Losing weight and keeping it off: will incentives help?
Project title: The maintenance of Healthy Weight for Life program effects using financial incentives
Start date: January 2016
Estimated end date: August 2018
What is the issue?
Participants of weight loss programs often gradually regain any weight they have lost after the program ends, and there is limited evidence about measures that help to prevent this weight re-gain.
Healthy Weight for Life (HWFL) is a weight loss program that private health insurance company HCF offers to members who have a Body Mass Index of 28 or more (ie. those who are overweight or obese) and have osteoarthritis, a cardiovascular condition or type 2 diabetes.
The program, which is mainly provided online, delivers a step-by-step weight loss program over three six-week phases.
Each phase includes:
- A portion control eating plan
- Recommendations for gentle activity and physiotherapist-developed strength, balance and mobility exercises
- Personalised tracking of symptoms, progress and satisfaction
- Personal motivation, support and advice via phone, SMS, email, message board and mail.
The program has been successful in helping participants to reduce their weight by an average of 7 per cent. More than 80% of participants finish the program.
HCF is interested in the use of incentives to maintain weight loss after the program finishes.
Financial incentives are cash or non-cash rewards with a monetary value. There is evidence that financial incentives help to maintain behaviour change, including weight loss.
How is the project addressing the issue?
The project will investigate the effectiveness of financial incentives to maintain weight loss that participants achieve during the HWFL program.
While plans for the study are still being confirmed, at this stage the project team plans to randomly assign around 480 participants into three groups:
- A control group: participants receive the usual HWFL program
- Two financial incentive groups: details to be determined following formative evaluation involving a survey of participants who have completed the HWFL program.
The project will collect data including weight, waist circumference and dietary and physical activity behaviour, at the start and end of the 18-week HWFL program, six months after the end of the program (the maintenance phase) and a further six months later (the follow-up phase).
What are the expected outcomes?
The project is expected to show whether financial incentives help participants of weight loss programs to maintain their weight loss after the end of a program.
Updated February 2017
Associate Professor Philayrath Phongsavan, The University of Sydney
- Maintenance of weight loss after the completion of an evidence-based program is an area of little research.
- Policy makers may find this information relevant for improving existing weight loss programs.
- Private health insurance companies are in a position to provide healthy lifestyle interventions to a large proportion of the population but these interventions need to be evidence based. It is important to develop intervention approaches to weight loss maintenance that are relevant to the Australian health insurance context.
Focus group data has been collected and preliminary analysis completed.
Focus group results informed intervention options presented to HCF.
- World Congress on Public Health, oral presentation: Characteristics of Behavioural Economic Approaches to Promoting Behaviour Change in Lifestyle Interventions Using Financial Incentives. Melbourne, 5 April 2017.
- International Society of Behavioural Nutrition and Physical Activity (ISBNPA), oral presentation acceptance: Financial incentives are nice, but may not be enough to motivate weight loss maintenance: findings from a mixed method study of older health insurance members. ISBNPA 2017 Annual Meeting in Victoria, Canada, 8-10 June.
- Kite J, Indig D, Mihrshahi S, Milat A, Bauman A. Assessing the usefulness of systematic reviews for policymakers in public health: A case study of overweight and obesity prevention interventions.Prev Med 2015;81:99-107. doi: 10.1016/j.ypmed.2015.08.012