Moderate financial incentives can promote employee weight loss

Moderate financial incentives can promote employee weight loss, according to the findings of a new study by researchers at RTI International and the University of North Carolina at Chapel Hill.

The study, published in the September issues of the Journal of Occupational and Environmental Medicine, examined the impact of monetary rewards on weight loss in the absence of a structured weight-loss program.

More than 200 participants were recruited from among employees at one university and three community colleges in North Carolina. During the first three months participants were randomly assigned to receive either no money, $7 per percentage point of weight lost or $14 per percentage point of weight lost.

The researchers found that the larger financial incentive resulted in the greatest short-term weight loss. At 3 months, participants with no financial incentive lost 2 pounds, those in the $7 group lost about 3 pounds, and those in the $14 group lost nearly 5 pounds. The participants in the $14 group were five and a half times more likely than those in the no-incentive group to lose 5 percent of their body weight, a point where weight loss has clinically important health benefits.

Overall, 67 percent of participants lost some weight. Between baseline and 6 months, when the financial gains were equalized, weight losses were similar across groups.

A previous RTI study found the annual costs of obesity-attributable medical expenses and absenteeism range from $400 to more than $2,000 per obese employee, suggesting that modest financial incentives may reduce weight and, if sustainable, may improve the financial health of the company.

“Financial incentives tied directly to weight loss are an attractive strategy from an employer's perspective because they require no start-up costs and employees receive the incentive only if they achieve the targeted weight loss goal,” said Eric Finkelstein, Ph.D. director of RTI's Public Health Economics Program and the study's lead author. “Employees may also prefer incentive-based programs that provide the resources and flexibility to improve their health without being tied to the small menu of options that may be offered by the employer.”

To encourage healthy weight loss, participants were not compensated for weight loss greater than 10 percent of their baseline weight.

This study was preliminary work for two larger studies currently underway. The studies are led by Laura Linnan, Sc.D.; associate professor at UNC School of Public Health and a team of investigators that includes Deborah Tate, Ph.D.; Kelly Evenson, Ph.D; and Thomas Keyserling, M.D., M.P.H., of the University of North Carolina School of Public Health as well as Finkelstein.

These studies are testing different weight loss supports that employers may offer, including financial incentives, web-based weight loss programs and environmental policies and supports. Results of these studies will help determine the most effective, and cost-effective approaches for worksite-based weight loss programs.

This preliminary study was funded by two grants from the Centers for Disease Control and Prevention and was supported by the Center for Health Promotion and Disease Prevention at the University of North Carolina at Chapel Hill and the Center of Excellence in Health Promotion Economics at RTI.