Group refunds , deposit not paid as lump sum , participants setting their own deposit size and additional behaviour change techniques were associated with greater weight loss during treatment .
Post-treatment , there was no significant effect of MCCs on weight loss .
There was a significant small-to-medium effect of MCCs on participant retention during treatment .
Research er-set deposits paid as one lump sum , refunds delivered on an all-or-nothing basis and refunds contingent on attendance at classes were associated with greater retention during treatment .
Post-treatment , there was no significant effect of MCCs on participant retention .
The results support the use of MCCs to promote weight loss and participant retention up to the point that the incentive is removed and identifies the conditions under which MCCs work best
Financial incentives to improve health have received increasing attention , but are subject to ethical concerns .
Monetary Contingency Contracts ( MCCs ) , which require individuals to deposit money that is refunded contingent on reaching a goal , are a potential alternative strategy .
This review evaluates systematic ally the evidence for weight loss – related MCCs .
Weight loss expectations in obese patients and treatment attrition: an observational multicenter study.
OBJECTIVE To investigate the influence of weight loss expectations ( expected 1-year BMI loss , dream and maximum acceptable BMI ) on attrition in obese patients seeking treatment . RESEARCH METHODS AND PROCEDURES Obese subjects ( 1,785 ; 1,393 women ; median age , 46 years ; median BMI , 36.7 kg/m(2 ) ) seeking treatment in 23 medical Italian centers were evaluated . Baseline  diet  and  weight history , weight loss expectations , and primary motivation for seeking treatment ( health or improving appearance ) were systematic ally recorded . Psychiatric distress , binge eating , and body image dissatisfaction were tested at baseline by self-administered question naires ( Symptom Check List-90 , Binge Eating Scale , and Body Uneasiness Test ) .  Attrition and BMI change at 12 months were prospect ively recorded . RESULTS At 12 months , 923 of 1,785 patients ( 51.7 % ) had discontinued treatment . Compared with continuers , drop-outs had a significantly lower age , a lower age at first dieting , lower dream BMI , a higher expected 1-year BMI loss , and a higher weight phobia . At logistic regression analysis , the strongest predictors of attrition at 12 months were lower age and higher expected 1-year BMI loss . The risk of drop-out increased systematic ally for unit increase in expected BMI loss at 12 months ( hazard ratio , 1.12 ; 95 % confidence interval , 1.04 to 1.20 ; p = 0.0018 ) . The risk was particularly elevated in the first 6 months . DISCUSSION Baseline weight loss expectations are independent cognitive predictors of attrition in obese patients entering a weight-losing program ; the higher the expectations , the higher attrition at 12 months . Unrealistic weight goals should be tackled at the very beginning of treatment
Group refunds , deposit not paid as lump sum , participants setting their own deposit size and additional behaviour change techniques were associated with greater weight loss during treatment .
Post-treatment , there was no significant effect of MCCs on weight loss .
There was a significant small-to-medium effect of MCCs on participant retention during treatment .
Research er-set deposits paid as one lump sum , refunds delivered on an all-or-nothing basis and refunds contingent on attendance at classes were associated with greater retention during treatment .
Post-treatment , there was no significant effect of MCCs on participant retention .
The results support the use of MCCs to promote weight loss and participant retention up to the point that the incentive is removed and identifies the conditions under which MCCs work best
Financial incentives to improve health have received increasing attention , but are subject to ethical concerns .
Monetary Contingency Contracts ( MCCs ) , which require individuals to deposit money that is refunded contingent on reaching a goal , are a potential alternative strategy .
This review evaluates systematic ally the evidence for weight loss – related MCCs .