When one size really doesn’t fit all

More intensive and personalized strategies may be needed for weight loss

University of Pennsylvania School of Nursing

Modest weight loss can lead to meaningful risk reduction in adults with obesity. Although both behavioral economic incentives and environmental change strategies have shown promise for initial weight loss, to date their efficacy alone or in combination have not been compared.

In a two-year randomized clinical trial, researchers investigated whether financial incentives and environmental change strategies, together or separately, help employed adults with obesity lose weight and keep it off. 

Of note, the strategies tested in this study did not include any individual counseling sessions or classes. While participants across all study groups lost a modest amount of weight, study participants felt they would have benefitted more from intensive guidance such as on-going counseling and coaching. The findings have been published in the Journal of the American Medical Association (JAMA).

"In our Healthy Weight trial, incentives and environmental strategies led to modest but nonsignificant improvements in weight loss," explains Karen Glanz, PhD, MPH, the George A. Weiss University Professor and Professor of Nursing at the University of Pennsylvania School of Nursing (Penn Nursing). Glanz is the lead author of the article. 

"From a translational standpoint, benefits designs could consider incorporating ongoing financial incentives for weight loss among employees with obesity, while linking online support to more intensive personalized approaches."

The article, "Effect of Financial Incentives and Environmental Strategies on Weight Loss in the Healthy Weight Study," is available online. Coauthors of the article include Pamela Shaw, PhD, Pui Kwong, MPH, Ji Rebekah Choi, MPH, Jingsan Zhu, MS, MBA, Qian Erin Huang, MPH, Karen Hoffer, BS, and Kevin G. Volpp, MD, PhD, all of the Perelman School of Medicine at the University of Pennsylvania; and Annie Chung, BA, of Children's Hospital of Philadelphia. This research reported was supported by Cooperative Agreement 1U48DP005053 from the U.S. Centers for Disease Control and Prevention.