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Financial Incentives for Extended Weight Loss: A Randomized, Controlled Trial
Open accessAbstract
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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“As such, several studies have documented the benefits of financial incentives to change relatively intractable health-compromising behaviours (Cahill & Perera, 2011; Halpern et al., 2011; John et al., 2011; Kim et al., 2012; Kimmel et al., 2012; Kullgren et al., 2013; Volpp et al., 2008).”
From Addressing sleep disturbances: an opportunity to prevent cardiometabolic disease? (2014) · cites this paper as John et al., 2011
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“Since many health-compromising behaviours have benefits that may vary across individuals, financial incentives may act as a universal, simple, adaptable, alternative reinforcer (Halpern et al., 2011; John et al., 2011, 2012; Kim et al., 2012; Kimmel et al., 2012; Kullgren et al., 2013; Loewenstein et al., 2013; Shea et al., 2012; Volpp et al., 2008, 2011).”
From Addressing sleep disturbances: an opportunity to prevent cardiometabolic disease? (2014) · cites this paper as John et al., 2011
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Metadata
- 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.
- Venue
- Journal of General Internal Medicine
- Published
- 2011-01-20
- Volume
- 26
- Issue
- 6
- Pages
- 621-626
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- 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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