Study says: Financial reward + competition = More weight loss

If we’ve learned anything from March Madness, it’s that an office pool is fun: It not only holds out the promise of a financial windfall; it pits us against our co-workers in vying for the payoff. So when it comes to tackling obesity, could the same combination of inducements work to trim workforce fat? A new study, published Monday in the Annals of Internal Medicine, says it can.

At Children’s Hospital of Philadelphia, 105 employees who were obese (having a body-mass index between 30 and 40) joined a weight-loss program that was actually a clinical trial. With workplace weight-loss contests springing up across the country, the trial aimed to find out who would lose the most weight over six months and keep it off for three months at least: subjects who got a reward for shedding pounds but did it solo; subjects who lost weight as a team and split a pot of money; or those who simply signed up to come in for monthly weigh-ins and had no financial incentive to lose weight.

Those who were assigned to diet solo stood to win $100 monthly if they met or exceeded the weight-loss goals set for them. The subjects who worked on weight-loss in teams never knew who their teammates were, but their team had a pool of $500 each month to split among members who had met their goals. A team member who met the weight-loss goals for the month was guaranteed to get $100 a month but might stand to win more if teammates fell short of their goals.

The control group, in which subjects were not offered a financial prize for weight loss, provided the chance to gauge how powerful a motivator money can be. But the team weight-loss condition had a little extra something to motivate its members: the prospect of winning more by showing up the competition.

The researchers found that money can be pretty powerful, and money plus competition more powerful still. After 24 weeks, the participants who worked in groups of five had lost an average of 4.8 kilograms (about 10 1/2 pounds). That was more than twice as much as the solo dieters had lost on average -- 1.7 kilograms (close to 4 pounds). And it was more than nine times as much as the control group had lost -- .5 kilograms (just more than 1 pound).

Three months after the incentives ended, those who lost weight as a group maintained more weight loss than did the control group. But the difference between those who got a reward to lose weight solo and those rewarded in groups largely disappeared.

The Affordable Care Act allows employers to use an increased share of insurance premiums to offer employees inducements to lose weight and improve their health. So expect to see a lot more weight-loss experimentation -- and competition -- around the workplace in years to come.

“Companies and communities are not waiting for effectiveness or cost-effectiveness results to try popular incentive programs such as ‘The Biggest Loser’ (where the winner takes all),” the authors wrote. But if organizations want to get the most bang for their buck, they’ll want more such studies, including studies that include another well established motivator -- teamwork.

“Group support has long been a feature of weight-loss programs, and it would be good to know how such support processes operate in the context of incentives,” wrote the editors.