Financial Incentives Assist in Increased Weight Loss

Summary
As obesity is a major cause of health concern in developed countries like the U.S., there are ongoing studies to find the best ways of losing weight. A study was conducted to see the effectiveness of incentive systems, such as offering financial gain, in promoting weight loss. The study showed that incentive participants lost more weight than control participants during a weight monitoring program; however, the difference was no longer observed during the follow-up maintenance period. More research is needed to devise techniques that promote sustained weight loss over longer periods of time.

Introduction
It is supposed that over 70 percent of American adults are overweight or obese. There have been various programs that promise weight loss, but only a few that result in actual weight reduction and its maintenance over time. Based on behavioral economics, financial incentive systems have been seen to be effective in promoting weight loss. Studies have shown that a person is likely to overestimate how much weight they would lose and also that he focuses more on monetary losses than gains. The researchers, therefore, tried to explore the concepts of “over-optimism” and “loss aversion” in human behavior, by observing the effectiveness of incentive systems on weight loss.

Methodology
* Sixty-six obese participants, in the age group of 30 to 70 years and with a BMI of up to 40, were randomized into either a weight-loss program (control condition), or a weight loss program with one of two financial incentive plans.
* Under the incentive plans, subjects attaining their goal each day would receive a monthly incentive of $168 (after verification of weight at the end of each month).
* One of the incentive plans divided the 24-week period into weight loss and weight maintenance phases. No financial incentives were provided during the weight maintenance phase.
*  There was no such differentiation between the two phases in the second incentive plan group.

Key findings
* Mean weight loss at 32 weeks was statistically greater in the incentive groups than the control group.
* Mean weight loss at 32 weeks was not statistically different between the two incentive programs.
* Notably, at the end of the 32-week program, when the participants returned for an evaluation; substantial weight regain was noticed, especially in the incentive group.

Shortcomings
The participants were mainly highly motivated men; therefore, the data cannot be generalized to the whole population. As the impact on weight loss was dependent only on the incentives, general feedback was not possible from participants. Moreover, the study was not blind and there could have been some possibility of selection bias.

Conclusion
This is the first study to demonstrate that incentives can successfully help keep weight off; however, substantial weight is regained following termination of incentives. The program was intended to utilize several effects like “over-optimism” and “loss aversion.” Individuals have a tendency to overestimate the weight they think they will lose; most of the participants put down “deposit money” at the start of the month as a guarantee for losing weight. The concept of “loss aversion” was then used to propel them towards losing weight, so as to not lose their deposit. However, other techniques need to be devised to promote weight loss maintenance following the end of financial incentives, which can be considered an important topic for future research.

For More Information:
Financial Incentives for Extended Weight Loss: A Randomized, Controlled Trial
Journal of General Internal Medicine, January 2011
By Leslie John; George Loewenstein, PhD; Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania, and the University of Pennsylvania, Philadelphia, Pennsylvania

*FYI Living Lab Reports Are Summaries of the Original Research.
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