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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“Obesity is associated with increased risk of type 2 diabetes mellitus (T2DM), dyslipidemia, hypertension, musculoskeletal disorders, cardiovascular diseases, and mortality [3, 4].”
Background
Your patient is a person: A narrative medical approach to weight discrimination in medicine
Ulrey, A. E. (2023) · Clinical Ethics · doi:10.1177/14777509231168335 · Cited by 8
“Mann et al. concluded that “ there is little support for the notion that diets lead to lasting weight loss or health bene ﬁ ts. ” 25 A long-term study of weight changes in postmenopausal women was conducted to determine the ef ﬁ cacy of dieting and exercise.”
Sensing the Snacking Experience: Bodily Sensations Linked to the Consumption of Healthy and Unhealthy Snack Foods—A Comparison between Body Mass Index Levels
Frederiksen, C., Byrne, D. V., & Andersen, B. V. (2024) · Foods · doi:10.3390/foods13030438 · Cited by 6
“With this request, it remains a necessity to create behavioural strategies that can effectively complement current efforts, as conventional approaches frequently prove insufficient for long-term success [2].”
Background
Consequences of receiving weight-related advice from a healthcare provider: Understanding the varied experiences of people with higher weight
Standen, E. C., Rothman, A. J., & Mann, T. L. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.116784 · Cited by 12
Self-citation
An Examination of Psychological Risk Factors for the Development of Substance Abuse Among Post- Bariatric Surgery Patients
Ivezaj, V. (2012) · Cited by 7
Should Medicare reimburse providers for weight loss interventions?
Kaplan, R. M. (2007) · American Psychologist · doi:10.1037/0003-066x.62.3.217 · Cited by 7
“In particular, the Mann et al. (2007) section on control group studies includes many of the same references as the Powell et al. (2007) section on lifestyle interventions.”
BackgroundInfluential
The complexity of food for people with multiple long-term health conditions
Francis, H., Carryer, J., & Wilkinson, J. (2018) · Journal of Primary Health Care · doi:10.1071/hc18020 · Cited by 7
Contrasting Personal Characteristics and Psychosocial Correlates of Exercise and Eating Behavior Changes in Women Successful vs. Unsuccessful with Weight Loss and Maintenance
Annesi, J. J. (2020) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12203 · Cited by 7
Mitigation of the effects of emotional eating on sweets consumption by treatment-associated self-regulatory skills usage in emerging adult and middle-age women with obesity
Annesi, J. J., & Johnson, P. H. (2020) · Appetite · doi:10.1016/j.appet.2020.104818 · Cited by 10
Effect of apple vinegar intake on metabolic parameters and constipation in patients with schizophrenia treated with clozapine: a pilot study
Hjorth, P., Petersen, S. M., Launholt, T. L., et al. (2020) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2020.1799432 · Cited by 7
Exercise Program-Induced Mood Improvement and Improved Eating in Severely Obese Adults
Annesi, J. J., & Tennant, G. A. (2013) · International Quarterly of Community Health Education · doi:10.2190/iq.33.4.f · Cited by 7
Opinions and acceptability of common weight-loss practices
Varnado‐Sullivan, P. J., Savoy, S. C., O’Grady, M. A., & Fassnacht, G. M. (2010) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/bf03325307 · Cited by 7
Why diets fail--expert diet advice as a cause of diet failure.
Applebaum, M. (2008) · American Psychologist · doi:10.1037/0003-066x.63.3.200 · Cited by 7
Client Experiences With Dietary, Exercise, and Behavioral Services in a Community-Based Weight Management Program
Zizzi, S., Kadushin, P., Michel, J., & Abildso, C. G. (2015) · Health Promotion Practice · doi:10.1177/1524839915610316 · Cited by 7
“Various researchers, therefore, have concluded that improving diet alone is not sufficient to achieve long-term weight loss maintenance (Mann et al., 2007).”
Background
Weight and cardiometabolic health: new perspectives
Tomiyama, A., Hunger, J., Nguyen-Cuu, J., & Wells, C. (2016) · International Journal of Obesity · doi:10.1038/ijo.2016.83 · Cited by 7
Self-citation
Psychosocial changes as correlates of weight regain vs. continued loss within 2‐year trials of a self‐regulation‐focused community‐based intervention
Annesi, J. J., & Mareno, N. (2017) · Clinical Obesity · doi:10.1111/cob.12173 · Cited by 7
“behaviours nearly always transpires (5,8).”
BackgroundResultInfluential
Anorexia: A perverse effect of attempting to control the starvation response
Nesse, R. M. (2017) · Behavioral and Brain Sciences · doi:10.1017/s0140525x16001503 · Cited by 7
(Dis-)solving the Weight Problem in Binge-Eating Disorder: Systemic Insights From Three Treatment Contexts With Weight Stability, Weight Loss, and Weight Acceptance
Meyer, L. B., Waaddegaard, M., Lau, M. E., & Tjørnhøj‐Thomsen, T. (2018) · Qualitative Health Research · doi:10.1177/1049732318764874 · Cited by 7
The impact of a weight-centred treatment approach on women's health and health-seeking behaviours
Aphramor, L. (2012) · Journal of Critical Dietetics · doi:10.32920/cd.v1i2.933 · Cited by 7
Best Practices in Policy and Access (Coding and Reimbursement) for Weight Loss Surgery
Shikora, S. A., Kruger, R. S., Blackburn, G. L., et al. (2009) · Obesity · doi:10.1038/oby.2008.573 · Cited by 7
“failed to halt progressive weight gain (31,32).”
