The book in overview iv that we can hope for with traditional approaches to weight loss. But what concerned me much more than these rather bleak figures was research that looked at how people regained weight they had lost over a period of five years as summarized in the following table. 1 Year 1 2 3 5 Weight Regained 45 % 52 % 68 % 115 % What this table( summarizing 20 research trials) tells us is that after we lose weight, on average, we not only put it all back on over time but we end up putting on 15 % more than we originally lost! When I had to lose weight because of being overweight and having a cholesterol problem, I started thinking very carefully about what this research was telling us. While psychological factors have been considered before in weight-loss programs – usually under the heading of‘ behavior modification’ – this component of the program was typically an add-on and only scratched the surface of the psychological issues involved. As I looked more deeply into the research, I realized there was a huge amount of fascinating research that was not being considered by most workers in the weight-loss field. When I lecture to doctors, dietitians and other workers in the field I often ask who has heard of the wealth of research into Restraint Theory and concepts like the‘ What the Hell effect’. Rarely do more than 5 % of these front line workers raise their hands. Too often none raise their 1 SARIS, WIM H. M. Very-low-calorie diets and sustained weight loss. Obesity Research. 2001; 9:295S – 301S.