Skin in the Game

December 24th, 2008 | Sources: JAMA, WSJ Health Blog

In 1960, 13% of US adults were obese. Now it’s 31% and it’s looking like obesity might surpass cigarette smoking as the numero uno preventable cause of premature death.

How can we get people to get serious about losing weight?

Kevin Volpp and colleagues at the University of Pennsylvania thought why not try financial incentives and you know what? They worked like a charm.

The scientists randomized 57 obese healthy male volunteers aged 30-70 years to either of 2 incentive programs or a control group. The goal was to lose 16 pounds in 16 weeks.

In both incentive schemes, participants had to pay to play and could only win if they met weight loss targets during the study. The first involved a cash lottery. In the second, players doubled their money straight-up if they met the targets.

In both schemes, the payout came out to about the same, $300 per qualifying player. The control group received educational materials and monthly weigh-ins.

At the end of 16 weeks, only 10% of the controls achieved the weight loss target. Fully half those in each incentive group made it and the difference was significant.  The findings were not impacted by age, income or initial BMI.

At 7 months, scientists found that the weight of control group participants had returned to pre-study values. Weight of participants in the incentive groups was significantly below baseline levels, although they had packed on some pounds since the study ended.  

And almost no one in the incentive groups was lost to follow-up!

Scientists will want to study the long-term benefits of incentive programs, determine whether the findings can be generalized to women and assess program cost-effectiveness but yea, we know how get their attention all right!


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