Weight Loss Incentive Programs: Help or Hindrance?

With so many individuals being overweight and obese, there is an ongoing impact on the workplace; lost productivity, absenteeism and limitations due to disabilities create financial burdens on employers and society. In an effort to acknowledge and address weight and health challenges, 80 percent of large employers offer some type of financial incentive to improve health. But how effective are these programs?

Weight loss incentives typically offer some type of financial reward. However, research on their effectiveness is mixed. A study evaluating corporate weight loss programs with more than 9,000 participants found that most participants initially lost weight regardless of incentives — but then gained the weight back. Another study offered participants a variety of incentives for achieving weight loss goals, including an immediate or delayed insurance adjustment or a daily lottery in which those who met their daily weight target could win $10 (18 percent likelihood) or $100 (1 percent likelihood). Almost all intervention participants lost weight but the mean weight loss was not significantly different than that of the control group. There were no significant differences across the intervention groups; however, among intervention participants, roughly 19 percent of the participants achieved the five percent weight loss goal.

On the other hand, incentives to increase physical activity seem to have better outcomes. One study measuring physical activity (increased steps) found that meeting percentile goals that adapt to circumstances or environment resulted in a gradual and, thus, potentially easier to maintain, behavioral change. As such, adaptive goals were much more effective than static goals, such as 10,000 steps per day. This study also found that immediate rewards increased the number of steps each day. A 2019 study suggests that technology has made participation in incentive programs easier and thus more effective. A systematic review of studies that included over 2,000 participants found that physical activity — measured as steps taken — increased by approximately 10-15 percent during the intervention and at the follow-up, thus providing short- and long-term benefits.

These and other findings suggest there are some benefits to incentive programs. For example, more immediate gratification yields better outcomes than the promise of a future reward. Also, incentives for physical activity, specifically increased daily steps, seem to be more effective than for weight loss. Recognizing this could benefit a more holistic behavioral approach to a healthier lifestyle.

Because immediate gratification can be motivating, creating a plan that incorporates an incentive for physical activity with a meal replacement program that leads to quick weight loss can be influential in establishing lasting behavioral change. Goal setting and financial incentives or contracts can be just the thing to start a patient on a health path of change.