Why is it so hard to change? The role of self‐integrity threat and affirmation in weight loss
Logel, C. R., Hall, W. M., Page‐Gould, E., & Cohen, G. L. (2018) · European Journal of Social Psychology · doi:10.1002/ejsp.2536 · Cited by 7
Predictors of effectiveness of glucagon-like peptide-1 receptor agonist therapy in patients with type 2 diabetes and obesity
Тихоненко, Е. В., Babenko, A. Y., & Shlyakhto, E. V. (2019) · Obesity and metabolism · doi:10.14341/omet9584 · Cited by 7
A glimpse into the pipeline of anti-obesity medication development: combining multiple receptor pathways
Park, C., Kim, Y., Raygani, S., & Grunvald, E. L. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1630199 · Cited by 7
“Moreover, even the most intense, high-quality strategies do not result in long-term weight loss (6).”
Er det overvekt eller vektfokus som er helseskadelig?
Samdal, G. B., & Meland, E. (2014) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.14.1334 · Cited by 6
Is obesity the next step in evolution through brain changes?
Ricart, W., Crujeiras, A. B., Mateos, A., Castells-Nobau, A., & Fernández‐Real, J. M. (2023) · Neuroscience Applied · doi:10.1016/j.nsa.2023.103927 · Cited by 7
“Research indicates that as many as 95% of individuals attempting weight loss through diet will regain it within two to five years, often exceeding their original weight, a phenomenon known as the yo-yo or rebound effect (Mann et al., 2007; Delahanty et al., 2012).”
How and why does discretionary food consumption change when we promote fruit and vegetables? Results from the ShopSmart randomised controlled trial
Opie, R., McNaughton, S. A., Crawford, D. A., Abbott, G., & Ball, K. (2019) · Public Health Nutrition · doi:10.1017/s1368980019002830 · Cited by 6
“Some studies have even shown that one- to two-thirds of dieters regain more weight than they lost on their diets(14).”
Background
Enhancing dieters' perseverance in adversity: How counterfactual thinking increases use of digital health tracking tools
Wang, K., Bublitz, M. G., & Zhao, G. (2021) · Appetite · doi:10.1016/j.appet.2021.105261 · Cited by 7
Weight stigma from media: Its associations with coping responses and health outcomes
Chen, T. T., Ching, B. H., Li, Y., He, C. C., & Wan, R. (2022) · Current Psychology · doi:10.1007/s12144-022-03179-8 · Cited by 7
“These strategies may help individuals reach their goal to lose weight temporarily, but long-term maintenance seems to be difficult (Mann et al., 2007; Tomiyama et al., 2013).”
Background
The science of weight controllability: Implications and future directions for weight at work research
Standen, E. C., & Mann, T. L. (2024) · Industrial and Organizational Psychology · doi:10.1017/iop.2023.78 · Cited by 6
“…in randomized controlled trials of diets: people can lose weight in the short term on practically any diet plan that limits their calorie intake, but most of the weight is regained over time for most individuals (for reviews, see Avenell et al., 2004; Dombrowski et al., 2014; Mann et al., 2007).”
BackgroundSelf-citation
From heart beats to health recipes: The role of fractal physiology in the Ancestral Health movement
Blaisdell, A. P. (2013) · Journal of Evolution and Health An Ancestral Health Society Publication · doi:10.15310/2334-3591.1001 · Cited by 6
Practical Application of Emotional Freedom Techniques for Food Cravings
Stapleton, P., Sheldon, T., & Porter, B. (2012) · Bond University Research Portal (Bond University) · Cited by 6
Is The “Health at Every Size” Approach Useful for Addressing Obesity?
Reel, J. J., & Stuart, A. R. (2012) · Journal of Community Medicine & Health Education · doi:10.4172/2161-0711.1000e105 · Cited by 7
“Since long-term maintenance of weight loss has limited “success” [9], and of the pursuit of weight loss is associated with weight cycling [5] and cumulative weight gain [16], focusing on health behaviors rather than body size is important.”
Background
Examining the most popular weight loss diets: How effective are they?
Sherer, E. L., & Sherer, J. A. (2008) · JAAPA · doi:10.1097/01720610-200811000-00008 · Cited by 6
A cross-sectional model of eating disorders in Argentinean overweight and obese children
Elizathe, L., Arana, F., & Rutsztein, G. (2016) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-016-0321-5 · Cited by 6
Reducing sugar use in coffee while maintaining enjoyment: A randomized controlled trial
Lenne, R. L., & Mann, T. L. (2017) · Journal of Health Psychology · doi:10.1177/1359105317723452 · Cited by 7
“, 2016), and efforts to treat it with calorie-restricting diets have had short-term, but not long-term success (Mann et al., 2007).”
BackgroundSelf-citation

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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