A recent study published in the December 9, 2008 issue of the Journal of the American Medical Association (JAMA), reveals that an incentive-based approach may help people lose weight more effectively than do traditional methods. Researchers from the Philadelphia VA Center for Health Equity Research and Promotion, the University of Pennsylvania School of Medicine, and the Wharton School in Philadelphia completed a randomized trial using 2 incentive-based approaches for losing weight and 1 control, by randomizing 57 subjects to 1 of the 2 approaches.

All participants were given a weight-loss goal of 16 pounds over a 16-week period. One incentive-based approach was based on a lottery system in which participants received a set monetary amount when they reached their target weight. In the other incentive-based approach, the subjects were bound by a contract to deposit their own money, with the understanding that if they did not reach their target weights, they would lose that money. How much money was involved? Over the 16-week study, the subjects who contracted to deposit their own money received an average of $378.49 and the lottery system subjects received $272.80.

The study's results: The 2 incentive groups lost significantly more weight than did the control (about 4 more pounds over the 16-week study). The lottery group lost 13.1 pounds on average, whereas the deposit-contract group, who invested their own money, lost an average of 14.0 pounds. About half of the subjects in both incentive groups met their 16-pound, weight-loss goal (47.4 percent in the deposit-contract group and 52.6 percent in the lottery group). In contrast, only 10.5 percent of control participants met the 16-pound goal.

The authors concluded that financial incentives may be a strategy worth pursuing when it comes to weight-loss success, even though there was some weight regain within those 2 groups, and further work is needed to test the effectiveness and cost-effectiveness of this type of approach.

My take on this study:

• For our fast-paced society, where many people are goal-driven, this study might suggest that, at least for some people, a financial risk could significantly increase a person's motivation and drive to meet weight-loss goals.
• The fact that even the monetary-incentive groups gained back some of the weight reinforces what both past research and experience reveal: weight-loss maintenance is difficult and complex, and we don't have all the answers yet.
• I think it's important to develop an internalized reward system whereby we can connect with such intangible rewards as increased self-esteem and confidence, which can be invaluable.
• Know what motivates YOU, and find ways to involve family members and friends in the process. For example, my sister embarked on a "Biggest Loser" contest 2 years ago and enlisted the help of family members (myself and my mom included), as well as close friends. I won't tell you who won the contest, since that's not the point, but it was a good experience for all of us, and someone won cold hard cash and a trophy! The best part, though, is that we gave each other encouragement, and it ended up being an experience that deepened all of our relationships with each other.
• Beware of competition for competition's sake. There's enough pressure and stress in our lives already, so think about whether this type of motivation will just stress you out and make you want to eat more or cheat on your meal plan. If so, look for other ways to get motivated, maybe by getting an exercise buddy.