MATERIAL INCENTIVES FOR WEIGHT LOSS

Table 4

Incentive, treatment components and key findings for negative reinforcement, fixed ratio schedule studies.

Reference / Design / Nature of Incentive / Administration Schedule / Behavior/ Outcome Being Reinforced / Treatment Components in Incentive Condition(s) / Treatment Components in Non-incentive Condition(s) / Key Findings
Follick, Fowler & Brown, 1984 (32) / 2 conditions
Incentive; Control / Deposit of $70
Refund in increments of $5 / Weekly / Attendance and homework completion / Behavior modification lessons + incentive / Behavior modification lessons; deposit returned at first session / Treatment group attended more sessions than control
No difference in weight lost between conditions
Forster, Jeffery, Sullivan & Snell, 1985 (23) / 4 conditions
Incentive was in each condition
Group education with required attendance at weigh-ins and session; Group education with optional attendance; Self-instruction with required attendance; Self-instruction with optional attendance / Biweekly payroll deduction between $5-$30
Participants selected size of deduction / Biweekly / Required attendance conditions: Meeting biweekly weight goal and attendance
Optional attendance conditions: Meeting biweekly weight goal / All given a weight loss manual, food diaries
Group education conditions: educator discussed manual and offered individualized advice
Incentive / N/A / Attendance was greater in required attendance conditions
No difference in weight loss across conditions
Harris & Bruner, 1971 (26) / 3 conditions
Self-control;
Deposit contract; Attention-placebo control / Participants selected size of deposit
Refunded in increments of either $1 or $.50/lb / Weekly with a delay of one week between weigh-in and return of the deposit / Pounds lost / Instruction for maintaining food diary; computing caloric intake and noting circumstances that produce eating; invitation to nutrition lecture; low-calorie recipes
1 group meeting to set goals and discuss personal dieting problems
Weekly weigh-ins
Incentive / Instruction for maintaining food diary; computing caloric intake and noting circumstances that produce eating; invitation to nutrition lecture; low-calorie recipes plus:
Self-control:
Behavior modification and relaxation training
Control: weekly weigh-ins and pseudo- counseling in which experimenter listened passively to dieting issues / Most weight loss was seen in the deposit contract condition, followed by self-control and control.
Differences between conditions were not maintained at 10-month follow-up.
Jeffery, Bjornson-Benson, Rosenthal, Kurth & Dunn, 1984 (24) / 3 conditions
Control; Constant contract; Increasing contract / All deposited $150
Control: Completely refunded for attending first session
Constant Contract: Refunds in increments of $30
Increasing contract: Refunds in increments of $5, $10, $20, $40, $75 / Weekly / Average group weight loss (per 5 lbs) / Group nutrition, exercise and behavioral principles lessons + incentive / Group nutrition, exercise and behavioral principles lessons / Greatest weight loss was greatest in increasing contract condition, followed by constant contract and control.
Jeffery, Bjornson-Benson, Rosenthal, Kurth & Dunn, 1984 (24)
Maintenance Strategy / 2 conditions
Intensive maintenance; Nonspecific maintenance / Deposit of $100
Refund in increments of $25 / Every 3 months / Attendance at quarterly assessment session / Intensive: 6 intensive relapse prevention sessions, weekly problem-solving sessions+ incentive
Nonspecific: Nonspecific maintenance discussion sessions every 3 mo + incentive / No programs or incentive (individuals opting out of maintenance strategy) / Neither incentive type was effective in maintaining weight loss
Jeffery, Danaher, Killen, Farquhar & Kinnier, 1982 (34) / 4 conditions
Mail; mail + incentive; Mail+ incentive + calls; Behavioral group program +incentive / $50 deposit
Mail+ incentive & behavioral group program: $5 for timely receipt of homework via mail; $10 for attendance at final interview
Mail + incentives+ calls: $5 for timely receipt of homework via mail and making daily calls; $10 for attendance at final interview / Weekly / Mail + incentive & group behavioral program: homework completion
Mail+ incentive + calls: homework completion and calling in / Mail + incentive: spouse checked homework; incentive
Mail + incentives + call: spouse checked homework, required to call in daily for additional weight loss information; incentive
Group behavioral program + incentive: Same as incentive + mail, except homework was submitted in person during weekly meetings / Mail: Instruction manual detailing stimulus control, self-observation, eating rate, social support, nutrition, exercise and motivation; homework detailing weekly exercise and intake; homework submitted via mail / All conditions produced weight loss and did not differ from each other.
Homework completion rates not discussed.
Jeffery, Forster & Snell, 1985 (28) / 2 conditions
Early treatment; Delayed treatment / Self-selected amount of at least $5 deducted from biweekly paycheck / Early treatment: Refund given during first 3 months if weight loss goal was met
Delayed treatment: Refund given during second 3 months if weight loss goal was met
Money remaining in account was divided among participants who achieved their goals / Meeting a self-selected weight loss goal / Weigh-ins each payday; semimonthly diet and exercise educational session / N/A / 44% reached goal weight
More weight lost in the early treatment condition at 3 mo
More weight lost overall in delayed treatment at 6 mo
Size of incentive and size of goal did not impact weight loss
Jeffery, Gerber, Rosenthal & Lindquist, 1983 (25) / 6 conditions
A: $30 individual
B: $150 individual
C: $300 individual
D: $30 group
E: $150 group
F: $300 group / A: $30 deposit
Refunds in increments of $1
B: $150 deposit
Refunds in increments of $5
C:
$300 deposit
Refunds in increments of $10
D-F were same as A-C respectively / Weekly / A-C: Individual weight loss (per lb)
D-F: Average group weight loss (per lb) / Educational program detailing stimulus control, self-observation, eating rate, social support, nutrition, exercise and motivation; food and exercise records, behavior modification recommended + incentive / n/a / Individuals in group contracts lost more weight initially and at 1 year follow up than those in individual contracts
Contract size was positively associated with weight loss post-treatment, but not at 3- and 12-mo follow up
Jeffery, Thompson & Wing, 1978 (27) / 4 conditions
Weight contract; Calorie contract; Attendance contract; Control / $200 deposit
Refunds in $20 increments for meeting weekly goal / Weekly / Weight contract: 2 lb/week rate of weight loss or loss of 2 lbs
Calorie contract: mean daily caloric intake amount estimated to produce 2 lbs/week weight loss
Attendance contract: attendance / Behavioral principles lessons, weigh-ins + $200 deposit / Behavioral principles lessons, weigh-ins / All three contract conditions lost more weight than the control
Weight and calorie contracts were equally effective in producing weight loss, and more effective than attendance contracts and control
Jeffrey, 1974 (29) / 3 conditions
External control with nonrefundable contingencies; Self-control with refundable contingencies; Self-control with nonrefundable contingencies / $35 deposit
$1.75 refunded if at least 1 lb was lost that week
$2.50 refunded for improving eating habits
$5.25 for attending final weigh in
Fined $5 for missing a session / Weekly / Losing at least 1 lb since last week
Improving eating habits
Attendance at final weigh in
Attendance at session / Manual of weight control procedures plus:
External control with nonrefundable contingency: Therapist administered refund.
Money not refunded was forfeited
Self-control with refundable contingencies: Participant privately decided whether to take their refund regardless of having met goal. Any refund not taken was returned at end of treatment
Self-control with nonrefundable contingencies: Participant privately decided whether to take their refund regardless of having met goal. Any refund not taken was forfeited / N/A / Jeffrey, 1974 (35)
Kramer et al., 1986 (35)
Maintenance Strategy / 3 conditions
Skill focus; Weight focus; Control / $120 deposit
Deposited during initial treatment (Jeffery et al., 1985)
Refunded in increments of $10 / Monthly / Skill focus: attendance at meetings
Weight focus: attending meeting and weighing the same or less than previous month / Skill focus: Monthly group meetings; general dietary and physical activity information; skill practice during meetings; community referrals
Weight focus: Monthly group meetings; subject-initiated discussion of weight-related issues / No contact / Kramer et al., 1986 (42)
Maintenance Strategy
Mahoney, 1974 (30) / 4 conditions
Self-reward for weight loss; Self-reward for habit improvement; Self-monitoring; Control / $35 deposit
Participants refunded themselves at an unspecified rate / Weekly / Self-reward for weight loss: meeting weekly weight loss goal
Self-reward for habit improvement: meeting weekly habit control goals / Informational pamphlets, weight charts, food diaries, self-monitored weight and eating habits daily during two week baseline, weekly weigh ins, standardized habit control and weight loss goals, plus incentive (either self-reward for weight-loss or habit control) / Delayed treatment control
Self-monitoring: Informational pamphlets, weight charts, food diaries, self-monitored weight and eating habits daily during two week baseline, weekly weigh ins self-monitored weight and consumption; standardized habit control and weight loss goals / Mahoney, 1974 (36)
Romanczyk, Tracey, Wilson & Thorpe, 1973 (31) / 7 conditions
No treatment control; Treatment conditions A-F / $10 deposit
All participants told that $10 would be refunded at end of intervention if sessions were attended
Group F: Refunded at rate of $.50/lb / Weekly / Per lb. lost / Condition F: Condition E + deposit contract / Condition A: Daily self-weighing + information pamphlet
Condition B: A+ daily caloric intake self-monitoring
Condition C: B + symbolic aversion with therapist
Condition D: C+ relaxation training
Condition E: D + behavioral management and stimulus control instruction with therapist / Groups B-F lost more weight than no-treatment control and group A.