Losing the pounds: Study finds cash incentives help obese people to lose weight

Those taking part were sent daily texts that included motivational messages, tips and links to online information

Those taking part were sent daily texts that included motivational messages and tips on lifestyle changes.
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Offering people who are obese financial incentives in text messages could help them lose more weight, a trial has found.

The approach is cheaper for the health service than traditional weight management programmes as it requires less staff and could potentially reach people from more deprived areas, researchers said.

As part of the year-long study, 585 men from Bristol, Belfast and Glasgow with an average body mass index of 37.7, were split into three groups.

One of the groups was told £400 ($503) was being held for each of them in an account and would be transferred over at the end of the trial.

However, money would be taken off the total if they failed to meet weight loss goals.

The group were also sent daily texts that included motivational messages, tips on lifestyle changes, links to information online and access to a study website on weight management with information about local services and an online tracker to monitor weight changes.

The second group was sent the same messages, with no financial incentive, while the third group was only granted access to the weight management information.

About 426 men included in the study logged their weight after 12 months.

Those in the financial incentives group lost 4.8 per cent of their body weight on average, compared to 2.7 per cent in the group who were sent the same messages but with no financial incentives and 1.3 per cent in the third group.

Prof Pat Hoddinott, of the nursing, midwifery and allied health professions research unit at the University of Stirling led the study, which has been presented at the European Congress of Obesity in Venice.

She said it was inspired by “behavioural economic theory which proposes that people are more motivated by the prospect of losing money than the prospect of gaining money”.

“However, not everyone can afford to deposit their own money, so we designed the Game of Stones trial, which uses an endowment incentive, where the money is put in an account at the start, allowing men on low incomes to join,” Prof Hoddinott said.

“A text message-based programme, meanwhile, costs less and is less labour-intensive than a traditional weight loss programme.

“Men who were living with obesity helped design the structure of the incentives and helped us write the text messages.”

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Prof Hoddinott also said the study recruited people from areas “normally underrepresented in weight management trials”.

“Some 39 per cent of the men lived in less affluent areas, 71 per cent reported a long-term health condition, 40 per cent reported two or more long-term conditions and 29 per cent reported that they were living with a disability.

“In addition, 25 per cent of the men told us they had a doctor-diagnosed mental health condition and a further 24 per cent reported low mental health scores.”

Men in the financial incentives group received £128 each on average at the end of the study, with 27 receiving the full £400.

“We reached an underserved group of men who seldom take part in health promotion activities,” Prof Hoddinott said.

“Weight management programmes are traditionally intensive, often with a weigh-in every week or two.

“In Game of Stones, there are just four brief ten-minute weigh-ins over a year.

“No intervention is delivered by the staff at the weigh-ins, so minimal staff training is required. No referral is needed to join.

“Men and NHS staff really valued this low-burden approach and it has the potential to address health inequalities. It was a win-win for all.”

Updated: May 14, 2024, 10:01 PM