Paying People Cash To Lose Weight Works

Paying participants in a weight loss program just US$160 can help them lose weight and keep the pounds off, study shows.

AsianScientist (Jun. 20, 2017) – A study published in Social Science and Medicine has shown that selling rewards programs to participants entering a weight loss programme is a low cost strategy to increase both the magnitude and duration of weight loss. A team from the Duke-NUS Medical School (Duke-NUS) and Singapore General Hospital (SGH) led the research, which has implications for insurance companies and employers looking for low cost strategies to improve population health.

Obesity is increasingly prevalent worldwide, leading to the rise of non-communicable diseases such as cardiovascular disease, diabetes and cancer. Although obesity is largely preventable, it has been difficult to encourage healthier food choices and sustained physical activity.

Using insights from behavioral economics, Professor Eric Finkelstein from Duke-NUS and Dr. Tham Kwang Wei from SGH developed a rewards program to help overweight or obese adults lose weight.

In the randomized eight-month-long Trial on Incentives for Obesity (TRIO), 161 participants were paid S$234 (~US$180) to access a 16-week intensive weight loss program. The program required participants to attend weekly sessions at the Lifestyle Improvement and Fitness Enhancement (LIFE) Centre in SGH where they were taught skills to maintain a healthy lifestyle and encouraged to lose at least five percent of their body weight.

Participants also paid an additional S$165 (~US$120) for the rewards programme. Participants in the intervention arm could earn monthly rewards either in cash or as a lottery ticket with a one in ten chance of winning ten times the cash amount if they met monthly weight loss and step goals.

Additional rewards were offered for meeting five or eight percent weight loss goals. The maximum possible reward value over the eight month period was S$660 (~US$475) if all weight loss and step goals were met. Those randomized to the control arm had their money returned and were ineligible for rewards.

At the end of month four, weight loss was more than twice as great in the rewards arm compared with the control arm (average 3.4 kg versus 1.4 kg weight loss). At months eight and 12, weight loss remained greater in the rewards arm.

Moreover, more than three times as many rewards arm participants achieved five percent or greater weight loss at month four, relative to control arm participants. At month four more than twice as many hit the five percent threshold and the percentage with five percent or greater weight loss was still greater at month 12.

The average payout to participants in the rewards arm was S$225 (~US$160). After subtracting the fee to access the rewards, third party costs were S$60 (~US$43) per participant. Furthermore, although only 42 percent of participants earned more than they paid in, ~80 percent reported satisfaction with the rewards scheme.

“Our findings not only show the value of rewards to increase weight loss and weight loss maintenance, but they show it can be done in a manner that minimizes third party payments, such as those by employers or insurers. This should help to expand access to these types of programs,” said Finkelstein, a professor in the Duke-NUS Programme for Health Services and Systems Research.

“Even small amounts of weight loss, sustained over time, confer great health benefits and can help prevent chronic disease. This study shows that the enhancement and maintenance of weight loss is feasible through a rewards program with participant ownership, coupled with an evidence-based, medical weight loss programme,” said Tham, Director, LIFE Centre and Senior Consultant, Department of Endocrinology, SGH.

The article can be found at: Finkelstein et al. (2017) Applying Economic Incentives to Increase Effectiveness of an Outpatient Weight Loss Program (TRIO) – A Randomized Controlled Trial.


Source: Duke-NUS School of Medicine; Photo: Shutterstock.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.

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