The past, present, and future of behavioral obesity treatment
Open accessAbstract
Over the last century, hundreds of evaluations have been conducted to examine weight-management interventions related to diet, physical activity, and behavior therapy. These investigations have contributed to a growing body of knowledge that has consistently advanced the field of obesity treatment, while also revealing some persistent challenges. This narrative review summarizes key findings from randomized controlled trials conducted in adults that have combined diet, physical activity, and behavior therapy, an approach variously referred to as behavioral treatment, comprehensive lifestyle modification, or intensive lifestyle intervention. The review shows that current behavioral approaches induce average reductions in baseline body weight of 5 to 10% at 6 to 12 months. Such losses have proven effective in reducing the risk of type 2 diabetes in persons with impaired glucose tolerance and in improving other obesity-related complications. These benefits have also been associated with reductions in healthcare costs. Despite these advances, behavioral treatment is challenged by the need for larger losses to achieve optimal improvements in health, by difficulties associated with maintaining weight loss, and by barriers limiting access to treatment. New anti-obesity medications, when combined with behavioral obesity treatment, hold promise of addressing the first two issues.
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- Authors
- Chao, A. M., Moore, M., & Wadden, T. A.
- Affiliations
- Johns Hopkins University (US)
- University of Pennsylvania (US)
- Corresponding author
- Chao, Ariana M.
- Venue
- International Journal of Obesity
- Published
- 2024-04-27
- Volume
- 49
- Issue
- 2
- Pages
- 196-205
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- PMC
- PMC11729970
- OpenAlex
- W4395701658
- Cited by
- 40
- References
- 147
- Citations by year
- 2026: 14 · 2025: 21 · 2024: 5
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Nursing Research (R56NR020466, R01NR020197)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- obesity treatment, behavioral weight loss, lifestyle modification, diet, physical activity, behavior therapy, type 2 diabetes prevention, impaired glucose tolerance, health care costs, weight loss maintenance, access to treatment, anti-obesity drugs
- MeSH terms
- Behavior Therapy, Diabetes Mellitus, Type 2, Humans, Life Style, Obesity, Weight Loss, Exercise
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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