Financial incentive strategies for maintenance of weight loss: results from an internet-based randomized controlled trial.

ABSTRACT: BACKGROUND/OBJECTIVE:Financial incentives can improve initial weight loss; we examined whether financial incentives can improve weight loss maintenance. SUBJECTS/METHODS: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. RESULTS:Of 191 participants randomized, the mean age was 49.0 (SD?=?10.5) years and weight loss prior to randomization was 11.4 (4.7)?kg; 92% were women and 89% were White. Mean weight changes during the next 6 months (Phase I) were: lottery -3.0 (5.8)?kg; direct -2.8 (5.8)?kg; and control -1.4 (5.8)?kg (all pairwise comparisons p?>?0.1). Weight changes through the end of 12 months post-weight loss (Phase II) were: lottery -1.8 (10.5)?kg; direct -0.7 (10.7)?kg; and control -0.3 (9.4)?kg (all pairwise comparisons p?>?0.1). The percentages of participants who maintained their weight loss (defined as gaining ?1.36?kg) were: lottery 79%, direct 76%, and control 67% at 6 months and lottery 66%, direct 62%, and control 59% at 12 months (all pairwise comparisons p?>?0.1). At 6 and 12 months after initial weight loss, changes in self-reported physical activity or eating behaviors did not differ across arms. CONCLUSIONS:Compared with the active control of daily texting based on daily home weighing, lottery-based and direct monetary incentives provided no additional benefit for weight loss maintenance.

SUBMITTER: Yancy WS 

PROVIDER: S-EPMC5968035 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature