Financial incentives for extended weight loss: a randomized, controlled trial

Area of Science:

• Behavioral economics
• Obesity research
• Public health interventions

Background:

• Previous weight loss interventions using incentives showed significant weight regain after 16 weeks.
• Longer-term effectiveness of financial incentives for weight management remains under investigation.

Purpose of the Study:

• To assess the efficacy of a longer-term weight loss intervention incorporating financial incentives.
• To evaluate sustained weight loss outcomes following the intervention period.

Main Methods:

• A 32-week randomized controlled trial involving three arms: a control group and two financial incentive groups using deposit contracts.
• Participants (Veterans with BMI 30-40) aimed for 1 pound of weight loss per week during a 24-week phase, followed by an 8-week maintenance phase.
• Weight loss was measured after 32 weeks, with follow-up assessments post-intervention.

Main Results:

• Participants in the financial incentive groups achieved significantly greater weight loss compared to the control group after 32 weeks (mean difference: 7.53 pounds).
• No significant difference in weight loss was observed between the two financial incentive arms.
• Post-intervention follow-up at 36 weeks revealed substantial weight regain in both incentive and control groups, with no significant net weight loss difference.

Conclusions:

• Financial incentives can drive significant weight loss during an 8-month intervention period.
• The positive effects of financial incentives on weight loss are not sustained after the intervention ends, indicating a need for long-term maintenance strategies.