Money with a tape measure 

Obesity and obesity-related illness are at near epidemic levels in the United States and other parts of the World.   The prevalence of overweight and obesity patients has more than doubled in the past three decades, leading to rising costs to treat a non-communicable disease associated with treated the illnesses associated with being overweight.  Researchers and medical providers are struggling to find a way to cope with the increasing demand for effective treatments.  Yet, no matter what we try to manage the increasing girth of this population, the numbers of those affected continue to skyrocket with their waistlines.   Many countries have begun to look at sin taxes and punishment for those that are overweight as a means to attempt to prevent the adipose onslaught.  Although not well studied, an incentive to live and have a healthy weight may be one viable alternative.   

 A study from 2017 looked at the very question of whether rewards will help with weight loss and maintenance once it is lost[1].  This study tests whether adding a rewards program to an existing evidence-based weight loss program can increase weight loss and weight loss maintenance.  The reward tested was a cash payment and free treatment program.  The study was a randomized controlled trial completed in Singapore from October 2012 to October 2015.  The subjects were 161 overweight or obese individuals randomized to either control or reward group.  Both groups of participants received a four-month weight loss program.  Those in the reward arm paid a fee of $165.00 ($121 US) to access a program that provided rewards of up to S$660 ($487 US) for meeting weight loss and physical activity goals.  The primary outcome was weight loss at 4, 8, and 12 months.  The study revealed a significant increase in weight loss in the reward arm.  In fact, the average weight loss was more than twice as great in the reward arm compared to the control arm at 4, 8, and 12 months.  

The bottom line:  This study reveals that a rewards program can be used to improve weight loss and weight loss maintenance when combined with an evidence-based weight loss program.  Further study should look at both rewards without a weight loss program and see if replicating this approach is to cost-effectively expand these programs to maximize their reach to a larger population.