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Cash incentives alongside motivational texts could boost weight loss

Cash incentives alongside motivational texts could boost weight loss

Cash incentives of up to £400 alongside motivational text messages could be used to help men with obesity lose weight, a UK trial has found.

After a year, men who were offered the ‘Game of Stones’ financial reward had lost a significant 3.2% more weight than those who had the daily messages offering motivation and tips alone.

Both groups were also given access to a study website with evidence-based information on weight management, information about local weight management services and an online tracker to monitor their weight change. A third control group was on a waiting list.

Reporting the findings in JAMA, the researchers from the University of Stirling said the financial incentive was the aspect that significantly improved weight loss compared to the control groups.

The idea was based on evidence that when people deposit their own money and lose it if they miss weight loss goals but taking into account that it excludes people who cannot afford that approach.

In the study every man in the financial incentive group was told £400 had been set aside for them in an account.

But they would lose money if they did not meet weight loss targets along the way – 50 would be taken away if they didn’t lose 5% of their body weight after three months, £150 for not hitting 10% after six months and £200 if they had not maintained the 10% weight loss after a year.

Of the 426 men who remained in the study for a year, those in the financial reward group lost an average of 4.8% of their body weight over 12 months compared with 2.7% for the text messaging only group and 1.3% for the control group, the researchers reported.

They calculated that four men would need to receive text messages with financial incentives for one to achieve weight loss of 5% or more and five would need to take part for one to achieve 10% weight loss.

The men in the text messaging with financial incentives group received £128 each, on average, with 27 receiving the full £400.

A secondary finding was that the men in the text messaging with financial incentives group rated their health as being significantly better at the end of the trial. The men taking part had an average BMI at the start of 37.

Professor Pat Hoddinott, chair in primary care at the University of Stirling said the goal had been to recruit men from under-represented populations in weight management trials.

Around 39% of the men lived in less affluent areas, 71% reported a long-term health condition, 40% reported two or more long-term conditions and 29% reported that they were living with a disability.  In addition, a quarter of the men – who had an average age of 50 years – reported having a doctor-diagnosed mental health condition.

The team hope the strategy will be adopted by the NHS and a health economic evaluation is now being done.

‘We reached an underserved group of men who seldom take part in health promotion activities.

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.’

She added: ‘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.’


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Please note, only GPs are permitted to add comments to articles

David Church 17 May, 2024 5:55 pm

Have I got this straight? – If GPs send motivational text messages and some of their practice income to overweight people, they will NOT spend it on more food? But presumably the hungry GPs lose weight?
Does it work for alcoholics as well?

Dave Haddock 19 May, 2024 12:03 am

The obvious mechanism is to use the tax and benefits systems to operate financial incentives.
Higher taxes and reduced benefit payments for the obese.
Which would only be fair; the obese as a group are both less productive, and more expensive in NHS and disability costs than those not obese.