A low-cost reinforcement procedure improves short-term weight loss outcomes

Am J Med. 2011 Nov;124(11):1082-5. doi: 10.1016/j.amjmed.2011.04.016. Epub 2011 Aug 17.

Abstract

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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Attitude
  • Body Mass Index
  • Cost-Benefit Analysis
  • Counseling / economics
  • Exercise
  • Female
  • Humans
  • Interpersonal Relations
  • Life Style
  • Male
  • Middle Aged
  • Nutrition Therapy / economics
  • Obesity / economics
  • Obesity / psychology
  • Obesity / therapy*
  • Overweight / economics
  • Overweight / psychology
  • Overweight / therapy*
  • Token Economy*
  • Weight Loss*