Financial Incentives for Extended Weight Loss: A Randomized, Controlled Trial
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Previous efforts to use incentives for weight loss have resulted in substantial weight regain after 16 weeks.
To evaluate a longer term weight loss intervention using financial incentives.
A 32-week, three-arm randomized controlled trial of financial incentives for weight loss consisting of a 24-week weight loss phase during which all participants were given a weight loss goal of 1 pound per week, followed by an 8-week maintenance phase.
Veterans who were patients at the Philadelphia Veterans Affairs Medical Center with BMIs of 30–40.
Participants were randomly assigned to participate in either a weight-monitoring program involving a consultation with a dietician and monthly weigh-ins (control condition), or the same program with one of two financial incentive plans. Both incentive arms used deposit contracts (DC) in which participants put their own money at risk (matched 1:1), which they lost if they failed to lose weight. In one incentive arm participants were told that the period after 24 weeks was for weight-loss maintenance; in the other, no such distinction was made.
Weight loss after 32 weeks.
Results were analyzed using intention-to-treat. There was no difference in weight loss between the incentive arms (P = 0.80). Incentive participants lost more weight than control participants [mean DC = 8.70 pounds, mean control = 1.17, P = 0.04, 95% CI of the difference in means (0.56, 14.50)]. Follow-up data 36 weeks after the 32-week intervention had ended indicated weight regain; the net weight loss between the incentive and control groups was no longer significant (mean DC = 1.2 pounds, 95% CI, -2.58–5.00; mean control = 0.27, 95% CI, -3.77–4.30, P = 0.76).
Financial incentives produced significant weight loss over an 8-month intervention; however, participants regained weight post-intervention.
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- Financial Incentives for Extended Weight Loss: A Randomized, Controlled Trial
Journal of General Internal Medicine
Volume 26, Issue 6 , pp 621-626
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- behavioral medicine
- randomized trials
- behavioral economics
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- Author Affiliations
- 1. Department of Social and Decision Sciences, Carnegie Mellon University, 208 Porter Hall, 5000 Forbes Avenue, Pittsburgh, PA, 15213, USA
- 2. Center for Health Incentives, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- 3. Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
- 4. Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
- 5. Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- 6. Department of Health Care Management, The University of Pennsylvania Wharton School, Philadelphia, PA, USA