Should We be Paid to Lose Weight?

by Christine Gary

Would you lose weight if you got paid? A study in the Journal of General Internal Medicine suggests you would. Participants were asked to deposit $3 daily, an amount matched by researchers. If participants lost a pound per week, they kept the cash at month’s end. If they failed, they forfeited the fund. When compared with a control group, participants with money to be made lost significantly more weight. In fact, incentivized dieters “were nearly five times as likely to meet their goal when compared with dieters who had no potential for a financial reward,” reports Time Magazine.

Back in the real world, financial incentives are inspiring the two-thirds of Americans who are overweight to ditch their potato chips. Companies who adopt this wellness craze dangle cash prizes for employees who drop pounds. Baylor Health Care System in North Texas has over 6,000 employees tracking their exercise and weight, earning $50 for every 100 days they complete. Coverage by NBC news hails the system as a win-win: “Employees are slimming down and fattening their paychecks, while the company has cut its health care costs.”

Dr. Joseph Chemplavil, a Newport News-based cardiovascular endocrinologist, saw patients perk up when he initiated his “Dollar for Pound” program. The benefits are twofold. Chemplavil’s patients are not only being paid to lose weight, but also saving money. A healthy weight reduces the need for medications, lowers prescription drug costs, and requires fewer visits to the doctor. In today’s troubled economy, these lower costs can make a noticeable difference in an individual’s quality of life.

Independent web sites, like HealthyWage.com, offer payouts to obese users who achieve a healthy body mass index (30-80 lb loss). Corporate sponsors fund 12-month challenges where users can sign up for free and win $100 dollars. Or they can up the ante of their weight loss incentive by putting $300 on the table, and win $1000. In an interview with Time Magazine, online user, Welmoed Sisson explains, “Sure, I’d like to look and feel better, but it is so subjective. Money is a better motivator because it is tangible. You can hold it in your hand.” Attaching a paycheck to weight loss provides short-term gain where there were only long term health benefits before. And humans are more likely to respond to short-term rewards.

In the recent study, monetary motivation was effective for inducing initial weight loss, but participants regained weight post-intervention. Time magazine sat down with the lead study author and director of the Center for Health Incentives at the University of Pennsylvania, Dr. Kevin Volpp. He predicts that “we will undoubtedly see more of these programs and initiatives in the future.” But he advises “techniques to promote weight loss maintenance following cessation of financial incentives as an important topic for future research.” He suggests emphasizing habit formation during interventions.

Habit formation is thought to be more likely if incentives are tied to a behavior – such as rewarding yourself with a massage for walking three times a week. Walking is a behavior-related goal over which one has total control, unlike weight loss, which is an outcome-related goal over which one has only partial control. Weight loss involves complex psychological motives and it may be better to use money only to incentivize simple, mechanical tasks.

Other questions to consider are whether people will resort to unhealthy methods, like starvation and laxatives, to earn money? Will paid weight loss send the wrong message? By equating shedding pounds to a job, it becomes a chore. It places “the emphasis totally on external rewards rather than internal ones,” says Dr. Sara Folta, assistant professor in the John Hancock Research Center at the Friedman School. “Someone who is internally motivated – driven more by their own values, beliefs, and life goals – is more likely to maintain a behavior.  In fact, study after study has shown what common sense might dictate: as soon as you remove an unrelated, external incentive, the behavior stops.” You should want to lose weight for yourself, because you deserve health. Perhaps Jenny Craig is right: “self-love is the only weight-loss aid that really works in the long run.”

Christine Gary is completing a Masters Degree in Nutrition Communication at the Tufts Friedman School of Nutrition. She’s an international marathon runner devoted to raising funds for charity: http://www.christinegary.com


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