The acceptability of financial incentives in helping older adults maintain weight loss

By Bronwyn McGill

The paper

McGill B, O’Hara B, Grunseit A, Bauman A, Osborne D, Lawler L, Phongsavan P. Acceptability of financial incentives for maintenance of weight loss in mid-older adults: a mixed methods study. BMC Public Health. 2018;18:244. doi:10.1186/s12889-018-5136-z

The project

The maintenance of Healthy Weight for Life program effects

Why we studied this topic

Health insurers internationally are looking at financial incentives to help promote healthy behaviour in their members. However, there has been little research on the acceptability of financial incentives to Australian private health cover members.

The Healthy Weight for Life weight loss program is offered by several health insurers in Australia to members who are overweight and obese, and have type 2 diabetes, cardiovascular disease or osteoarthritis. Since participants of weight loss programs often gradually regain any weight they have lost after the program ends, there has been interest in assessing the acceptability of financial incentives to help members keep the weight off.

What this paper adds

This is the first research to study the acceptability of financial incentives for the maintenance of weight loss in mid to older health insurance members in Australia.

We conducted an online survey of 130 participants of the Healthy Weight for Life program and held six focus groups among a further 28 participants who received the program through HCF.

While more than half of survey respondents thought financial incentives could be useful to support weight loss maintenance and a healthy lifestyle, participants of the focus groups doubted their value. They believed that financial incentives would only work for them if they involved a reduction in health insurance premiums (which is not possible in Australia). They conceded that financial incentives may be more acceptable to younger members.

The paper concludes that health insurance members in Australia consider their improved health and weight loss as far more motivating factors than financial incentives. Participants also overwhelmingly advocated for extending the support provided by the program team to include maintenance of weight loss in the longer term.

What was surprising?

Participants of the focus groups felt responsible for their own weight loss and nominated ongoing peer support as a way of helping themselves to maintain it. While this is not an option offered by the Healthy Weight for Life program, there was overwhelming support for such a service from all participants, regardless of gender or age.

What it means for policy

This paper indicates that introducing financial incentives for weight loss maintenance would not necessarily be acceptable to mid to older health insurance members in Australia.

Incentives that motivate people through positive discussion of the health benefits of sustained weight loss are likely to be more effective. Offering peer and program support may also be key to helping people keep weight off.