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Skinner treatment works, is expensive


But despite their relative success, Skinnerian weight-loss programs have not become the default treatment for obesity the way AA has for alcoholism. One reason, of course, is that most would-be weight-losers can't afford these programs (insurance usually won't cover them) or don't have the time, patience, or motivation to commit to one. At up to $3,500, the six-month Miriam outpatient program is a relatively good deal, especially compared with Canyon Ranch, which offers a well-regarded residential program for about $1,200 a day.

"We know how to get people to eat healthier and exercise," says Steven Blair, an exercise and epidemiology researcher at the University of South Carolina. "The question is how to roll out the needed behavioral strategies to 50 million unfit adults in the U.S. Even if there were enough trained counselors to work with that many people, which there aren't, the cost issues would be overwhelming."

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