Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
Department of Preventive Medicine, University of Tennessee Health Science Center, University of Tennessee, Memphis, Tennessee, USA.
Obesity (Silver Spring). 2022 Jan;30(1):106-116. doi: 10.1002/oby.23322.
This study examined the impact of a financial incentive scheme integrating process and outcome incentives across weight-loss induction and weight maintenance on 18-month weight outcomes.
This was a randomized controlled trial. Participants with overweight or obesity (n = 418; 91% female; 28% racial/ethnic minority) were randomized to an 18-month, online, group-based behavioral weight-control program (Internet-Only) or the same program with financial incentives provided for 12 months, contingent on self-regulatory weight-control behaviors (self-weighing, dietary self-monitoring, and physical activity) and weight-outcome benchmarks (Internet+Incentives). No financial incentives were provided from Months 13 to 18 to examine the durability of weight-control behaviors and outcomes without incentives.
Weight-loss induction at Month 6 was significantly greater for Internet+Incentives than Internet-Only (6.8% vs. 4.9%, respectively, p = 0.01). Individuals receiving incentives were significantly more likely to maintain weight loss ≥ 5% at Month 12 (45% in Internet+Incentives vs. 32% in Internet-Only, p < 0.02) and remain weight stable (39% vs. 27%, respectively, p < 0.01). Internet+Incentives participants also reported significantly greater behavioral engagement through Month 12. However, once incentives ceased, there were no differences in sustained weight outcomes (Month 18), and engagement declined dramatically.
Despite promoting greater treatment engagement and initial weight loss, financial incentives as offered in this study did not promote better extended weight control.
本研究考察了将减肥诱导和体重维持阶段的过程激励和结果激励相结合的财务激励计划对 18 个月体重结果的影响。
这是一项随机对照试验。参与者为超重或肥胖者（n=418；91%为女性；28%为少数族裔），被随机分配到为期 18 个月的在线团体行为体重控制项目（仅互联网组）或相同的项目，该项目在 12 个月内提供财务激励，前提是自我监管体重控制行为（自我称重、饮食自我监测和身体活动）和体重结果基准（互联网+激励）。从第 13 个月到第 18 个月不提供任何财务激励，以检验没有激励时体重控制行为和结果的持久性。
在第 6 个月，互联网+激励组的减肥效果明显优于仅互联网组（分别为 6.8%和 4.9%，p=0.01）。接受激励的个体在第 12 个月时保持减肥≥5%的可能性显著更高（互联网+激励组为 45%，仅互联网组为 32%，p<0.02），体重保持稳定的可能性也更高（分别为 39%和 27%，p<0.01）。互联网+激励组的参与者在第 12 个月时也报告了显著更高的行为参与度。然而，一旦激励停止，持续的体重结果（第 18 个月）就没有差异，并且参与度急剧下降。
尽管财务激励促进了更大的治疗参与和初始体重减轻，但在本研究中提供的财务激励并没有促进更好的长期体重控制。
