Evaluating the Effectiveness of Financial Incentives in Promoting Weight Loss Among Obese Individuals.

Study Summary

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 rarely been applied to weight loss, and to the best of our knowledge never to weight loss by low-SES obese veterans. We propose testing two different approaches to using financial incentives to encourage weight loss. In the first, we build on previous work showing the effectiveness of 'deposit contracts', in which subjects are given the opportunity to put their own money at risk if they do not lose weight. In this incentive condition, subjects receive a direct payment conditional on daily weight loss, and an optional additional payment based on their own contributions to the deposit contract. We will match their contribution 1:1 to make the option of depositing their own money attractive to this predominantly low SES population. In the second approach we build on our own prior work using lotteries to promote drug adherence. In this incentive condition, participants are entered into a daily lottery, and receive any payoffs they earn from the lottery only if they stay on track with their weight-loss goal. Given their popularity in the general population, lotteries hold the promise of providing a cost-effective means of motivating weight loss and making efforts to lose weight more salient to obese patients.

Interventions

• BEHAVIORAL Financial Incentives