Cash incentives help men to lose more weight, finds study

One group received daily supportive text messages plus the opportunity to earn £400 if they achieved their weight loss goals; the second received only text messages; and the third received no extra support or financial incentive.

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The men were given targets to shed 5% of their bodyweight within three months, 10% after six months, and to maintain that 10% weight loss by 12 months  – at which point the cash was paid to the group offered the monetary incentive.

The project - dubbed the Games of Stones - found that after one year the men receiving both text messages and the cash incentive lost the most weight.

Professor Pat Hoddinott, from the university's Nursing, Midwifery and Allied Health Professions Research Unit, who led the study, said the study could offer a "low-cost solution to the health service" by helping to prevent or reverse conditions such as diabetes.

New research presented at the European Congress on Obesity in Venice on Monday found that obesity is linked 40% of cancer cases, compared to the 25% previously thought. 

It also comes days after an analysis of millions of working-age adults across Europe found that people take more sick days the heavier they are, owing to complications ­including joint pain, diabetes, depression and heart disease.

Severely obese adults were 2.5 times more likely to have had at least one week off with poor health in the past year.

Prof Hoddinott said: “Losing weight can make people feel better, reduce their risk of many health problems such as diabetes, and helps the health service with their aim to keep men well.

"However, we know men often don’t like to go to traditional weight loss groups.

"This was a very carefully planned study, created for men with men.

"We worked closely with various men’s health groups and charities, including Men’s Health Forum in the UK and Ireland, with more than 1000 men living with obesity informing the design of the incentive structure.

“The research showed that offering cash incentives was a popular and effective way of helping men to lose weight.

"This initiative would be a low-cost solution for the health service to offer to men, requiring only four short weight appointments, and with money paid out only at the end to those who lose over 5% of their starting weight.”

Obesity is one of the biggest challenges now facing the NHS (Image: Getty)

The Game of Stones participants had an average age of 51, and 39% lived in more deprived areas.

Nearly one in three (29%) had a disability, 40% had multiple long-term conditions, and 25% told researchers they had been diagnosed with a mental health condition.

Of the 585 who joined the study, 426 completed the 12-month follow up.

Average weight loss after one year varied from 5% in the group receiving texts and the offer of a cash reward, to 3% in the text-only group, and 1% in the control group receiving no support.

However, only 27 out of the 196 men in the text-and-cash group banked the £400 after maintaining a 10% weight loss. 

The findings have been published in the Journal of the American Medical Association (JAMA) and are being presented at the European Congress for Obesity in Venice.

Nevil Chesterfield, 68, from Bristol, was among those who took part. 

He said the men-only aspect was an "important draw", and that the prospect of a cash prize was highly motivating. 

Mr Chesterfield said: "I think the competitive element was helpful as was the series of boosts to self-esteem provided by hitting each target.

“The financial incentive was important – it did give the project tremendous credibility when I explained it to my peer group.

"Partaking in a university study sounds worthy, and the fact that it is intended to inform future health policy gives seriousness, but the payments for hitting targets takes it to new heights, particularly with male friends.

"To them it becomes something more than some sort of diet.”

By 2021, 70 per cent of men in Scotland were overweight or obese (Image: Scottish Health Survey/Scot Govt)

Ciarán Gibson, 35, from Belfast, said he had previously struggled with his weight for years but managed to lose nearly two stone over the year-long study, easing arthritis symptoms.

He said: “I thought I might benefit from being part of the study to keep me motivated to reach my goals.

“The appointments were infrequent and easy to attend but regular enough to keep me feeling accountable for my weight loss. I didn't want to go to my next appointment having put on more weight."

Professor Frank Kee, a public health physician and co-Investigator from Queens University Belfast, said: “Given the huge cost imposed upon the health service of overweight and obesity, and their consequences, we believe that investing in a service like this could pay for itself over the long term if the impact we observed in the trial is sustained.

"We are currently examining this health economic question in more detail.”

Researchers hope the findings will help inform policy makers and be adopted by NHS organisations to support action to tackle obesity.

Professor Katrina Turner, a co-investigator on the study and head of the Centre for Academic Primary Care at Bristol University, said: “When around 25% of men in the UK are living with obesity, we need effective weight loss interventions that can be implemented at scale and across different health settings.”