Mayo Clinic Study: Financial Incentives Further Weight Loss

A yearlong study highlights the potential of monetary rewards to promote healthier lifestyles

By Stephen Miller, CEBS March 18, 2013
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Participants in a weight-loss study who received financial incentives were more likely to stick with a weight-loss program and lost more weight than study participants who received no incentives, according to Mayo Clinic research.

Obesity continues to be a major concern in the U.S. because extra weight can contribute to many conditions, such as heart disease and diabetes. Reducing obesity has been closely linked with lowering medical claims and increasing productivity.

Previous studies have shown that financial incentives help people lose weight, but this study examined a larger group of participants (100) over a longer period (one year), said lead author Steven Driver, M.D., an internal medicine resident at Mayo Clinic.

An adult who has a body mass index—a calculation determined by using weight and height—of 30 or higher is considered obese, according to the U.S. Centers for Disease Control and Prevention. In the study, 100 healthy adult Mayo employees or their dependents, ages 18-63 with a body mass index of 30 to 39.9, were assigned to one of four weight-loss groups: two with financial incentives and two without.

All participants were given a goal of losing four pounds per month up to a predetermined goal weight. Participants were weighed monthly for one year, whereas previous financial incentive studies followed patients for 12 or 36 weeks.

Participants in the incentive groups who met their goals received $20 per month, while those who failed to meet their targets paid $20 each month into a bonus pool. Participants in both incentive groups who completed the study were eligible to win the pool by lottery. Among the results:

  • Study completion rates for the incentive groups were significantly higher compared with the nonincentive groups: 62 percent vs. 26 percent.
  • Mean weight loss in the incentive groups was 9.08 pounds compared with 2.34 pounds for the nonincentive groups.
  • Participants in the incentive group who paid penalties were more likely to continue their participation in the study than those in the nonincentive groups.

“The take-home message is that sustained weight loss can be achieved by financial incentives,” Driver stated in the release. “The financial incentives can improve results and improve compliance and adherence.”

“This is yet another study validating that the most successful programs will leverage both loss aversion and competitive drive,” said David Roddenberry, co-founder of HealthyWage, a wellness program provider, to SHRM Online. He noted that the program’s incentives involved “both the threat of losing of money and also the opportunity to win large prizes—and bragging rights as in a weight loss ‘bet.’ ”

“You’d like to believe that a long, healthy life

is reward enough. The truth is,

a $50 gift card works better.”

Tailoring Incentives

“There’s a good reason that 79 percent of large U.S. companies now offer wellness programs,” added Michael Levy, president of Online Rewards, a provider of employee incentive programs. “Employers know their employees’ poor health habits are the biggest challenge to maintaining affordable benefits, and they’re seeing diminishing returns on cost-shifting strategies such as increasing deductibles and co-pays.”

According to Levy, participation can be as low as 5 percent in corporate wellness programs without suitable incentives. “You’d like to believe that a long, healthy life is reward enough. The truth is, a $50 gift card works better.”

Employers need to find the right incentives to gain and sustain meaningful employee participation in wellness programs, he advised. In addition to premium contributions, “gift cards, travel vouchers, electronics and other prizes, even additional paid time off and bonus cash can be powerful motivators,” he noted.

Rewards should be tailored to the pay grade of the recipient so that they succeed in changing behavior. “The most successful programs incorporate combinations of incentives in order to appeal to the broadest cross-section of the employee population,” Levy said.

Rewards also should be delivered frequently, “so act monthly, not annually,” he advised. “Smaller, attainable challenges with monthly rewards that lead to a large annual reward are the most effective. With the right incentives, participation in health reimbursement arrangements (HRAs) and biometric screenings, for example, can be as high as 80 percent.”

Finally, a wellness program website can help employees and employers to get engaged in the program, track progress, and celebrate success, Levy observed.

Stephen Miller, CEBS, is an online editor/manager for SHRM.

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