NEW YORK, December 5, 2022 /PRNewswire/ — Paying obese people cash to lose a specific amount of weight or to perform weight reduction activities works better than offering free standalone tools, such as weight loss programs, diet books and wearable fitness trackers, a new study shows.
Led by researchers at NYU Grossman School of Medicine, the study tracked the weight loss efforts for up to one year of 668 low-income, mostly Hispanic men and women whose average weight at the start of the trial was 218 pounds. All were randomly assigned to receive one of three sets of incentives for six months, including some who received cash payments and those who did not.
Publication in the journal JAMA internal medicine on line December 5results showed that offering money directly to study participants, on average $440 in total, to lose at least 5% of their original body weight (about 10 pounds) was most effective in the short term. Forty-nine percent of those who received the money lost that amount of weight after six months. That number dropped to just 41% after a full year of tracking.
Similarly, paying other study volunteers an average of $303 during the initial study period to achieve weight loss goals, such as attending at least two weight loss counseling classes each month, weighing yourself at least three times a week, or exercising for at least least 75 minutes per week, was also effective. Some 39% of these study participants lost 5% of their starting weight after six months, and nearly 42% lost the minimum weight after 12 months of follow-up.
All study participants received a free one-year voucher for the Weight Watchers program, which included weight loss classes, tips and advice. Wearable fitness machines (Fitbits), digital scales and food diaries were also provided so that trial volunteers could track their weight during the study and afterwards.
Of those who received no financial incentive and only received the free tools, one in five lost the minimum weight after six months. But that figure jumped to almost a third after a year.
“Our study provides strong evidence that offering incentives, especially cash rewards, even if only for six months, helps people of limited means who struggle with obesity lose weight. “, says the study’s principal investigator. Melanie Jay, MD, associate professor in the Department of Medicine and the Department of Population Health at NYU Langone Health. “However, any kind of incentive to lose weight can work, even if it’s just about offering the tools to make it happen.”
Jay cautions that while the study results showed a short-term benefit, more research is needed to see if these weight losses are sustained for many years and if periodic “booster” incentives are needed to maintain the long-term reductions.
Additionally, while incentives tied to actual weight loss performed better in the short term, incentives tied to weight loss goals stabilized after one year. Jay says this suggests that goal-based financial rewards may last longer than others in the long run. More research is needed among more diverse groups in which obesity is a problem for many, she says, not just urban Hispanics living with obesity. These groups include Blacks, Native Americans and United States military veterans, who have been identified by federal health agencies as being disproportionately affected by obesity.
Interventions are needed to address the persistent obesity epidemic in the United States. National reports estimate that more than 40 percent of American adults are obese, defined as those with a body mass index, or BMI, over 30, a measure of height and weight.
“New tools are needed beyond encouragement and education to help some people struggling with obesity,” says Jay, who is also director of NYU Langone’s Comprehensive Obesity Program. “There is no single solution to the worsening weight problem in the United States. Our national approach must include multiple approaches, including incentives tailored to the different needs of the groups most deeply affected by the diseases and obesity-related diseases, such as type 2 diabetes, heart disease, and certain cancers.”
For the study, which took place from November 2017 at May 2021the researchers recruited volunteers from hospital clinics in New York City and Angels, where diet, exercise routine and weight reductions could be easily tracked through monthly visits. The participants were between the ages of 18 and 70 and all came from neighborhoods with a median income below $40,000. For those who received cash incentives, payments were made monthly as weight was lost or goals were met.
Financial support for the study was provided by grants R01MD011544 and UL1TR001445 from the National Institutes of Health.
Besides Jay, other researchers in the NYU Langone study are Stephanie Orstaddoctorate; Christina HernándezMPH; Suzanne Parraga, BS; Victoria Sweat, MA; Sandra Wittler, doctorate; and Andre Wallach, MD. Other researchers are the principal investigator of the study Joseph LadapoMD, PhD, at the University of Florida in Gainesville; and study co-investigators Soma Wali, MD; Chi-Hong Tsengdoctorate; A young Rebecca ChungBS; Miguel CuevasBS; Robert Ponce, BS; and Noah GoldsteinPhD, at UCLA in Angels; Judith Wylie RosettEdD, RD, at the Albert Einstein College of Medicine in the Bronx, NY; and Suzanne ShuPhD, at Cornell University in Ithaca, NY
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SOURCE NYU Grossman School of Medicine and NYU Langone Health
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