Financial Incentives Can Help Low-Income Patients Lose Weight

Obesity is an increasingly prevalent condition in the United States, and it disproportionately affects the economically disadvantaged. Treatments for obesity are often costly and out of reach for those with limited resources. A new study seeks to address this issue by exploring the effectiveness of financial incentives for weight loss in primary care patients with obesity living in socioeconomically disadvantaged neighborhoods.

The study, published in JAMA Internal Medicine, included 668 participants with obesity living in low-income neighborhoods in New York City and Los Angeles. Participants were randomly assigned to one of three groups: goal-directed incentives, outcome-based incentives, or a resources-only group. The resources-only group was given a one-year commercial weight loss program membership, self-monitoring tools, health education, and monthly one-on-one check-in visits.

The goal-directed group included resources and financial incentives linked to evidence-based weight-loss behaviors. The outcome-based arm also included resources, but financial incentives were linked to percentage of weight loss.

At the six-month mark, the adjusted proportion of participants who lost at least five percent of their baseline weight was 22.1 percent in the resources-only group, 39.0 percent in the goal-directed group, and 49.1 percent in the outcome-based incentive group. This difference of 27.03 percentage points between the outcome-based incentive group and the resources-only group demonstrates that financial incentives were more effective than resources alone for weight loss among this population.

Goals versus Outcomes

Although the mean percentage of weight loss was similar in the incentive arms, participants in the incentive groups could earn up to $750. The mean earned incentive was $440.44 in the goal-directed group and $303.56 in the outcome-based group.

This study provides evidence that outcome-based and goal-directed financial incentives are more effective than resources only for weight loss in socioeconomically disadvantaged populations with obesity. The authors suggest that future studies should evaluate the cost-effectiveness and long-term outcomes of these financial incentive strategies. For people with obesity living in low-income neighborhoods, financial incentives may be a viable option to help them reach their weight-loss goals.

This new study adds to the growing research that suggests that financial incentives are more effective than resources alone for weight loss in this population. While it is important to note that the mean percentage of weight loss was similar in the incentive arms, the financial incentives did help to motivate participants to achieve their goals. Future research should continue to explore the potential of financial incentives to help those with obesity reach their weight-loss goals.
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