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Outcomes in a Program that Offers Financial Rewards for Weight Loss

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  • John Cawley
  • Joshua A. Price

Abstract

Obesity rates in the U.S. have doubled since 1980. Given the medical, social, and financial costs of obesity, a large percentage of Americans are attempting to lose weight at any given time but the vast majority of weight loss attempts fail. Researchers continue to search for safe and effective methods of weight loss, and this paper examines one promising method - offering financial rewards for weight loss. This paper studies data on 2,407 employees in 17 worksites who participated in a year-long worksite health promotion program that offered financial rewards for weight loss. The intervention varied by employer, in some cases offering steady quarterly rewards for weight loss and in other cases requiring participants to post a bond that would be refunded at year's end conditional on achieving certain weight loss goals. Still others received no financial incentives at all and serve as a control group. We examine the basic patterns of enrollment, attrition, and weight loss in these three groups. Weight loss is modest. After one year, it averages 1.4 pounds for those paid steady quarterly rewards and 3.6 pounds for those who posted a refundable bond, under the assumption that dropouts experienced no weight loss. Year-end attrition is as high as 76.4%, far higher than that for interventions designed and implemented by researchers.

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  • John Cawley & Joshua A. Price, 2009. "Outcomes in a Program that Offers Financial Rewards for Weight Loss," NBER Working Papers 14987, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:14987
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    1. Mazhar, Ummad & Rehman, Fahd, 2022. "Productivity, obesity, and human capital: Panel data evidence," Economics & Human Biology, Elsevier, vol. 44(C).
    2. Wen You & Yuan Yuan & Kevin J. Boyle & Tzeyu L. Michaud & Chris Parmeter & Richard W. Seidel & Paul A. Estabrooks, 2022. "Examining Ways to Improve Weight Control Programs’ Population Reach and Representativeness: A Discrete Choice Experiment of Financial Incentives," PharmacoEconomics - Open, Springer, vol. 6(2), pages 193-210, March.
    3. Johannesson Magnus & Östling Robert & Ranehill Eva, 2010. "The Effect of Competition on Physical Activity: A Randomized Trial," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 10(1), pages 1-31, September.
    4. Cuffe, H.E. & Harbaugh, W.T. & Lindo, J.M. & Musto, G. & Waddell, G.R., 2012. "Evidence on the efficacy of school-based incentives for healthy living," Economics of Education Review, Elsevier, vol. 31(6), pages 1028-1036.
    5. List, John A. & Samek, Anya Savikhin, 2015. "The behavioralist as nutritionist: Leveraging behavioral economics to improve child food choice and consumption," Journal of Health Economics, Elsevier, vol. 39(C), pages 135-146.
    6. Joan Costa-Font & Mario Györi, 2023. "Income windfalls and overweight: evidence from lottery wins," Empirical Economics, Springer, vol. 64(5), pages 2005-2026, May.
    7. Marco Fabbri & Paolo Nicola Barbieri & Maria Bigoni, 2019. "Ride Your Luck! A Field Experiment on Lottery-Based Incentives for Compliance," Management Science, INFORMS, vol. 65(9), pages 4336-4348, September.
    8. Cawley, John & Price, Joshua A., 2013. "A case study of a workplace wellness program that offers financial incentives for weight loss," Journal of Health Economics, Elsevier, vol. 32(5), pages 794-803.
    9. Peter J. Huckfeldt & Darius N. Lakdawalla & Tomas J. Philipson, 2012. "Economics of Obesity," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 7, Edward Elgar Publishing.
    10. John A. List & Anya Samek, 2017. "A Field Experiment on the Impact of Incentives on Milk Choice in the Lunchroom," Public Finance Review, , vol. 45(1), pages 44-67, January.
    11. Boris Augurzky & Thomas K. Bauer & Arndt R. Reichert & Christoph M. Schmidt & Harald Tauchmann, 2012. "Does Money Burn Fat? – Evidence from a Randomized Experiment," Ruhr Economic Papers 0368, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    12. Finkelstein, Eric A. & Tham, Kwang-Wei & Haaland, Benjamin A. & Sahasranaman, Aarti, 2017. "Applying economic incentives to increase effectiveness of an outpatient weight loss program (TRIO) – A randomized controlled trial," Social Science & Medicine, Elsevier, vol. 185(C), pages 63-70.
    13. Scott A. Carson, 2013. "US Male Obesity from 1800-2000: A Long Term Perspective," CESifo Working Paper Series 4366, CESifo.
    14. Allais, Olivier & Bazoche, Pascale & Teyssier, Sabrina, 2017. "Getting more people on the stairs: The impact of point-of-decision prompts," Social Science & Medicine, Elsevier, vol. 192(C), pages 18-27.
    15. Augurzky, Boris & Bauer, Thomas K. & Reichert, Arndt R. & Schmidt, Christoph M. & Tauchmann, Harald, 2012. "Does Money Burn Fat? Evidence from a Randomized Experiment," IZA Discussion Papers 6888, Institute of Labor Economics (IZA).
    16. repec:zbw:rwirep:0368 is not listed on IDEAS
    17. Schofield, Heather & Loewenstein, George & Kopsic, Jessica & Volpp, Kevin G., 2015. "Comparing the effectiveness of individualistic, altruistic, and competitive incentives in motivating completion of mental exercises," Journal of Health Economics, Elsevier, vol. 44(C), pages 286-299.
    18. Alan Maynard, 2012. "The powers and pitfalls of payment for performance," Health Economics, John Wiley & Sons, Ltd., vol. 21(1), pages 3-12, January.

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    More about this item

    JEL classification:

    • D01 - Microeconomics - - General - - - Microeconomic Behavior: Underlying Principles
    • D03 - Microeconomics - - General - - - Behavioral Microeconomics: Underlying Principles
    • I1 - Health, Education, and Welfare - - Health
    • J01 - Labor and Demographic Economics - - General - - - Labor Economics: General

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