Cash Incentives Help People Lose Weight, Researchers Find

Financial incentives for losing weight help people shed more pounds than programs that don’t affect dieters’ wallets, a study found.

Participants who received money monthly for losing weight or paid into a pool when they didn’t meet goals, dropped 9.1 pounds on average, compared with 2.3 pounds for those without cash incentives, according to research released today in advance of the American College of Cardiology meeting in San Francisco.

“Just wanting to lose weight isn’t enough,” said Donald Hensrud, chairman of preventive medicine at the Mayo Clinic in Rochester, Minnesota, who helped write the study. “People need creative strategies. Financial incentives can be powerful.”

More than two-thirds of companies are experimenting with programs that encourage healthier behavior in workers, such as higher insurance premiums for smokers or reduced rates for fitness clubs. One common tactic is to withhold incentives or raise fees for obese workers, penalties that can be lifted if they lower their body mass index, according to Michael Wood, a senior benefits consultant in Seattle at Towers Watson & Co.

“The jury is still out as to whether financial incentives will improve the rate of success of people losing weight on a long-term basis,” Wood said in a telephone interview.

$168 Billion

More than two-thirds of U.S. adults are overweight or obese, according to the Centers for Disease Control and Prevention. Obesity-related health costs are more than $168 billion annually, according to a Feb. 20 study in JAMA-Surgery.

Today’s study followed 100 adults ages 18 to 63 years who were obese based on their body mass index. They were weighed monthly for a year. The study was one of the longest looking at workplace financial incentives for weight loss.

Fifteen people received the maximum $360 over the year by attending every monthly weigh-in and reaching and maintaining their weight loss goal, Hensrud said. The study participants paid $2,200 into the pool in penalties, which was then divided among the eight people who reached the overall weight-loss goal of 10 percent and two other people in a general lottery. The researchers spent $12,000 for the monthly incentives.

Future studies should look at what financial incentives work best and how long the programs need to be in place to help people maintain their weight loss, Hensrud said.

Rising Tide

More than two-thirds of companies offer financial incentives to encourage participation in wellness activities, an increase from about half in 2010, according to the 18th annual Towers Watson survey on employer health care released today.

While incentive programs can cost companies about $100 to $1,200 year for each person and any spouse, healthier employees lower health insurance costs, Wood said. Companies also can build program costs into their health insurance bill, he said.

Thirty-six percent of companies reward employees for participating in a smoking-cessation program and 42 percent charge tobacco users about $50 a month, according to the survey.

About 16 percent of companies reward or penalize employees based on outcomes other than tobacco use, including weight control or cholesterol levels, an increase from 10 percent in

2012. That number is expected to jump to 47 percent in 2014 as more companies say they will enact these programs, according to the Towers Watson survey taken from November 2012 to January 2013 of 583 employers with a total of 11.3 million workers.

Fear Factor

In the Mayo Clinic study, each person was assigned to one of four groups. One group was provided weight-loss education, another received education and financial incentives, a third was provided education plus behavior modification and the last had financial incentives with education and behavior modification.

Those in the financial incentive groups who met their weight-loss goals received $20 a month, while those who didn’t had to pay $20 into a bonus pool. Half of the bonus pool went to people who met their study goals and the other half was put into a lottery for everyone who completed the yearlong study no matter their results, Hensrud said.

“Fear of losing money tends to motivate people about two and a half times more than the prospect of gaining the same amount of money, so we intentionally designed the incentives so that participants would have some of their own skin in the game,” said Steven Driver, a lead study author and a resident physician in internal medicine at the Mayo Clinic.

Sixty-two percent of the people with financial incentives completed the study compared with 26 percent in the non-incentive groups. The researchers estimated that 6.5 pounds of the 9.1 pounds average weight loss was attributable to the incentives.

Hensrud said financial incentives don’t work alone and may need to be combined with other methods to help people lose weight. Also, the incentive program didn’t pay for itself so more work may be needed to find programs that don’t add to company costs, he said.

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