An intervention with text messaging plus a financial incentive significantly improved weight loss in men with obesity, according to a study published in the Journal of the American Medical Association to coincide with the 31st European Congress on Obesity.
“Effective interventions to attain weight loss in men are needed,” wrote Pat Hoddinott, MB, BS, PhD, and colleagues. “Behavior change interventions delivered with text messaging can be effective and scalable components of weight loss programs. Financial incentives can help men with over – weight and obesity to lose weight, and adding behavior change techniques and economic theory may enhance effectiveness.”
The investigators randomly assigned 585 men with BMI≥30 kg/m 2 to receive 12 months of behavioral focused text messages combined with financial incentives (n=196), 12 months of behavioral focused text messages alone (n=194), or a waiting list (control group; n=195).
“Daily text messages were identical for the two intervention groups and did not mention financial incentives. They incorporated weight management evidence, website links to information resources, and theory-based behavior change techniques based on the Health Action Process Approach, self-determination theory, and the behavior change maintenance model,” the researchers wrote.
At 12-month follow-up, the mean percent weight change was significantly greater in the group receiving text messaging with a financial incentive (mean difference, 3.2%) compared with control. However, weight change was not significantly greater in the text messaging-alone group (mean difference, 1.4%) compared with control.
The 12-month mean percentage weight changes from baseline were 4.8% for the group receiving text messaging with financial incentives, 2.7% for the text messaging-alone group, and 1.3% for the control group.
“This study included 39% of men from lower socioeconomic backgrounds who have typically been underrepresented in clinical trials of weight loss in people with obesity,” Dr. Hoddinott and coinvestigators noted. “Including men with obesity living in disadvantaged areas in making decisions about the design of the incentives, number of assessments, goals, and text messages may have contributed to the effectiveness of the text messaging with the financial incentives intervention.”