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- Title
Financial incentive-based approaches for weight loss: a randomized trial.
- Authors
Volpp KG; John LK; Troxel AB; Norton L; Fassbender J; Loewenstein G; Volpp, Kevin G; John, Leslie K; Troxel, Andrea B; Norton, Laurie; Fassbender, Jennifer; Loewenstein, George
- Abstract
<bold>Context: </bold>Identifying effective obesity treatment is both a clinical challenge and a public health priority due to the health consequences of obesity.<bold>Objective: </bold>To determine whether common decision errors identified by behavioral economists such as prospect theory, loss aversion, and regret could be used to design an effective weight loss intervention.<bold>Design, Setting, and Participants: </bold>Fifty-seven healthy participants aged 30-70 years with a body mass index of 30-40 were randomized to 3 weight loss plans: monthly weigh-ins, a lottery incentive program, or a deposit contract that allowed for participant matching, with a weight loss goal of 1 lb (0.45 kg) a week for 16 weeks. Participants were recruited May-August 2007 at the Philadelphia VA Medical Center in Pennsylvania and were followed up through June 2008.<bold>Main Outcome Measures: </bold>Weight loss after 16 weeks.<bold>Results: </bold>The incentive groups lost significantly more weight than the control group (mean, 3.9 lb). Compared with the control group, the lottery group lost a mean of 13.1 lb (95% confidence interval [CI] of the difference in means, 1.95-16.40; P = .02) and the deposit contract group lost a mean of 14.0 lb (95% CI of the difference in means, 3.69-16.43; P = .006). About half of those in both incentive groups met the 16-lb target weight loss: 47.4% (95% CI, 24.5%-71.1%) in the deposit contract group and 52.6% (95% CI, 28.9%-75.6%) in the lottery group, whereas 10.5% (95% CI, 1.3%-33.1%; P = .01) in the control group met the 16-lb target. Although the net weight loss between enrollment in the study and at the end of 7 months was larger in the incentive groups (9.2 lb; t = 1.21; 95% CI, -3.20 to 12.66; P = .23, in the lottery group and 6.2 lb; t = 0.52; 95% CI, -5.17 to 8.75; P = .61 in the deposit contract group) than in the control group (4.4 lb), these differences were not statistically significant. However, incentive participants weighed significantly less at 7 months than at the study start (P = .01 for the lottery group; P = .03 for the deposit contract group) whereas controls did not.<bold>Conclusions: </bold>The use of economic incentives produced significant weight loss during the 16 weeks of intervention that was not fully sustained. The longer-term use of incentives should be evaluated.<bold>Trial Registration: </bold>clinicaltrials.gov Identifier: NCT00520611.
- Publication
JAMA: Journal of the American Medical Association, 2008, Vol 300, Issue 22, p2631
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.2008.804