10.07.2009

Cash incentive for slimmers more effective than diets, study claims


Paying people to lose weight works better than diet plans, research suggests. A scheme being trialled by the NHS that rewards slimmers with cash or shopping vouchers could be more than twice as effective, it is claimed.

Those who sign up to the programme, from a company known as Weight Wins, are paid if they lose a certain amount of weight and then keep it off for a period of three months or more, with payments increasing the more weight someone can shed.

Slimmers on a 13-month “Pounds for Pounds” plan can be paid up to £425 for losing 50lb (23kg), while a six-month reduction of 30lb would accrue £160.

Weight Wins, the company running the scheme, is extending it to offer a maximum of £1,000 for a loss of 150lb, to be achieved and maintained over two years. Preliminary results for 600 obese people found they lost an average of 14.4lb in six months. One in four of those who were still attending regular weigh-ins to get paid after 12 months lost an average of 29lb, equivalent to a 13 per cent reduction. The typical diet programme leads to a loss of only around 5 per cent, the company’s founders say.

But the results are not from a controlled trial, and the scheme is not without its critics, including the Conservative MP Ann Widdecombe. Ms Widdecombe, who lost 35lb on ITV’s Celebrity Fit Club show in 2002, said: “If the NHS had money to spare it would be okay, but the fact is the NHS is short of money. There are plenty of people who cannot get funding to pay for treatment for illnesses,” she said. “We can all control our own weight. If the NHS has to prioritise, then this should be at the end of its priorities.”

Winton Rossiter, managing director of Weight Wins, said that offering money as an incentive could be cost-effective for the NHS, which spends more than £4 billion annually on treating obesity and related illnesses. The findings, verified by the University of Hertfordshire, will be presented this week at the National Obesity Forum, a charity set up by medical practitioners.

The Weight Wins programme is being tested by the NHS in Eastern and Coastal Kent, as part of a national trial. The full results are expected early next year. There are already similar pay-to-quit schemes to encourage people to stop smoking, while GPs can already refer seriously overweight people to dieticians or exercise classes that are subsidised by the NHS.

Weight Wins says that its cash rewards programme could save the NHS £1.7 billion in lifetime medical expenses for every million people taking part. A total of 31 million adults in Britain are now thought to be overweight or obese.

People can pay upwards of £45 to enrol in the scheme privately, with the chance of more than doubling their money, Mr Rossiter said. “We believe we could have a breakthrough solution to resolving the obesity epidemic. Most people know how to lose weight, through controlled dieting and exercise, but they fail to maintain their plans because of a lack of motivation. Financial incentives work because they reward you for losing weight steadily and safely month by month, and then you have a bonus for keeping it off.”

Women made up 60 per cent of the participants in the study, who were signed up to six-month or 13-month programmes and given up to half the time to get down to a target weight and the remaining time to maintain it, with according payments and bonuses being due at the end date.

The participants had an average age of 43 and an average weight of 15.5 stone and body-mass index (BMI) score of 33.8 before starting the plan. Those that completed six months had reduced their average BMI (calculated by dividing weight in kilograms by the square of your height in metres) to 31.6, but those who continued for more than a year reduced it to 29.6 — enough to be considered overweight, but no longer clinically obese.

“Pounds for Pounds” is not the only way of making money from losing weight. Thousands of other Britons are also reported to have signed up to diet-betting websites, which allow people to place bets on the amount of weight they can lose. The Department of Health is also subsidising gym memberships for 16-22-year-olds in parts of Newcastle, Bristol, Torbay, Manchester and Bury St Edmunds, on the condition that they exercise regularly over a year.

The National Obesity Forum said: “We would only support this if there was a proper randomised controlled trial that proved that weight was being kept off.”

One participant, Gina Belcher, 39, paid £95 to sign up and is set to receive £190 for shedding 1½ stone in three months and keeping it off for another six. Mrs Belcher, of Whimple, Devon, who weighed 11 stone when she started, said: “It’s a little bonus that kept me determined to finish.”

The mother-of-two, saw the Pounds for Pounds programme advertised in a magazine and thought that getting paid to lose weight sounded too good to be true.

Her sustained weight loss is measured by monthly visits to her local GP or pharmacy to weigh in, but she will only see her return next month when she finishes.

She said. “I had done various weight-loss schemes and classes in the past, but was starving myself silly to weigh in on the scales, and I had to drive into town and pay for the privilege of attending a class every week.

“I was looking for something that would be more of a lifestyle change, long-term, than starting and stopping a diet and then putting all the weight you’d lost back on again.”

Having reduced her dress size from 14 or 16 to a “curvy 12”, she says she is happy with her current weight of 10 stone, but keeps in shape by walking the 1.2 miles to and from her daughter’s school every day and longer-distance “power-walks” for charity.

“It has been a lifestyle shift. We try and snack on healthy things rather than biscuits or crisps, but it’s not like those things are forbidden. I can treat myself occasionally and still go out for dinner, but it’s been a real incentive to think that I was making money out of this – I’m feeling more energised and motivated, and treated myself to a treadmill in the sales.”

Mrs Belcher, who runs her own holiday accommodation business but also provides massage therapy for NHS and private patients, said that she felt hypocritical providing advice about healthy lifestyles but not being overweight herself.

She says NHS patients could benefit from the scheme, “because of the flexibility about losing weight how you like, but then making sure you keep it off.”

“I’m all for paying people a small amount to get and stay well, rather than paying the multimillion pound bill that comes when things go wrong.”

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