Food rewards to encourage behavioral change seem to make sense. People generally respond well to food as a reinforcer. The rationale for the use of food rewards in behavioral therapy is that food is a primary or natural reinforcer, which does not require any learning process in order to be effective. Other sources of behavioral or psychological reinforcers that occur naturally are warmth, air, sleep, water and sex. Of these natural reinforcers, food can be used in most settings and is easily provided without a significant amount of effort. Food as a reinforcer seems an obvious choice, but years of research does not lead us to conclude that food rewards are consistently effective. This article discusses the use of food as a reinforcer and possible alternative strategies to behavioral solutions.