BWHealthy Weight Pilot Study: A randomized controlled trial to improve weight-loss maintenance using deposit contracts in the workplace (original) (raw)
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Strong monetary contingencies for weight loss during treatment and maintenance
Behavior Therapy, 1981
Strong monetary contingencies were used during the treatment and maintenance phase of a weight control program. Thirty-eight overweight adults deposited 225,225, 225,15 of which was returned at each of eight weekly treatment meetings and seven monthly maintenance meetings. For clients in Group I, the deposits were returned for weight loss during treatment and attendance during maintenance. In Group II, deposits were repaid for attendance during treatment and weight loss during maintenance. There were no differences in weight loss between groups, and no evidence that contracts contingent on weight loss were significantly more effective than those for attendance. Clients lost significant amounts of weight during both treatment and maintenance, suggesting that prolonged use of strong monetary contracts may facilitate weight loss. . The failure of clients to continue to lose substantial amounts of weight after treatment suggests that the changes in eating and exercise behaviors obtained during treatment are not maintained during follow-up. Indeed, clients report a decrease in the use of behavioral techniques and a deterioration of behavior changes during follow-up Oeffery, Vender, & Wing, 1978).
Deposit money: A component in a self-directed minimal intervention program for weight control
Behavior Therapy, 1983
The present study investigated the effect of deposit money as a component in a minimal intervention program for weight control. Subjects were informed that they would be randomly.assigned to one of two behavioral weight control programs or to a self-directed, "do-whatever-you-want," minimal intervention condition. All subjects actually were assigned to one of two minimal intervention conditions and attended only two weigh-ins following an introductory meeting. Subjects who paid a deposit, returned for attending meetings, lost an average of 3.4 pounds after 4 months which was significantly more than the average of .4 pounds lost by those who did not pay a deposit. The number of weeks subjects in both groups reported using self-change methods was significantly correlated with weight loss. Deposit money did not significantly affect attrition and subjects lost weight without training in goal setting and situational management.
Clinical trials (London, England), 2016
Obesity continues to be a serious public health challenge. Rates are increasing worldwide, with nearly 70% of the US adults overweight or obese, leading to increased clinical and economic burden. While successful approaches for achieving weight loss have been identified, techniques for long-term maintenance of initial weight loss have largely been unsuccessful. Financial incentive interventions have been shown in several settings to be successful in motivating participants to adopt healthy behaviors. Keep It Off is a three-arm randomized controlled trial that compares the efficacy of a lottery-based incentive, traditional direct payment incentive, and control of daily feedback without any incentive for weight-loss maintenance. This design allows comparison of a traditional direct payment incentive with one based on behavioral economic principles that consider the underlying psychology of decision-making. Participants were randomized in a 2:1 ratio for each active arm relative to con...
Nutrition & diabetes, 2018
Financial incentives can improve initial weight loss; we examined whether financial incentives can improve weight loss maintenance. Participants aged 30-80 years who lost at least 5 kg during the first 4-6 months in a nationally available commercial weight loss program were recruited via the internet into a three-arm randomized trial of two types of financial incentives versus active control during months 1-6 (Phase I) followed by passive monitoring during months 7-12 (Phase II). Interventions were daily self-weighing and text messaging feedback alone (control) or combined with a lottery-based incentive or a direct incentive. The primary outcome was weight change 6 months after initial weight loss. Secondary outcomes included weight change 12 months after initial weight loss (6 months after cessation of maintenance intervention), and self-reported physical activity and eating behaviors. Of 191 participants randomized, the mean age was 49.0 (SD = 10.5) years and weight loss prior to ...
The effect of financial incentives for patients on weight loss: a meta-analysis
2012
Being overweight (BMI≥25kg/m 2) and obesity (BMI≥30kg/m 2) are common and costly. While reward systems can affect behaviors, it is uncertain whether financial incentives are beneficial in weight loss programs. Objective: To estimate the effectiveness of financial incentives in weight loss programs. Data sources: We searched the English-language literature in MEDLINE, EMBASE, CINAHL, the Cochrane Database of Systematic Reviews, and the Cochrane Register of Controlled Clinical Trials) from 1966 to November 2011. Additional studies were identified by searching reference lists of all relevant articles. Search terms included financial, economic, monetary, reward, incentive or reimbursement, and diet, weight loss, obesity or overweight. Study selection: We included controlled trials evaluating the effect of financial incentives in weight loss programs for overweight individuals. We excluded studies that did not provide weight change over time. Data extraction: Data were extracted from articles by using predefined data fields, including study quality indicators. We performed subgroup analyses to examine the effect of study duration (at 4 months and 12 months) and a self-set goal versus program fixed goal on the effectiveness of financial incentives on weight loss. Results: Overall, the results of the meta-analysis show that using financial incentives was associated with higher weight loss (-0.32 SMD, 95%CI (-0.56,-0.08),, random effects model). The benefit of incentives was greater at 4 months (-0.56 SMD, 95%CI (-0.89,-0.23),random effects model) but there was no effect at 12 months. The effect of financial incentives in programs with predetermined, imposed weight loss goals was significant (-0.48 SMD, 95%CI (-0.67,-0.29)) but there was no benefit in studies with self-set weight loss goals. Conclusions: Our results suggest that financial incentives are beneficial on weight loss both overall, and at 4 months. This benefit appears greater in studies with an imposed weight loss goal compared to self-set goals. These results suggest that financial incentives should be used more widely in weight loss programs. Future studies are needed to determine the best way to administer these financial rewards (e.g., deposit contracting, competitions or lotteries).
