restriction versus isocaloric diets models based on macronutrients composition: impacts on body weight regulation, anthropometric, and bioimpedance parameters in women with obesity
Pescari, D., Mihuţa, M. S., Bena, A., & Stoian, D. L. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1493954 · Cited by 14
Lay theories of self‐control influence judgments of individuals who have failed at self‐control
Freeman, N., Shmueli‐Blumberg, D., & Muraven, M. (2013) · Journal of Applied Social Psychology · doi:10.1111/jasp.12098 · Cited by 14
“Most calorie-restricting diets typically lead to little if any long-term weight loss (Mann et al., 2007) and only 7%–37% of smokers who try to quit with various medications and 14.”
BackgroundInfluential
Influence of Self-Control and Affect on Binge Eating Behavior
조혜진, & Kwon, S. (2011) · The Korean Journal of Clinical Psychology · doi:10.15842/kjcp.2011.30.4.008 · Cited by 11
Effects of multiple cycles of weight loss and regain on the body weight regulatory system in rats
Rosenbaum, J. L., Frayo, R. S., Melhorn, S. J., Cummings, D. E., & Schur, E. A. (2019) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00110.2019 · Cited by 13
Healthy Body, Healthy Mind: A Mindset Intervention for Obese Youth
Orvidas, K., Burnette, J. L., Schleider, J. L., Skelton, J. A., Moses, M., & Dunsmore, J. C. (2020) · The Journal of Genetic Psychology · doi:10.1080/00221325.2020.1796573 · Cited by 14
Accept Yourself! A Pilot Randomized Controlled Trial of a Self-Acceptance-Based Treatment for Large-Bodied Women With Depression
Berman, M. I., Park, J., Kragenbrink, M. E., & Hegel, M. T. (2022) · Behavior Therapy · doi:10.1016/j.beth.2022.03.002 · Cited by 13
Differential associations of job control components with both waist circumference and body mass index
Bean, C., Winefield, H. R., Sargent, C., & Hutchinson, A. D. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.08.034 · Cited by 11
“Despite the overwhelming impetus for reducing the incidence and prevalence of obesity, effective and sustainable strategies remain elusive at both policy and individual levels (Cooper et al., 2010; Gill et al., 2010; Mann et al., 2007).”
Background
Social Ecological Influences on Obesity Control: Instigating Problems and Informing Potential Solutions
Yancey, A. K. (2007) · Obesity Management · doi:10.1089/obe.2007.0020 · Cited by 11
“Everybody watches and everybody comments”
Bombak, A. E. (2015) · Food Culture & Society · doi:10.1080/15528014.2015.1088196 · Cited by 14
“Early weight loss dieting has been found to predict later obesity (Ikeda et al. 2004; Mann et al. 2007).”
Background
Size as Diversity Absent from Multicultural Textbooks
Kasardo, A. E. (2018) · Women & Therapy · doi:10.1080/02703149.2018.1524069 · Cited by 11
Weight control intentions and mental health among Canadian adolescents: a gender-based analysis of students in the COMPASS study
Doan, N., Romano, I., Butler, A. E., Laxer, R. E., Patte, K. A., & Leatherdale, S. T. (2021) · Health Promotion and Chronic Disease Prevention in Canada · doi:10.24095/hpcdp.41.4.01 · Cited by 12
Bi-Directional Relationship Between Self-Regulation and Improved Eating: Temporal Associations With Exercise, Reduced Fatigue, and Weight Loss
Annesi, J. J., Johnson, P. H., & Porter, K. J. (2014) · The Journal of Psychology · doi:10.1080/00223980.2014.913000 · Cited by 11
“, 2008), and based on the plethora of failed treatments (Cooper et al., 2010; Mann et al., 2007); possibly evidence-based adherence methods for physical activity should precede behavioral methods to improve eating.”
BackgroundInfluential
Association of Reduction in Waist Circumference with Normalization of Mood in Obese Women Initiating Exercise Supported by the Coach Approach Protocol
Annesi, J. J., & Gorjala, S. (2010) · Southern Medical Journal · doi:10.1097/smj.0b013e3181de0eb5 · Cited by 11
On the Limitations of the Rhetoric of Beauty: Embracing Ugliness in Contemporary Fat Visual Representations
Snider, S. (2018) · Springer eBooks · doi:10.1007/978-3-319-76783-3_16 · Cited by 11
Government Dietary Guidelines: Uncertain Science Leads to Questionable Public Health PolicyPreprint
Archer, E., Marlow, M. L., & Williams, R. A. (2018) · SSRN Electronic Journal · doi:10.2139/ssrn.3211651 · Cited by 11
Coaction of Exercise and Eating Improvements Within a Behavioral Obesity Treatment: Directionality and Psychological Mechanisms
Annesi, J. J. (2022) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2022.2057904 · Cited by 10
“Obesity treatments through behavioral (non-surgical/nonpharmacological) approaches have historically demonstrated limited success beyond the very short term (Dombrowski et al., 2014; Loveman et al., 2011; Mann et al., 2007).”
Background
How pharmaceutical companies misappropriate fat acceptance
Bombak, A. E. (2023) · Critical Public Health · doi:10.1080/09581596.2023.2273201 · Cited by 13
“Alternatively, they will be in the same state as individuals often futilely trying to maintain lost weight despite involuntary, biological impediments (Fothergill et al., 2016; MacLean et al., 2011; Mann et al., 2007; Ogden et al., 2012).”
Background
The Combined Effects of High-Intensity Interval Exercise Training and Dietary Supplementation on Reduction of Body Fat in Adults with Overweight and Obesity: A Systematic Review
Gaweł, E., Hall, B., Siatkowski, S., Grabowska, A., & Zwierzchowska, A. (2024) · Nutrients · doi:10.3390/nu16030355 · Cited by 14
Relationship of initial self-regulatory ability with changes in self-regulation and associated fruit and vegetable consumption in severely obese women initiating an exercise and nutrition treatment: moderation of mood and self-efficacy.
Annesi, J. J. (2011) · Europe PMC (PubMed Central) · Cited by 10
Media Influences on Body Image & Eating Behaviors in Adolescents
Kwon, M. (2020) · Springer eBooks · doi:10.1007/978-3-030-45103-5_7 · Cited by 12
Nondiet Weight-Neutral Curricula Limited in Current Accredited US Dietetic Programs
Huebner, G., McGuirt, J. T., Perrin, M. T., et al. (2021) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2020.12.005 · Cited by 10
Feminist Existentialism, Biopolitics, and Critical Phenomenology in a Time of Bad Health
Welsh, T. (2021) · Routledge eBooks · doi:10.4324/9781003168676 · Cited by 15
Weight-Normative versus Weight-Inclusive Narratives in Weight-Related Public Health Campaigns: Effects on Anti-Fat Attitudes, Stigma, Motivation, and Self-Efficacy
McGregor, S., Roberts, S., Grant, S., & O’Loghlen, E. (2022) · Obesities · doi:10.3390/obesities2010008 · Cited by 13
“Research has established that a focus on weight loss alone often fails to produce longterm weight reduction or, importantly, improvements in health behaviour and physical health [64].”
Background
The medical model of “obesity” and the values behind the guise of health
Mehl, K. R. (2023) · Synthese · doi:10.1007/s11229-023-04209-z · Cited by 12
“Such participants may not have attended these follow-up appointments because they had gained back the weight (Mann et al. 2007).”
BackgroundInfluential
Influence on Adiposity and Atherogenic Lipaemia of Fatty Meals and Snacks in Daily Life
Laguna‐Camacho, A. (2017) · Journal of Lipids · doi:10.1155/2017/1375342 · Cited by 10
“When change in dietary intake is monitored, it is usually at intervals of several months [68].”
Background
Exercise Predicts Long-Term Weight Loss in Women With Class 1 and Class 2 Obesity Through Effects on Emotional Eating and its Correlates
Annesi, J. J. (2017) · Journal of Physical Activity and Health · doi:10.1123/jpah.2017-0170 · Cited by 10
Dieting attempts modify the association between quality of diet and obesity
Sares‐Jäske, L., Knekt, P., Lundqvist, A., Heliövaara, M., & Männistö, S. (2017) · Nutrition Research · doi:10.1016/j.nutres.2017.08.001 · Cited by 13
Engineering Mammalian Designer Cells for the Treatment of Metabolic Diseases
Wang, Y., Wang, M., Dong, K., & Ye, H. (2017) · Biotechnology Journal · doi:10.1002/biot.201700160 · Cited by 10

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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