Behaviorism exploded in prominence in the 1950s and ’60s, both in academic circles and in the public consciousness. But many academics, not to mention the world’s growing supply of psychotherapists, had already staked their careers on the sort of probing of thoughts and emotions that behaviorism tends to downplay. The attacks began in the late 1950s. Noam Chomsky, then a rising star at MIT, and other thinkers in the soon-to-be-dominant field of cognitive science acknowledged that behavior modification worked on animals but claimed it did not work on people—that we’re too smart for that sort of thing. Then, seizing on Skinner’s loudly proclaimed conviction that communities should actively shape human behavior to promote social justice and harmony, they argued that if behavior modification were to work on humans, it would be a morally repugnant and even fascist method of forcing people to toe an official line.
In 1971, Stanley Kubrick’s seminal film A Clockwork Orange echoed this fear by centering on a government’s attempt to reduce criminal behavior via methods amounting to a brutal caricature of behavior modification: the “debilitating and will-sapping techniques of conditioning” that presaged “the full apparatus of totalitarianism,” as one character puts it. (The movie actually depicts Pavlovian, not Skinnerian, conditioning—a distinction lost on the public.) That same year, Time put Skinner on its cover, headlining its profile “Skinner’s Utopia: Panacea, or Path to Hell?” The overheated charges stuck. By the mid-1970s, the behavior-analysis field had essentially gone underground, its remaining practitioners having moved from prominent universities to relatively obscure ones.
Vargas took me to Harvard to see one of the few signs that her father was once the luminary of its psychology department, or indeed that he was ever there: an odd, cluttered display of circuit boards, random machinery, and a photo of Skinner, placed next to a self-service café in the basement of the psychology building, a curiosity to be contemplated over a cappuccino.
Skinner remains a staple of Psych 101 at most colleges, but typically only for a brief, often sneering mention, as if behaviorism was a strange, ugly fad. “He became a whipping boy for cognitive scientists,” says Dean Keith Simonton, a psychologist at the University of California at Davis, who has studied how his field views Skinner. “Psychology students were taught that his techniques didn’t work, that it was a bad direction for psychology to go in, and that he was a bad person, though he wasn’t. He just got kind of a bad rap.” It was a rap that the public bought wholesale, notes Christopher Bryan, a psychologist at UC San Diego. “There was a notion that there’s something icky about psychological techniques intended to manipulate people,” he says.
It made little difference that holdout behaviorists continued to accumulate evidence that Skinner’s techniques helped tame all sorts of otherwise confounding behavioral problems, including nail-biting, narcotics addiction, child abuse, and, yes, criminal recidivism (no Clockwork Orange–style punishment involved). But the most stunning example was autism: studies in the late 1980s and early ’90s established that behavior analysis, unlike any other treatment, was effective in helping children with autism communicate, learn, and refrain from violent behavior, to the extent that some patients shed their diagnosis. The success with autism pumped money into the field of behavior analysis, leading many of its researchers to look for other big challenges. And by the beginning of the 21st century, there was widespread concern about an obesity epidemic.
That Skinner’s theory could be successfully applied to obesity was no surprise. Decades earlier, when no one spoke of an obesity problem, Skinner had been writing about diet and exercise as an example of how behavior could be modified. In a 1957 paper in American Scientist, he cited a Harvard University study in which rats were conditioned to eat when they weren’t hungry, causing what Skinner called “behavioral obesity.” His followers did not have to reach far for the converse, speculating that an organism might be induced to willingly reduce food intake, were it rewarded for doing so.
They were eventually proved right by Weight Watchers, which launched its “behavior modification plan” in the mid-1970s. The program’s close adherence to Skinner’s basic principles has consistently garnered some of the best long-term weight-loss results of any mass-market program. The key characteristic of Weight Watchers and other Skinnerian weight-loss programs is the support and encouragement they provide to help participants stick with them. (Much the same is true of AA, which is strikingly similar to a behavior-modification program.) Weight Watchers and the other programs do not claim to magically burn fat, or make appetite disappear, or blast abs. They aim to gradually establish healthful eating and moderate exercise as comfortable, rewarding routines of daily life rather than punishing battles of willpower and deprivation.
