A recent study published in the New England Journal of Medicine discovered that 2.2 billion adults and children worldwide suffer from health problems associated with being overweight or obese. Dr. Ashkan Afshin, the paper’s lead author and a professor at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle said, “Excess body weight is one of the most challenging public health problems of our time, affecting nearly one in every three people.”

Singaporean researchers have decided to tackle weight loss issues in the country by giving out cash in a study to better understand the value of rewards in weight loss programmes.

Researchers offer enticing rewards for those in the rewards programme

This study was a collaboration between Duke-NUS Medical School and Singapore General Hospital (SGH). Researchers used insights from behavioural economics to come up with a rewards program designed to address the disconnection between short-term temptation and long-term health to trial it amongst overweight or obese adults.

In the randomised Singapore-based Trial on Incentives for Obesity (TRIO), 161 participants paid SGD234 to obtain access to a 16-week intensive weight loss program. Participants attended weekly sessions at the Lifestyle Improvement and Fitness Enhancement (LIFE) Centre at SGH where they were trained to maintain a healthy lifestyle and encouraged to shed at least 5% of their body weight.

Some participants forked out an additional SGD165 for the rewards program. If they met monthly weight loss and step goals, these participants could earn monthly cash rewards or a lottery ticket with a 1/10 chance of winning 10 times the cash amount. At the fourth and eighth month, further rewards were offered for meeting 5% or 8% weight loss goals.

Participants in the rewards programme perform better

After four months, researchers found that those who had joined the basic weight loss programme lost 1.4kg. However, weight loss was more than twice as great in the rewards group with an average of 3.4 kg lost. In addition, weight loss remained greater in the rewards group compared to the basic group at months eight and 12 (average 3.3 kg vs. 1.8 kg weight loss at month eight and 2.3 kg vs 0.8 kg weight loss at month 12).

People in the rewards scheme won an average of SGD225. This resulted in a total net win of SGD60 per person after accounting for the participation fee. Despite the fact that only 42% of people actually won more money than they had pain in, roughly 80% of the participants said they were satisfied with the scheme.

“Our findings not only show the value of rewards to increase weight loss and weight loss maintenance. They show it can be done in a manner that minimises third party payments, such as those by employers or insurers. This should help to expand access to these types of programmes,” said Professor Eric Finkelstein, a member of the Duke-NUS programme for health services and systems research.

Kwang Wei Tham, director of the LIFE Centre and senior consultant in the endocrinology department at SGH also commented on the study results saying, “Even small amounts of weight loss, sustained over time, confer great health benefits and can help prevent chronic disease. This study shows that the enhancement and maintenance of weight loss is feasible through a rewards programme with participant ownership, coupled with an evidence-based, medical weight loss programme.” MIMS

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