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 .
Financial incentive-based approaches for weight loss: a randomized trial.
CONTEXT Identifying effective obesity treatment is both a clinical challenge and a public health priority due to the health consequences of obesity . OBJECTIVE To determine whether common decision errors identified by behavioral economists such as prospect theory , loss aversion , and regret could be used to design an effective weight loss intervention . DESIGN , SETTING , AND PARTICIPANTS Fifty-seven healthy participants aged 30 - 70 years with a body mass index of 30 - 40 were r and omized to 3 weight loss plans : monthly weigh-ins , a lottery incentive program , or a deposit contract that allowed for participant matching , with a weight loss goal of 1 lb ( 0.45 kg ) a week for 16 weeks . Participants were recruited May-August 2007 at the Philadelphia VA Medical Center in Pennsylvania and were followed up through June 2008 . MAIN OUTCOME MEASURES Weight loss after 16 weeks . RESULTS The incentive groups  lost significantly more weight than the control group ( mean , 3.9 lb ) . Compared with the control group , the lottery group lost a mean of 13.1 lb ( 95 % confidence interval [ CI ] of the difference in means , 1.95 - 16.40 ; P = .02 ) and the deposit contract group lost a mean of 14.0 lb ( 95 % CI of the difference in means , 3.69 - 16.43 ; P = .006 ) . About half of those in both incentive groups met the 16-lb target weight loss : 47.4 % ( 95 % CI , 24.5%-71.1 % ) in the deposit contract group and 52.6 % ( 95 % CI , 28.9%-75.6 % ) in the lottery group , whereas 10.5 % ( 95 % CI , 1.3%-33.1 % ; P = .01 ) in the control group met the 16-lb target . Although the net weight loss between enrollment in the study and at the end of 7 months was larger in the incentive groups ( 9.2 lb ; t = 1.21 ; 95 % CI , -3.20 to 12.66 ; P = .23 , in the lottery group and 6.2 lb ; t = 0.52 ; 95 % CI , -5.17 to 8.75 ; P = .61 in the deposit contract group ) than in the control group ( 4.4 lb ) , these differences were not statistically significant . However , incentive participants weighed significantly less at 7 months than at the study start ( P = .01 for the lottery group ; P = .03 for the deposit contract group ) whereas controls did not . CONCLUSIONS The use of economic incentives produced significant weight loss during the 16 weeks of intervention that was not fully sustained . The longer-term use of incentives should be evaluated . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00520611
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 .