Financial Incentives Show Significant Success for Weight Loss in Men


Researchers analyzed groups of men given financial incentives to motivate weight-loss behaviors compared with a non-incentivized control group.

Obese men who received financial incentives during a 12-month weight-loss study saw significant decreases in weight compared with a group who only received text messages for weight-loss motivation and resources, as well as the waiting list control group.1

“More than 600 million adults worldwide have obesity. From 1999 to 2018, the prevalence of obesity among adults in the US rose from 30.5% to 42.4%, with a substantially higher percentage among racial and ethnic minority groups. Obesity also contributes to diabetes, heart disease, stroke, and cancer, and it is estimated that $147 billion are attributable to obesity-related illnesses in the US,” wrote Ladapo et al.2

Key Takeaways

  • Researchers analyzed the efficacy of financial incentives to encourage weight loss in men over a 12-month study period.
  • They found that financial incentives were the best weight-loss facilitators compared with text message resources only.
  • Researchers also identified socioeconomic backgrounds and how financial incentives can further encourage individuals from low-income areas to lose weight.

Results of the first study confirmed results of Ladapo et al’s. The latter study compared low-income individuals receiving financial incentives with another group only receiving weight-management resources. The results showed that goal-directed and outcome-based financial incentives were more successful than just obesity management resources.2

With adult obesity numbers continuously rising, weight-loss management also seems to be an issue among low-income populations. In Hoddinott et al’s study, comparing financial incentives with text-message-administered weight-loss resources, the success of monetary rewards might have been heightened by the socioeconomic backgrounds of the participants.

More than 600 million adults worldwide have obesity. | image credit: Mohd Azrin /

More than 600 million adults worldwide have obesity. | image credit: Mohd Azrin /

Financial Incentives Compared with Text Message Incentives

In Hoddinott et al’s study, 585 men (mean [SD] age, 50.7 [13.3] years; mean weight, 261.25 [43.87] pounds; mean BMI, 37.7 [5.7]; 525 [90%] white) were separated into 3 cohorts: a group receiving text-message resources and financial incentives (n=196), one receiving text messages only (n=194), and a third control group remaining on what the authors called a “waiting list” (n=195).1

The text messages sent to individuals in respective groups “incorporated weight management evidence, website links to information resources, and theory-based behavior change techniques based on the Health Action Process Approach, self-determination theory, and the behavior change maintenance model.”1

For individuals receiving financial incentives, a payment of $490 was put into a study account that participants could access at the end of the 12-month study period. Furthermore, highlighting the financial incentive aspect, participants would secure $64 if they reported a 5% loss in weight after 3 months, $191 for a 10% loss in weight at 6 months, and $254 if a 10% loss in weight was maintained by the end of the study. Finally, participants were told money would be taken away if they were unable to attain specific weight-loss goals.

“Compared with the control group, the mean percent weight change was significantly greater in the text messaging with financial incentive group but was not significantly greater in the text messaging alone group,” wrote the authors.1

READ MORE: Focus On Obesity Management Before Addressing Comorbidities

For the text message with financial incentives group, individuals lost a mean of 12.6 pounds (-4.8%). The text message only group lost a mean of 6.6 pounds (-2.7%) and the control group lost a mean of 3.3 pounds (-1.3%).

Aside from the mean weight-loss statistics, researchers also found that 39% of participants lived in lower socioeconomic areas. This finding is key to the overall context of the study since it’s safe to assume men with poorer economic backgrounds were more motivated to achieve the study’s weight-loss goals and earn their financial rewards.1

In comparison with the Hoddinott et al study, participants in Ladapo et al’s previous study included 668 enrolled men and women (mean [SD] age, 47.7 [12.4] years; mean weight, 218.17 [45.28] pounds; mean BMI, 37.95 [6.55]; 81% women). Similarly, participants were separated into 3 groups: the goal-directed group with financial incentives for evidence-based behaviors and weight-loss resources; the outcome-based group with financial incentives for percentage of weight lost; and a resources-only group receiving “a 1-year commercial weight-loss program membership, self-monitoring tools, health education, and monthly 1-on-1 check-in visits.”2

Of all the participants who achieved at least a 5% loss in weight, 49.1% of the outcome-based group achieved 5% weight loss, 39% of the goal-directed group achieved it, and 22.1% of the resources-only group achieved a 5% loss in weight at the 6-month mark of the study.2

With up to $750 available for participants to attain throughout the study period, the mean earned incentives were $440.44 in the goal-directed group and $303.56 in the outcome-based group, despite more participants in the outcome-based group achieving a 5% loss in weight.

While the personal motivations of both studies’ participants were unknown, the most effective motivation was monetary. Especially in low-income populations, and until another resource is introduced for weight-loss management, there may not be a better incentive than those that are financial.

“Providing participants with cash that they could retain if they met study goals may have facilitated enrollment of participants with lower incomes, in contrast to deposit contract financial incentives where participants risk losing their own money. Including men with obesity living in disadvantaged areas in making decisions about the design of the incentives, number of assessments, goals, and text messages may have contributed to the effectiveness of the text messaging with the financial [incentive] intervention,” concluded Hoddinott et al.1

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1. Hoddinott P, O’Dolan C, Macaulay L, et al. Text messages with financial incentives for men with obesity: a randomized clinical trial. JAMA. Published online May 14, 2024. doi:10.1001/jama.2024.7064
2. Ladapo JA, Orstad SL, Wali S, et al. Effectiveness of goal-directed and outcome-based financial incentives for weight loss in primary care patients with obesity living in socioeconomically disadvantaged neighborhoods: a randomized clinical trial. JAMA Intern Med. 2023;183(1):61–69. doi:10.1001/jamainternmed.2022.5618
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