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Do money incentives help people lose weight?

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Posted March 22, 2013

Everyone is losing their marbles over a new study that suggests money incentives help folks lose weight. As Yoni Freedhoff accurately pointed out, the media attention seems a bit excessive for a non-peer reviewed abstract presented at a conference and authored by someone who can gain financially from this concept catching on.

What’s even more interesting is that most seem to have forgotten that basically an identical study had already been published back in 2008 in one of the world’s top medical journals. In fact, we covered this study nearly 5 years ago!

That not-so-new study suggested that monetary reward may be a better motivator for behavior change and ultimately, weight-loss, than the commonly touted health benefits.

Here’s the details of that peer-reviewed and published study:

Dr. Volpp and colleagues tracked the weight change in 57 obese individuals (30-70 years of age) who were randomized to either a no-treatment control group or to 1 of 2 financial incentive programs (a lottery incentive group, or a deposit incentive group). All participants were instructed to lower their weight (via diet and exercise) by 1 lb per week for the duration of the 16 week intervention, thus aiming for a total target weight-loss of 16 lbs. Individuals in the incentive groups received their financial rewards on a monthly basis, only if they had met or exceeded their target weight loss (1lb/wk). Those that failed to make the weight-loss goal were merely told how much money they would have received if they had been successful, whereas the control group received no reward regardless of their progress.

Over the course of the 4 month intervention individuals in the incentive groups earned an average of approximately $300, in contrast to $0 awarded to those in the control group. Interestingly, the average weight loss achieved by those receiving a financial incentive was significantly greater as compared to that of the control group (13-14lbs vs. 4 lbs, respectively). Furthermore, only 10% of individuals in the control group versus approximately 50% of those in the incentive groups achieved the target weight-loss of 16lbs.

However, during a subsequent 3-month follow-up, study participants gained back much of the lost weight after the cessation of the financial incentives – a finding which is common to most, if not all, weight-loss intervention studies.

This study extends findings of a previous investigation in which participants who were offered $14 per percent decrease in weight lost about 5lbs, while those who were offered no compensation lost 2lbs during the 3 month intervention.

So how can any of this be applied in the real-world?

The thinking goes – if an overweight individual has previously had trouble adhering to a diet and/or exercise program, investing some of his/her own money may provide a novel incentive to stay on track in order to avoid losing money – the basic concept of loss aversion.  For example, you can hand over $100 to a trusted friend/spouse/family member and sign a contract before embarking on a lifestyle change. This trusted individual is instructed to return the money in full if you achieve your goal, or otherwise to donate your money to a cause that you find distasteful – like the NRA or the Church of Scientology.

More than anything else, its a cute and gimmicky approach to providing incentive for weight loss, and the idea makes for great headlines (as recently illustrated). I’m sure financial incentives can work for some, but this is no obesity panacea.

Source: PLOS Obesity Panacea, story by Peter Janiszewski

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