A study into men living with obesity in the UK has concluded that combining financial incentives with behavioral text messages can aid people who are trying to lose weight. Participants receiving the promise of money and encouraging messages saw a 5 percent reduction in weight over 12 months, but receiving texts alone wasn’t enough to significantly impact weight loss.
“One of the most effective incentive strategies in the literature uses ‘deposit contracts’, where people deposit their own money and lose it if they do not meet weight loss goals,” explained study lead Professor Pat Hoddinott, of the Nursing, Midwifery and Allied Health Professions Research Unit at the University of Stirling, in a statement.
“This is informed 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.”
The study took a sample of 585 men in Belfast, Bristol, and Glasgow with a Body Mass Index (BMI) of over 30 and divided them into three groups: text messaging with financial incentives, text messaging alone, or waiting list (control).
The design of the incentive structure and text message content were informed by men living with obesity. The messages were motivational in nature, and included tips from other men about changing their eating and lifestyle habits (like: Remember Gavin’s tip: the power of meal prep. Helps you stay ahead. Time for another batch prep session?”), as well as links to evidence-based websites.
The findings demonstrated that it was the combination of incentive and messages that proved the most effective.
“In this randomized trial that included 585 men with obesity, text messaging with behavioral messages combined with a financial incentive resulted in a 5 percent weight loss at 12 months, compared with weight loss of 3 percent for text messaging alone, and 1 percent for the control group,” concluded the authors. “The difference in weight loss was statistically significant for the comparison between text messaging with financial incentives and the control group but not between the text messaging alone and the control group.”
The study authors list several limitations, including its generalizability to other groups of people, and that weight regain is common following weight loss and could possibly be greater in the context of financial incentives. The study also used BMI as a measure of obesity, a scale whose limitations have been discussed at length (unsurprising, since it wasn’t even developed by a physician).
It’s true that it’s possible to have a weight range that qualifies as obese and be metabolically healthy, while a lower weight range doesn’t guarantee health. That said, it’s also true that an obese weight range can affect the body in lots of different ways, including an association with certain types of cancer and other health conditions.
To want to lose weight is one of the most common desires among adults for a myriad of reasons that go beyond physical health, but barriers to a person achieving their personal goals can include less support, both mentally and financially. It’s possible, then, that exploring routes that enforce a multi-pronged approach in supporting someone’s goals could get them past their personal finish line.
The study is published in JAMA.
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