Journal of Occupational & Environmental Medicine, 2007
Learning Objectives • Recall whether economic theory and research on using financial incentives to alter health-related behaviors suggest that incentives should be linked to participating in a program or directly to outcomes. • Compare rates of any weight loss, clinically relevent loss of 5% or more, and attrition in overweight and obese employees who, for 3 months, were randomly assigned to receive one of two levels of financial incentive or no incentive. • State whether weight losses documented at 3 months persisted at 6 months when financial gains were equalized.
Effectiveness of a worksite-based weight loss randomized controlled trial: The worksite study
Obesity, 2015
Objective-To determine the effectiveness of an individually-targeted Internet-based intervention with monetary incentives (INCENT) at reducing weight of overweight and obese employees when compared to a less-intensive intervention (Livin' My Weigh [LMW]) 6-months after program initiation. Design and Methods-Twenty-eight worksites were randomly assigned to either INCENT or LMW conditions. Both programs used evidence-based strategies to support weight loss. INCENT was delivered via daily e-mails over 12 months while LMW was delivered quarterly via both newsletters and onsite educational sessions. Generalized linear mixed models were conducted for weight change from baseline to 6-month post program and using an intention-to-treat (ITT) analysis to include all participants with baseline weight measurements. Results-Across 28 worksites, 1,790 employees (M=47 years of age; 79% Caucasian; 74% women) participated. Participants lost an average of 2.27 lbs (p<0.001) with a BMI decrease of 0.36 kg/m 2 (p<0.001) and 1.30 lbs (p<0.01) and a BMI decrease of 0.20 kg/m 2 (p<0.01) in INCENT and LMW, respectively. The difference between INCENT and LMW group in weight loss and BMI reduction were not statistically significant. Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:
Obesity (Silver Spring, Md.), 2015
In behavioral studies of weight loss programs, participants typically receive interventions free of charge. Understanding an individual's willingness to pay (WTP) for weight loss programs could be helpful when evaluating potential funding models. This study assessed WTP for the continuation of a weight loss program at the end of a weight loss study. WTP was assessed with monthly coaching contacts at the end of the two-year Hopkins POWER trial. Interview-administered questionnaires determined the amount participants were willing to pay for continued intervention. Estimated maximum payment was calculated among those willing to pay and was based on quantile regression adjusted for age, body mass index, race, sex, household income, treatment condition, and weight change at 24 months. Among the participants (N = 234), 95% were willing to pay for continued weight loss intervention; the adjusted median payment was 45permonth.BlackshadahigheradjustedmedianWTP(45 per month. Blacks had a higher adjusted median WTP (45permonth.BlackshadahigheradjustedmedianWTP(65/month) compa...
Obesity (Silver Spring, Md.), 2016
In the Weight Loss Maintenance (WLM) Trial, a personal contact (PC) intervention sustained greater weight loss relative to a self-directed (SD) group over 30 months. This study investigated the effects of continued intervention over an additional 30 months and overall weight change across the entire WLM Trial. WLM had 3 phases. Phase 1 was a 6-month weight loss program. In Phase 2, those who lost ≥4 kg were randomized to a 30-month maintenance trial. In Phase 3, PC participants (n = 196, three sites) were re-randomized to no further intervention (PC-Control) or continued intervention (PC-Active) for 30 more months; 218 SD participants were also followed. During Phase 3, weight increased 1.0 kg in PC-Active and 0.5 kg in PC-Control (mean difference 0.6 kg; 95% CI:-1.4 to 2.7; P = 0.54). Mean weight change over the entire study was -3.2 kg in those originally assigned to PC (PC-Combined) and -1.6 kg in SD (mean difference -1.6 kg; 95% CI:-3.0 to -0.1; P = 0.04). After 30 months of the...
Combining behavioral weight loss treatment and a commercial program: A randomized clinical trial
Obesity, 2013
Commercial weight loss programs such as Weight Watchers (WW) offer widely recognized and accessible treatment, but typically produce weight losses that are modest relative to professionally delivered programs. This study tested the hypothesis that a novel weight loss approach that combined the fundamental components of professionally delivered behavioral weight loss (BWL) treatment with the existing WW program would produce better weight losses than WW alone; no differences were expected between the novel treatment and BWL alone. Participants were 141 overweight and obese adults (90% women, 67% non-White, mean age = 49.7 ± 9.2 years, mean BMI = 36.2 ± 5.5 kg/m 2) randomly assigned to 48 weeks of BWL, 48 weeks of WW, or 12 weeks of BWL followed by 36 weeks of WW (Combined Treatment, CT). Assessments were conducted at baseline and weeks 12, 24, and 48, with weight change as the primary outcome. Linear mixed model analysis showed that 24-week weight losses did not differ significantly between treatment groups; however, weight losses at 48 weeks were greater in the WW group (M=6.0 kg, SE=0.8) compared to the CT group (M=3.6 kg, SE=0.8; p=0.032), with BWL not significantly different from either (M=5.4 kg, SE=0.8). Further, a greater proportion of WW participants lost 10% of baseline weight by 48 weeks compared to BWL or CT (36.7%, 13.0%, and 15.2%, respectively, p's<0.05). This study shows that the WW program can produce clinically meaningful weight losses and provides no evidence that adding brief BWL to the WW program improves outcome. Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: