Cited by 346Behavioral Health and InterventionsObesity, Physical Activity, DietObesity and Health Practices

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Financial Incentives for Extended Weight Loss: A Randomized, Controlled Trial

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John, Leslie K., Loewenstein, George, Troxel, Andrea B., Norton, Laurie, Fassbender, Jennifer E., Volpp, Kevin G.·2011·Journal of General Internal Medicine

DOI 10.1007/s11606-010-1628-yPMC PMC3101962

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Abstract

Background Previous efforts to use incentives for weight loss have resulted in substantial weight regain after 16 weeks.Objective To evaluate a longer term weight loss intervention using financial incentives.Design A 32-week, three-arm randomized controlled trial of financial incentives for weight loss consisting of a 24-week weight loss phase during which all participants were given a weight loss goal of 1 pound per week, followed by an 8-week maintenance phase.Participants Veterans who were patients at the Philadelphia Veterans Affairs Medical Center with BMIs of 30-40.Intervention Participants were randomly assigned to participate in either a weight-monitoring program involving a consultation with a dietician and monthly weigh-ins (control condition), or the same program with one of two financial incentive plans. Both incentive arms used deposit contracts (DC) in which participants put their own money at risk (matched 1:1), which they lost if they failed to lose weight. In one incentive arm participants were told that the period after 24 weeks was for weight-loss maintenance; in the other, no such distinction was made.Main measure Weight loss after 32 weeks.Key results Results were analyzed using intention-to-treat. There was no difference in weight loss between the incentive arms (P = 0.80). Incentive participants lost more weight than control participants [mean DC = 8.70 pounds, mean control = 1.17, P = 0.04, 95% CI of the difference in means (0.56, 14.50)]. Follow-up data 36 weeks after the 32-week intervention had ended indicated weight regain; the net weight loss between the incentive and control groups was no longer significant (mean DC = 1.2 pounds, 95% CI, -2.58-5.00; mean control = 0.27, 95% CI, -3.77-4.30, P = 0.76).Conclusions Financial incentives produced significant weight loss over an 8-month intervention; however, participants regained weight post-intervention.

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Authors: John, L. K., Loewenstein, G., Troxel, A. B., Norton, L., Fassbender, J. E., & Volpp, K. G.
Affiliations: Carnegie Mellon University (US)
Leonard Davis Institute of Health Economics (US)
Philadelphia VA Medical Center (US)
University of Pennsylvania (US)
Corresponding author: John, Leslie K.
ORCID: John, Leslie K.
Loewenstein, George
Troxel, Andrea B.
Norton, Laurie
Volpp, Kevin G.
Venue: Journal of General Internal Medicine
Publisher: Springer Science and Business Media LLC
Published: 2011-01-20
Volume: 26
Issue: 6
Pages: 621-626
ISSN: 0884-8734 (ISSN-L)
1525-1497
DOI: 10.1007/s11606-010-1628-y
PMC: PMC3101962
OpenAlex: W2112703815
Cited by: 346
References: 21
Citations by year: 2026: 4 · 2025: 3 · 2024: 10 · 2023: 11 · 2022: 25 · 2021: 37 · 2020: 26 · 2019: 24 · 2018: 31 · 2017: 26 · 2016: 30 · 2015: 33 · 2014: 34 · 2013: 24 · 2012: 21
FWCI: 36.59
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Journal of General Internal Medicine (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Agriculture
William and Flora Hewlett Foundation
National Institutes of Health (5p30ag012836-30)
Economic Research Service
National Institute on Aging (P30-AG-012836)
Topics: Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
Keywords: financial incentives, weight loss, weight regain, deposit contracts, obesity, veterans, weight loss maintenance, behavioral interventions
MeSH terms: Adult, Aged, Body Weight, Female, Follow-Up Studies, Hospitals, Veterans, Humans, Male, Middle Aged, Motivation, Obesity, Reward, Time Factors, Weight Loss

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Financial Incentives for Extended Weight Loss: A Randomized, Controlled Trial

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