• Posted May 15, 2024

One Key to Weight Loss for Men: Competing for Cash

A competitive game with a potential cash reward appeared to help overweight British men lose weight, researchers report.

The incentive was winning the "Game of Stones" -- a stone is a British measurement of body weight equal to 14 pounds -- and pocketing the equivalent of just over $500 in American dollars if the man achieved weight-loss goals.

Weight loss was more successful among men who engaged in Games of Stones versus those who weren't offered the challenge, said a team led by Dr. Pat Hoddinott, of the University of Stirling in Scotland.

Nevil Chesterfield, 68, lost weight and called Game of Stones "a real success for me."

"The financial incentive was important -- it did give the project tremendous credibility when I explained it to my peer group," he said in a news release from the University of Bristol, which partnered in the research.

"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," Chesterfield said.

The premise of Game of Stones was simple.

Men living with obesity were promised the cash reward if they met three weight-loss targets: 5% weight loss at three months, 10% at six months and maintaining that 10% weight loss at 12 months.

The study itself involved 585 men from the United Kingdom, averaging 51 years of age, who were all obese. Many faced unique challenges. For example, 39% lived in poorer neighborhoods, 29% had some form of disability, 25% had been diagnosed with a mental health condition and 40% had multiple long-term health issues.

The men were divided into three groups: One was simply asked to lose weight without any additional support; another group was issued daily supportive text messages to help them on their weight-loss journey; and a third received the texts and were enrolled in the Game of Stones competition.

"This was a very carefully planned study, created for men with men," Hoddinott said. "We worked closely with various men's health groups and charities, including Men's Health Forum in the UK and Ireland, with more than 1,000 men living with obesity informing the design of the incentive structure."

Overall, 73% of the men completed the full year of study follow-up.

The results showed that the texts-plus-competition group lost the most weight: An average 5% drop in body weight over the 12-month study.

That's compared to an average 3% drop in weight among the guys that got the supportive texts only, and only a 1% decline among men who got neither the texts nor the cash game.

The findings were published May 14 in the Journal of the American Medical Association and were simultaneously presented at the annual European Congress on Obesity in Venice, Italy.

Belfast resident Ciarán Gibson, 35, was in the Game of Stones group.

"After struggling for many years with losing and keeping off weight through diet and exercise, I thought I might benefit from being part of the study to keep me motivated to reach my goals," he said.

"The appointments were infrequent and easy to attend but regular enough to keep me feeling accountable for my weight loss," Gibson added. "I didn't want to go to my next appointment having put on more weight! I was very happy with my progress. I believe I lost just shy of two stone over the course of the study. It's helped with my arthritis and overall, I'm much happier with having a more healthy BMI."

Of course, handing out $500 to people to lose weight could raise eyebrows. Study co-author Frank Kee, a public health physician at Queen's University in Belfast, acknowledged that.

"Given the huge cost imposed upon the [British] 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," he said. "We are currently examining this health economic question in more detail."

More information

There's help for losing weight at the American Heart Association.

SOURCE: University of Bristol, news release, May 14, 2024