Opportunity 

Obesity is one of the leading causes of preventable death in the United States due to its prevalence and connection to serious health conditions such as heart disease, stroke, type 2 diabetes, and certain types of cancer.   

Identifying effective strategies for treating obesity is a clinical challenge and a public health priority. 

Intervention 

We conducted a one-year randomized trial testing different premium-based financial incentives for weight loss promotion. We enrolled 200 obese employees and randomly assigned them to a control group or one of three incentive arms offering an incentive valued at $550.  

The first intervention arm offered a health insurance premium adjustment for the following year (delayed). In contrast, the second arm offered the adjustment in the first pay period after achieving the goal (immediate). The third arm offered a daily lottery incentive separate from premiums.  

Way to Health was used to administer and manage the program. 

Impact 

The financial incentives offered to participants in incentive arms did not improve weight loss outcomes after 12 months.  

This study was one of the first randomized trials of premium-based financial incentives. Future interventions should test incentives outside of insurance premiums and try other amounts.