Individual- versus group-based financial incentives for weight loss: a randomized, controlled trial

Ann Intern Med. 2013 Apr 2;158(7):505-14. doi: 10.7326/0003-4819-158-7-201304020-00002.


Background: Data on the effectiveness of employer-sponsored financial incentives for employee weight loss are limited.

Objective: To test the effectiveness of 2 financial incentive designs for promoting weight loss among obese employees.

Design: Randomized, controlled trial. ( NCT01208350)

Setting: Children's Hospital of Philadelphia.

Participants: 105 employees with a body mass index between 30 and 40 kg/m2.

Intervention: 24 weeks of monthly weigh-ins (control group; n = 35); individual incentive, designed as $100 per person per month for meeting or exceeding weight-loss goals (n = 35); and group incentive, designed as $500 per month split among participants within groups of 5 who met or exceeded weight-loss goals (n = 35).

Measurements: Weight loss after 24 weeks (primary outcome) and 36 weeks and changes in behavioral mediators of weight loss (secondary outcomes).

Results: Group-incentive participants lost more weight than control participants (mean between-group difference, 4.4 kg [95% CI, 2.0 to 6.7 kg]; P < 0.001) and individual-incentive participants (mean between-group difference, 3.2 kg [CI, 0.9 to 5.5 kg]; P = 0.008). Twelve weeks after incentives ended and after adjustment for 3-group comparisons, group-incentive participants maintained greater weight loss than control group participants (mean between-group difference, 2.9 kg [CI, 0.5 to 5.3 kg]; P = 0.016) but not greater than individual-incentive participants (mean between-group difference, 2.7 kg [CI, 0.4 to 5.0 kg]; P = 0.024).

Limitation: Single employer and short follow-up.

Conclusion: A group-based financial incentive was more effective than an individual incentive and monthly weigh-ins at promoting weight loss among obese employees at 24 weeks.

Primary funding source: National Institute on Aging.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Behavior Therapy
  • Body Mass Index
  • Employee Incentive Plans
  • Female
  • Group Processes
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Motivation*
  • Obesity / economics*
  • Obesity / psychology
  • Obesity / therapy*
  • Reward*
  • Weight Loss*

Associated data