Even Paying Cash Doesn't Provide Weight-Loss Motivation

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Over one third of Americans are obese, and the cost of treating related medical conditions (e.g. heart disease, stroke and Type 2 diabetes) totals more than $145 billion. Or put another way, that's nearly $1,550 more per person, as compared to people of normal weight, according to the Centers for Disease Control.

There are weight-loss diets galore, companies that specialize in behavioral motivation, others that provide meals with specified calorie content, drugs, and surgeries and none seem to be making a real dent in the obesity problem.

One means of motivating people to lose weight that hasn't been widely utilized is money. Some companies are using financial incentives to encourage their employees to make the effort. A recent study examines the effectiveness of one such effort premium-based financial incentives.

Dr. Mitesh S. Patel of the University of Pennsylvania's Wharton School and the School of Medicine, and colleagues, investigated whether or not health insurance premium-based incentives might be effective in motivating obese employees of the University health system to lose weight specifically 5 percent of their starting body weight. They tested several means of providing the incentive, to determine if that would make a difference in motivating the study's participants. They enrolled 197 obese people in their year-long study, randomly assigning them to one of four study groups, as follows:

  • Group 1: Control they weren't offered any financial reward
  • Group 2: They would receive bi-weekly health insurance premium discounts valued at $550 immediately after reaching their weight loss goal
  • Group 3: They would receive the same premium discounts the year after they reached their goal
  • Group 4: They would be eligible for a daily lottery payment if they reached their daily weight loss goal, and had weighed in the previous day

Disappointingly, although some employees did meet the 5 percent weight-loss goal, no one group was any more effective than the control group at losing weight. While the control group gained an average of 0.1 pound over the year, the three groups lost only 1.2, 1.4, and 1.0 pounds respectively. Thus, none of the different means of providing incentives to obese employees was clearly superior, and the investigators could not specify why.

They noted that the "apparent failure of the incentives to promote weight loss suggests that employers that encourage weight reduction through workplace wellness programs should test alternatives to the conventional premium adjustment approach by using alternative incentive designs, larger incentives, or both."