Cash Incentives, Penalties May Spur People to Shed More Pounds

Study found those who won or lost $20 depending on weight-loss success stuck with the program

By Denise Mann

HealthDay Reporter

THURSDAY, March 7 (HealthDay News) -- Money talks when it comes to motivating people to lose weight, a new study shows.

And it doesn't have to be a ton of cash, either. Just receiving $20 a month for losing 4 pounds -- or having to hand over $20 for not shedding the weight -- was enough incentive for many people to stay the course, according to research that is to be presented Monday at the annual meeting of the American College of Cardiology, which is set to begin this weekend in San Francisco.

"Financial incentives and disincentives can help people lose weight, and keep it off for one year," said study author Dr. Steven Driver, resident physician in internal medicine at the Mayo Clinic in Rochester, Minn. "It's not about getting rich, it's about being held accountable."

In the study, 100 employee volunteers who were considered obese (body mass index between 30 and 39.9) were placed into one of four weight-loss groups: two with financial incentives and two without. All of the weight-loss plans included an educational component, and one included a structured behavioral plan as well.

Those individuals in the financial incentive groups who met their goal received $20 per month, while those who didn't had to pay a penalty of $20 into a larger bonus pool. Participants in the two incentive groups who completed the study were eligible to win this bonus pool when the study ended.

When all was said and done, those who were paid money for shedding pounds lost more and were more likely to complete the study. Specifically, 62 percent of those who got paid for losing weight each month stayed the course, compared with only 26 percent of those who had no opportunity to receive financial incentives. Among people in the incentive groups, weight loss was slightly more than 9 pounds, on average. In contrast, participants who did not receive money to lose weight lost an average of 2.3 pounds.

More study is needed to see how long these changes can last, Driver noted. "The real challenge is to extend this research, and see if we can develop a sustainable financial incentive model that lasts for longer than one year," he said.

Many employers are beginning to offer such programs to encourage healthier behaviors among employees, Driver added.

And this is a good thing, said study co-author Dr. Donald Hensrud, chair of preventive, occupational and aerospace medicine at Mayo Clinic. "We need to use creative strategies to help people eat less and exercise more, and do all of those things that they know they should be doing," he said.

One expert said the findings make sense.

"I don't find it surprising that even a really small financial incentive helps spur some weight loss," said Dr. Scott Kahan, director of the National Center for Weight and Wellness, in Washington, D.C.

The real question is how long these healthy habits will last, he pointed out.

"The challenge is how to help people lose weight in a way that is sustainable. This is more data that financial incentives and disincentives do play a role in what our behaviors are, but things like this are not likely to make a long-term impact on the obesity epidemic by themselves," Kahan said.

"We need to be thinking about a comprehensive approach that addresses much more than increasing initial motivation," he explained. "We need to maintain this motivation over time."

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