The 'Pounds for Pounds' weight loss financial incentive scheme: an evaluation of a pilot in NHS Eastern and Coastal Kent.

BACKGROUND

Financial incentive programmes have the potential to modify health-related behaviours, including those associated with achieving weight loss. This study evaluated a pilot NHS commissioned financial incentive weight loss programme, based on the commercial Weight Wins 'Pounds for Pounds' programme.

METHODS

Participants chose a weight loss plan based on their target weight. Plans ranged from 15 lb (6.8 kg) weight loss over 3 months to 50 lb (22.7 kg) weight loss over 7 months, with optional additional 'maintenance' periods. Rewards, which were received after successful plan completion, ranged from £70 to £425 per year.

RESULTS

Mean baseline weight for the 402 participants was 101.8 kg (SD 46.1 kg), with 77.4% having a BMI ≥30 kg/m(2). Clinically significant weight loss (≥5%) occurred in 44.8% [95% confidence interval (CI): 40.0-49.7%] of participants. Estimated mean weight loss at 12 months was 4.0 kg (95% CI: 2.4-5.6 kg) under the assumption of return-to-baseline weight for those who had left the programme before reporting a 12 month weight.

CONCLUSIONS

The estimated mean 12 month weight loss of 4.0 kg at 12 months is comparable to other evaluations of other non-medical weight loss interventions. A randomized controlled trial is required to evaluate the clinical and cost-effectiveness of this financial incentive scheme.