Weight-Loss Incentives

Finding the motivation to exercise, or to lose weight, can be difficult, as millions of people can attest. To get around this problem, many workplace wellness programs offer financial incentives — often in the form of reduced health insurance premiums — to follow an exercise regimen or to lose weight. But as a recent study suggests, many of these programs may be ineffective at encouraging weight loss.

Published earlier this month in the journal Health Affairs, the study aimed to test various approaches that workplaces might provide when offering financial incentives for weight loss. As described in a HealthDay article on the study, researchers at the University of Pennsylvania recruited 197 obese participants, who were each given a goal of losing 5% of their body weight. Each participant was then assigned to one of four groups: a control group with no financial incentives, and three programs that each offered an incentive of $550 for meeting the weight-loss goal. Two of these programs featured reduced health insurance premiums — one offering an immediate reduction as soon as the weight-loss goal was reached, and one offering reduced premiums starting the next year. The third program entered participants who met their weight-loss goal into a daily lottery.

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After 12 months, there were some very small differences between each of the groups — members of the control group had gained an average of 0.1 pounds, while members of the immediate premium reduction group had lost an average of 1.4 pounds. Similarly, members of the delayed premium reduction group had lost an average of 1.2 pounds, and those in the lottery group had lost an average of 1.0 pounds. But none of these differences, given the high starting weights of the participants, were statistically significant — meaning that they were small enough to have happened by chance. Furthermore, losing 1.4 pounds is unlikely to have any medically significant effect in an obese person.

So are all financial incentives useless for weight loss? Not necessarily. It’s possible that financial incentives are helpful, but not sufficient by themselves, in spurring people to lose weight. As we noted in a 2013 post here at Diabetes Flashpoints, a study that year found that being offered $20 a month to lose 4 pounds — and keep it off — led to even greater weight loss, with obese participants in the incentive group losing an average of over 9 pounds. One major difference in that study, however, was that all participants — even those in the control group — were given either weight-loss education or a structured weight-loss program.

Financial rewards aren’t, of course, the only tool that an be used for motivation. The opposite approach — charging a fine when people don’t meet a goal — may also be effective, as we noted in a 2012 post on a mobile app called GymPact (now shortened to Pact) that fines people for skipping workouts they’ve committed to completing. Of course, fining people for not losing weight may be more problematic, both practically and morally.

And then there are motivational approaches that don’t use money at all. As we noted in a 2010 post, having someone check in with you about how you’re sticking to your exercise plan — even if it’s someone you’ve never met — can have a beneficial effect. It’s possible that this same principle could be applied to weight loss, especially if there’s a structured weight-loss program that participants are supposed to follow.

What do you think are the best ways to motivate people to lose weight? Do you think financial incentives would motivate you, either by themselves or when they’re paired with a structured weight-loss program? Would a fine for not sticking to a program be more effective? Are there other motivational tools — such as checking in with a counselor, or other member of a weight-loss program — that you think might be even more useful? Leave a comment below!