Competitive Cash-for-Weight-Loss Plans Work Best: Study

But individual incentives also do well when companies pay to help employees keep pounds off

By Barbara Bronson Gray

HealthDay Reporter

TUESDAY, April 2 (HealthDay News) -- Paying people to lose weight works, but some sort of competition or group effort may make it work even better, a new study reports.

The research showed how two company-sponsored weight-loss programs produced different results depending on how the rewards were structured.

The study, published April 1 in the journal Annals of Internal Medicine, demonstrates that when it comes to designing programs to help employees lose weight, details about how incentives are offered and how much cash is up for grabs can make a big difference in short-term outcomes.

The sustainability of weight loss accomplished in such efforts remains unclear, however.

In one group of five participants, the prize of meeting an individual weight-loss goal was $100, no more or less. In another, also with five members, the prize was $100, but with a chance at more if other members didn't succeed. The latter group had nearly three times the weight loss as the former.

Dr. Jeffrey Kullgren, the lead author of the study and an assistant professor of internal medicine at the University of Michigan, became interested in how to motivate people to lose weight from his work as a practicing primary-care physician. "I realized that behavior change is really hard," he said. With more than 80 percent of large employers thinking of offering some form of financial incentives to help people modify risk factors, he said it was important to see what really works.

"A lot of innovation is going on without a lot of evidence," Kullgren said. "The trains have left the station, so we're trying to be sure [programs] help people get where they need to be."

His research follows on the heels of a study, presented last month at the American College of Cardiology annual meeting in San Francisco, that showed those who got $20 a month for shedding four pounds -- or had to pay $20 for not losing the weight -- were more likely to reach weight-loss goals.

Kullgren's study involved 105 employees of the Children's Hospital of Philadelphia who were between the ages of 18 and 70 and considered obese. The goal for everyone was to lose a pound a week.

The researchers studied two types of incentive strategies: a group incentive and an individual one. In the individual approach, employees were offered $100 for each month they met or exceeded weight-loss goals. For the other, groups of five employees were offered $500 a month to be divided equally among only the members who met their goals. Those who didn't meet their goals received no money. The five-member groups had no way of learning each other's identities, so they couldn't intentionally tempt or discourage each other in an effort to personally win a bigger share of the pie.

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