Cash incentives to lose weight: Could this help solve Asia’s obesity epidemic?

By Gary Scattergood contact

- Last updated on GMT

The average pay out to participants in the rewards arm was $225. ©iStock
The average pay out to participants in the rewards arm was $225. ©iStock
Academics in Singapore say giving obese people cash incentives to lose weight could help stem the rise in non-communicable diseases.

Professor Eric Finkelstein from Duke-NUS Medical School (Duke-NUS) used insights from behavioural economics to develop a rewards programme aimed to address the disconnect between long-term health and short-term temptation.

He then teamed up with Dr Kwang Wei Tham from Singapore General Hospital (SGH) to test it out among overweight or obese adults.

In the randomised eight month Singapore-based trial, 161 participants paid S$234 to access a 16-week intensive weight loss programme. 

They then received rewards for meeting 5% or 8% weightloss goals at months four and eight. The maximum possible reward value over the eight-month period was S$660 if all goals were met.

The programme required participants to attend weekly sessions at SGH where they were taught skills to maintain a healthy lifestyle and encouraged to lose at least 5% of their body weight.

At the end of month four, weight loss was more than twice as great in the rewards arm compared with the control arm (average 3.4 kg versus 1.4 kg weight loss). At months eight and 12, weight loss remained greater (average 3.3 kg vs. 1.8 kg weight loss at month eight and 2.3 kg vs 0.8 kg weight loss at month 12).

Moreover, more than three times as many rewards arm participants achieved 5% or greater weight loss at month four, relative to control arm participants (40% vs. 12%). At month four more than twice as many hit the 5% threshold (41% vs. 21%) and the percentage with 5% or greater weight loss was still greater at month 12 (28% vs. 17%).

Reward satisfaction

The study, published in the journal Social Science and Medicine, ​reported the average pay out to participants in the rewards arm was $225. And although only 42% of participants earned more than they paid in, around 80% reported satisfaction with the rewards scheme.

"Our findings not only show the value of rewards to increase weight loss and weight loss maintenance, but they show it can be done in a manner that minimizes third party payments, such as those by employers or insurers. This should help to expand access to these types of programmes."​ said Dr Finkelstein.

Dr Kwang Wei Tham added: "Even small amounts of weight loss, sustained over time, confer great health benefits and can help prevent chronic disease. This study shows that the enhancement and maintenance of weight loss is feasible through a rewards programme with participant ownership, coupled with an evidence-based, medical weight loss programme.”

We recently reported that the annual economic cost of obesity in South East Asia could be as high as US$10bn,​ a number that could rocket to $45bn if people who are currently overweight go on to become obese.

A report published by The Economist Intelligence Unit revealed that obesity prevalence rates increased on average by 28% between 2010-14.

According to the data, 5.7% of Indonesians were obese by 2014, a 33% increase on 2010’s figure. The proportion is 13.3% in Malaysia (a 27% increase), 5.1% in the Philippines (a 24% increase), 6.2% in Singapore (a 24% increase), 8.5% in Thailand (a 27% increase) and 3.6% in Vietnam (a 38% increase).


Source: Social Science & Medicine

“Applying economic incentives to increase effectiveness of an outpatient weight loss program (TRIO) – A randomized controlled trial”

Authors: Eric A. Finkelstein​, et al

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