Financial incentives boost weight-loss programs, study finds

Paying cash to people with obesity for losing a specific amount of weight or completing weight-reducing activities works better than offering stand-alone free tools, such as weight-loss programs, diet books, and wearable fitness trackers, a new study shows.

Led by researchers at NYU Grossman School of Medicine, the study tracked the weight-loss efforts for up to a year of 668 low-income, mostly Hispanic men and women whose average weight to start the trial was 218 pounds. All were randomly assigned to receive one of three sets of incentives for six months, including some who received cash payments and those who received none.

Publishing in the journal JAMA Internal Medicine online Dec. 5, the results showed that offering study participants cash directly, on average $440 in total, for losing at least 5% of their original body weight (about 10 pounds) was most effective over the short term. Forty-nine percent of those offered cash lost this amount of weight after six months. This number dropped to just 41% after a full year of follow-up.

Similarly, paying other study volunteers an average of $303 over the initial study period to meet weight-loss goals, such as attending at least two weight-loss counseling classes each month, weighing themselves at least three times per week, or exercising for at least 75 minutes per week, was also effective. Some 39% of these study participants lost 5% of their starting weight after six months, and almost 42% lost the minimum amount of weight after 12 months of monitoring.

All study participants were offered a free one-year voucher for the Weight Watchers program, which included classes, counseling, and tips for losing weight. Wearable fitness devices (Fitbits), digital scales, and food journals were also provided so that trial volunteers could keep track of their weight during the study and thereafter.

One in five of those who received zero financial incentives and who were only offered the free tools lost the minimum weight after six months. But this grew to almost a third after a year.

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