The specifics may sound familiar: set modest goals (to encourage sustainable progress and frequent reinforcement); rigorously track food intake and weight (precise measurement is key to changing behavior, especially when it comes to eating, since a few bites a day can make the difference between weight loss and weight gain); obtain counseling or coaching (to diagnose what environmental factors are prompting or rewarding certain behaviors); turn to fellow participants for support (little is more reinforcing than encouragement from peers, who can also help with problem-solving); transition to less-calorie-dense foods (to avoid the powerful, immediate reinforcement provided by rich foods); and move your body more often, any way you like (to burn calories in a nonpunishing way).
Study after study proves the effectiveness of this rough Skinnerian formula, which is the basis of the great majority of well-regarded weight-loss programs. “Willpower doesn’t work,” says Jean Harvey-Berino, a University of Vermont behavioral scientist who researches weight-loss methods. “What works heavily relies on Skinner—shaping behavior over time by giving feedback, and setting up environments where people aren’t stimulated to eat the wrong foods.” As the evidence continues to pile up, it’s getting harder to find weight-loss researchers who disagree, says Jennifer Shapiro, a psychologist specializing in weight loss and the scientific director at Santech, a San Diego health-technology firm. “More and more studies demonstrate the effectiveness of behavioral approaches based on Skinnerian reinforcement.”
Not that Skinner ever gets much credit. The experts who run successful behavioral weight-loss programs, including Weight Watchers, seem at best vaguely aware of these techniques’ Skinnerian roots, or choose to downplay them. Instead, they frame their programs in the more fashionable terms of behavioral economics or social-cognitive theory, or offer the nontheoretical argument that they just plain work. But this would have been fine with Skinner, says Vargas. “He used to say that the ultimate worth of a science is in how much good it can do in the world.”
So widely accepted is the long-term effectiveness of Skinnerian weight-loss programs that most well-regarded bariatric-surgery clinics require patients to follow such a program before surgery, in order to prove their ability to avoid regaining much or even most of the weight after—as more than one-fourth of bariatric patients eventually do, according to some studies. Even clinical programs for rapid weight loss rely on Skinner’s tenets. The 25-year-old Weight Management Program at the Miriam Hospital—one of Brown University’s teaching hospitals in Providence, Rhode Island, and the home of the National Weight-Control Registry—is a highly regarded program in which many of the patients are more than 200 pounds overweight. Typically, patients are started out on an Optifast diet, a physician-mediated program that replaces some or all meals with liquids and food bars in order to “give patients some distance from food,” as one psychologist there puts it. But the Miriam program’s goal is for its patients to gradually build healthy eating habits with ordinary food, and to add in daily walks. The program reports that about one-third of its patients keep all the weight off for two or more years. And that figure, which is some 16 times the success rate implied by the “98 percent gain it all back” statistic we keep hearing, turns out to be fairly typical of leading clinical weight-loss programs.
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.”
And there’s another limitation. These programs work by sticking participants in a “Skinner box”—which was, literally, a closed glass box in which Skinner trained his animals; figuratively, it’s an environment that can be tightly controlled and in which behavior can be rigorously tracked, so as to ensure the dominance of the prompts and reinforcements that lead to a desired change. When a patient is “in the box”—that is, actively participating in a formal program—results are reliably good. The bigger challenge comes when people leave the program to plunge back into an environment rife with caloric temptation.
Most programs try to provide remote monitoring and support, but inevitably, many patients let these looser ties dissolve, and then they gain back weight. That’s why these programs tend to report long-term success rates of only about 30 percent. This is a much bigger problem for mass-market programs like Weight Watchers, which don’t charge enough to offer individual coaching or frequent, intimate group meetings. Effective as it is for a highly affordable program, Weight Watchers places its clients in a Skinner box of gossamer walls.