Financial incentive strategy for weight loss and maintenance of weight loss


Obesity, Weight Loss, Intervention, Financial incentive


Introduction: The aim of this study was to investigate the effect of financial incentives on weight loss, maintain in obese women and biochemical factors.

Methods: This quasi-experimental study was conducted on 103 women with body mass index (BMI)≥30 kg/m2. The participants were assessed over a 12-month follow-up in eight phases. Money payment for losing weight was incentive intervention in this study. The participants were given diet and physical activity.

Results: Mean of BMI was 34.78±4.29 kg/m2 in baseline, that reduced to 32.41±3.51 kg/m2 in the sixth phase, and 31.64±3.71 kg/m2 in the final phase (P<0.001). At baseline, mean of percentage of body fat (PBF) was 40.77±2.81 that reduced to 37.34±4.02 at the end of the study (P<0.001). Waist to hip ratio (WHR) and lean body mass (LBM) decreased significantly over the 12-month (P<0.001). At the end of each phase, the mean of BMI reduction of 0.39 units was observed in the subjects, and 9 units of change were achieved by the end of the study compared to the baseline. The mean of triglyceride in the first, fourth and seventh phases were 128.57±13.33, 101.43±57.99 and 87.40±57.59 mg/dl, respectively (P=0.003). The mean of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamate-pyruvate transaminase (SGPT) decreased significantly over the 12-month, P= 0.052 and P=005, respectively.

Conclusions: Financial incentives can effectively help on weight loss and maintenance of weight, and improve lipid profiles; blood sugar and liver enzymes. The use of motivational factors with proper training (diet and physical activity) will have a better result.


1. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA. 1999 Oct 27;282(16):1523-9. PubMed PMID: 10546691. Epub 1999/11/05.
2. Obesity and overweight. World health organization. (Accessed in May 2014, 20, at
3. Kim SH, Despres JP, Koh KK. Obesity and cardiovascular disease: friend or foe? Eur Heart J. 2016 Dec 21;37(48):3560-68. PubMed PMID: 26685971. Epub 2015/12/22.
4. Mehta NK, Patel SA, Ali MK, Narayan KV. Preventing Disability: The Influence Of Modifiable Risk Factors On State And National Disability Prevalence. Health Aff (Millwood). 2017 Apr 1;36(4):626-35. PubMed PMID: 28373327. Pubmed Central PMCID: PMC6668338. Epub 2017/04/05.
5. Kelly SP, Graubard BI, Andreotti G, Younes N, Cleary SD, Cook MB. Prediagnostic Body Mass Index Trajectories in Relation to Prostate Cancer Incidence and Mortality in the PLCO Cancer Screening Trial. J Natl Cancer Inst. 2017 Mar;109(3):1-9. PubMed PMID: 27754927. Pubmed Central PMCID: PMC5074530. Epub 2016/10/22.
6. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766-81.
7. Bidadian M, Bahrami H. A review on present challenges in treatment of obesity. J Res Behav Sci. 2013;10(7):757-71. .
8. Nammi S, Koka S, Chinnala KM, Boini KM. Obesity: an overview on its current perspectives and treatment options. Nutr J. 2004 Apr 14;3(1):3. PubMed PMID: 15084221. Pubmed Central PMCID: PMC421736. Epub 2004/04/16.
9. Mitchell M, White L, Oh P, Alter D, Leahey T, Kwan M, et al. Uptake of an Incentive-Based mHealth App: Process Evaluation of the Carrot Rewards App. JMIR Mhealth Uhealth. 2017 May 30;5(5):e70. PubMed PMID: 28559224. Pubmed Central PMCID: PMC5470010. Epub 2017/06/01.
10. Ries NM. Financial incentives for weight loss and healthy behaviours. Healthc Policy. 2012 Feb;7(3):23-8. PubMed PMID: 23372578. Pubmed Central PMCID: PMC3298019. Epub 2013/02/02.
11. Amiri P, Jalali-Farahani S, Zarkesh M, Gharibzadeh S, Hedayati M, Azizi F. Behavioral Interventions forWeight Management in Overweight and Obese Adolescents: A Comparison Between a Motivation-based Educational Program and Conventional Dietary Counseling. Int J Endocrinol Metab. 2020;18(1):e88192.
12. Volpp KG, John LK, Troxel AB, Norton L, Fassbender J, Loewenstein G. Financial incentive–based approaches for weight loss: a randomized trial. JAMA. 2008;300(22):2631-37.
13. Williams GC, Grow VM, Freedman ZR, Ryan RM, Deci EL. Motivational predictors of weight loss and weight-loss maintenance. J Pers Soc Psychol. 1996 Jan;70(1):115-26. PubMed PMID: 8558405. Epub 1996/01/01.
14. Webber KH, Tate DF, Ward DS, Bowling JM. Motivation and its relationship to adherence to self-monitoring and weight loss in a 16-week Internet behavioral weight loss intervention. J Nutr Educ Behav. 2010 May-Jun;42(3):161-7. PubMed PMID: 20138583. Epub 2010/02/09.
15. Crane MM, Tate DF, Finkelstein EA, Linnan LA. Motivation for participating in a weight loss program and financial incentives: an analysis from a randomized trial. J Obes. 2012;2012:290589. PubMed PMID: 22577524. Pubmed Central PMCID: PMC3345232. Epub 2012/05/12.
16. Paloyo AR, Reichert AR, Reuss-Borst M, Tauchmann H. Who responds to financial incentives for weight loss? Evidence from a randomized controlled trial. Soc Sci Med. 2015 Nov;145:44-52. PubMed PMID: 26448164. Epub 2015/10/09.
17. Tambor M, Pavlova M, Golinowska S, Arsenijevic J, Groot W. Financial incentives for a healthy life style and disease prevention among older people: a systematic literature review. BMC Health Serv Res. 2016;16(5):426.
18. 2018.
19. Zeger SL, Liang KY. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986 Mar;42(1):121-30. PubMed PMID: 3719049. Epub 1986/03/01.
20. Finkelstein EA, Linnan LA, Tate DF, Birken BE. A pilot study testing the effect of different levels of financial incentives on weight loss among overweight employees. J Occup Environ Med. 2007;49(9):981-9.
21. McGill B, O'Hara BJ, Grunseit AC, Bauman A, Osborne D, Lawler L, et al. Acceptability of financial incentives for maintenance of weight loss in mid-older adults: a mixed methods study. BMC Public Health. 2018 Feb 13;18(1):244. PubMed PMID: 29439689. Pubmed Central PMCID: PMC5811982. Epub 2018/02/15.
22. Faghri PD, Simon J, Huedo-Medina T, Gorin A. Perceived Self-Efficacy and Financial Incentives: Factors Affecting Health Behaviors and Weight Loss in a Workplace Weight Loss Intervention. J Occup Environ Med. 2017 May;59(5):453-60. PubMed PMID: 28486342. Pubmed Central PMCID: PMC5704946. Epub 2017/05/10.
23. Ananthapavan J, Peterson A, Sacks G. Paying people to lose weight: the effectiveness of financial incentives provided by health insurers for the prevention and management of overweight and obesity–a systematic review. Obes Rev. 2018;19(5):605-13.
24. Yancy Jr WS, Shaw PA, Wesby L, Hilbert V, Yang L, Zhu J, et al. Financial incentive strategies for maintenance of weight loss: results from an internet-based randomized controlled trial. Nutr Diabetes. 2018;8(1):1-11.