Theoretical, practical, and social issues in behavioral treatments of obesity.
Small weight rebounds are biology, not failure—set goals with the client, not at the client.
01Research in Context
What this study did
Friedling et al. (1979) wrote a think-piece for behavior analysts who run weight-loss programs.
They warned that the body fights back. When fat drops, metabolism slows and weight creeps up again.
The authors told us to stop labeling this bounce as client failure. Instead, they said, set goals together and protect the person’s pride.
What they found
The paper found no new data. It found a trap. Small losses and quick regain are normal biology, not bad behavior.
If we blame the client, we bruise self-esteem and risk dropout. Shared, modest targets keep people in the game.
How this fits with other research
McNamara (1978) set the table one year earlier. That paper gave a checklist to guard client rights at every step. Friedling et al. (1979) used the same guardrails but aimed them straight at the scale.
Iversen (2002) later turned the idea into a ruler. Maintenance in real life, the 2002 paper said, is the true score of social validity. If weight returns but confidence stays, the program still wins.
Wyatt (2009) updated the talk-track. When families push pills, the 2009 paper gives you lines that cite short drug follow-ups and lift behavioral staying power.
Saunders et al. (2005) then zoomed out. The 2005 review told us to move past single clinics and take behavior analysis to city-wide health. Same client-first ethic, bigger stage.
Why it matters
Next time the graph creeps up, pause before you correct. Ask the client what loss feels livable. Write that number into the plan, not the textbook ideal. Praise every maintained gram and protect dignity. You will keep people longer, and the data will still move.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Open the last weight graph with your client and jointly pick the next micro-target that feels doable.
02At a glance
03Original abstract
Although showing superior maintenance, behavioral treatments of obesity typically produce small weight losses at a decelerating rate. Rather than reflecting poor compliance with treatment, these findings are consistent with known compensatory metabolic changes that operate to slow weight loss and promote regain. Other problems associated with dieting include failure of caloric regulation, hyper-responsivity to food palatability, and hunger, which is greater under conditions of moderate restriction and unpredictability of access to food. The inevitability of treatment failure in many instances must be faced and efforts made to prevent further worsening of the obese patient's self-esteem. Prognosis and treatment planning may be aided by consideration of the historical difficulties of weight loss, the degree of hunger experienced on diets, which may reflect important physiological differences among individuals, and the use of food to optimize arousal level. Full involvement of the patient in setting goals and planning treatment is recommended.
Journal of applied behavior analysis, 1979 · doi:10.1901/jaba.1979.12-3