Financial Incentives for Weight Loss


Obesity is a major cause of premature aging and the second leading cause of preventable mortality in the United States, accounting for approximately 110,000 deaths per year. Financial incentives have been effective in modifying a number of health behaviors but they have not been applied to weight loss by low- SES obese veterans. We build on previous work showing the effectiveness of deposit contracts, in which subjects put their own money at risk if they do not lose weight, by adding a 1:1 match as well as a direct payment conditional on daily weight loss to make this approach more attractive to a low SES population. The proposed study, a 2-arm randomized control trial (RCT), would be tested with 24 patients at Philadelphia VA with BMIs between 30 and 40. Participants will receive for 16 weeks either weekly monitoring of their weights or the same monitoring plus a package of financial incentives if they lose weight at a rate proportional to a weight loss target of 16 lbs in 16 weeks consisting of: a.) daily payment of $3 and b.) return at the end of the month of the amount they deposited at the beginning of that month plus our 1:1 match. We will have 90% power to find a 15- pound difference in weight loss. The proposed intervention will serve as the basis for a larger-scale intervention study of incentives for weight loss and maintenance that has the potential to substantially reduce the health burden of obesity among Americans. Beyond assessing the effectiveness of the incentives on weight loss, we propose to use the difference in weight loss measured at 16 weeks to project the long-term cost-effectiveness if weight loss is sustained.

Funded By: 
Funded By: 
Award Dates: 
July 1, 2006 - June 30, 2007
PARC Grant Year: 
Year 13