Far more people with obesity living in a socioeconomically disadvantaged neighborhood lost weight when a financial incentive was added to the mix, according to a randomized clinical trial.
After 6 months, 49.1% of people lost at least 5% of their baseline weight when provided with resources such as commercial program memberships and self-monitoring tools plus outcome-based financial incentives linked to their percentage of weight loss, reported Melanie Jay, MD, of NYU Grossman School of Medicine in New York City, and colleagues.
Also effective were “goal-directed” incentives, which provided participants with the same weight loss resources, but paired them with financial incentives linked to engagement in weight-loss behaviors, with 39% of this group achieving at least a 5% weight loss, the group noted in JAMA Internal Medicine.
Participants in both the goal-directed and outcome-based financial incentive groups were eligible to earn up to $750. Mean earned incentives were $440.44 in the goal-directed group and $303.56 in the outcome-based group. The goal-directed group could also earn money by participating in weight management classes, using a food journal, and engaging in physical activity verified by a FitBit. Those in the outcome-based group were instead paid cash for losing specific amounts of weight.
Though a larger proportion of people lost weight with an outcome-based financial incentive, the total amount of weight lost on average was similar in both incentive arms.
Jay and team found that only providing participants with resources but no financial incentive was least effective, though still yielded a 5% or more weight loss in 22.1% of this group.
At month 6, this weight loss equated to a mean change of 2.21 kg (4.87 lb) lost for the resources-only group, 4.47 kg (9.85 lb) lost with goal-directed incentives, and 4.79 kg (10.56 lb) lost for the group receiving outcome-based incentives.
After a full year, 31.3% of participants in the resources-only group lost at least 5% of baseline weight, as did 41.9% of the goal-directed incentive group and 41.4% of the outcome-based incentive group, which equated to a 2.74 kg (6.04 lb), 5.43 kg (11.97 lb), and 4.61 kg (10.16 lb) loss, respectively.
Of note, no signal was seen for potentially dangerous weight loss behaviors in any of the arms, the authors said.
These findings weren’t totally surprising, Jay told MedPage Today, as her group expected to see more people lose weight when financial incentives were involved. That being said, she noted that they originally hypothesized that the goal-directed arm would do best because these participants in theory would be gaining more confidence over time to practice new behaviors.
“I am surprised that the patients in the outcome-based arm had similar amounts of weight …….