Behavioral treatment of obesity

The objectives of this paper are threefold: to examine the empirical support for certain fundamental assumptions underlying behavioral treatments for obesity; to review the overall efficacy of current behavioral treatments; and to propose new treatment approaches which might improve the effectiveness of clinical and public health interventions. It is argued that individual differences in fatness are more likely caused by individual differences in intrinsic susceptibility to a high risk environment shared by all than by individual differences in specific behaviors. Experienced behavioral teams, using multicomponent treatment packages, can now be expected to produce excellent weight losses. The most pressing continuing challenge is maintaining weight loss. In the clinical domain it is suggested that obesity should be viewed as a chronic condition requiring long-term supportive care and that procedures which directly change the environments in which clients live deserve more attention. In the public health domain, more attention needs to be given to providing cost-effective weight management services to the general population. Primary prevention, especially through policies that better protect affluent populations from the obesity-inducing aspects of our environment also deserve further study.