OBJECTIVE: Reinforcement-based treatments, based on behavioral economics models, can improve outcomes of medical conditions with behavioral components. This study evaluated the efficacy of a low-cost reinforcement intervention to produce initial weight loss. METHODS:Overweight individuals (n=56) were randomized to one of two 12-week treatments: Lifestyle, Exercise, Attitudes, Relationships, Nutrition manual with supportive counseling or that same treatment with opportunities to win $1 to $100 prizes for losing weight and completing weight-loss activities. RESULTS: Patients receiving reinforcement lost significantly more weight (6.0% ± 4.9% baseline bodyweight) than patients in the non-reinforcement condition (3.5% ± 4.1%; P=.04). Moreover, 64.3% of patients receiving reinforcement achieved weight loss of ≥ 5% baseline bodyweight versus 25.0% of those in the non-reinforcement condition (P=.003). Proportional weight loss was significantly related to reductions in total cholesterol and 24-hour ambulatory heart rate. CONCLUSION: This reinforcement-based intervention substantially enhances short-term weight loss, and reductions in weight are associated with important changes in clinical biomarkers. Larger-scale evaluation of reinforcement-based treatments for weight loss is warranted.
RCT Entities:
OBJECTIVE: Reinforcement-based treatments, based on behavioral economics models, can improve outcomes of medical conditions with behavioral components. This study evaluated the efficacy of a low-cost reinforcement intervention to produce initial weight loss. METHODS: Overweight individuals (n=56) were randomized to one of two 12-week treatments: Lifestyle, Exercise, Attitudes, Relationships, Nutrition manual with supportive counseling or that same treatment with opportunities to win $1 to $100 prizes for losing weight and completing weight-loss activities. RESULTS:Patients receiving reinforcement lost significantly more weight (6.0% ± 4.9% baseline bodyweight) than patients in the non-reinforcement condition (3.5% ± 4.1%; P=.04). Moreover, 64.3% of patients receiving reinforcement achieved weight loss of ≥ 5% baseline bodyweight versus 25.0% of those in the non-reinforcement condition (P=.003). Proportional weight loss was significantly related to reductions in total cholesterol and 24-hour ambulatory heart rate. CONCLUSION: This reinforcement-based intervention substantially enhances short-term weight loss, and reductions in weight are associated with important changes in clinical biomarkers. Larger-scale evaluation of reinforcement-based treatments for weight loss is warranted.
Authors: William C Knowler; Elizabeth Barrett-Connor; Sarah E Fowler; Richard F Hamman; John M Lachin; Elizabeth A Walker; David M Nathan Journal: N Engl J Med Date: 2002-02-07 Impact factor: 91.245
Authors: Kevin G Volpp; Leslie K John; Andrea B Troxel; Laurie Norton; Jennifer Fassbender; George Loewenstein Journal: JAMA Date: 2008-12-10 Impact factor: 56.272
Authors: Christopher D Gardner; Alexandre Kiazand; Sofiya Alhassan; Soowon Kim; Randall S Stafford; Raymond R Balise; Helena C Kraemer; Abby C King Journal: JAMA Date: 2007-03-07 Impact factor: 56.272