DEAR DOCTOR K:
My employer has started offering employees financial rewards for weight loss. I’m skeptical. Does this kind of financial incentive really work?
Offering financial incentives to employees for making healthy lifestyle changes is increasingly common. These days, nearly 80 percent of large employers do it. There are many ways to offer incentives, and doctors and economists are still learning what works best.
Some experiments have been successful. For example, employees at two large companies were randomly selected to receive up to $800 to quit smoking. They were three times more likely to quit than employees encouraged to quit but not given money for doing so.
Other experiments have not worked as well. Employees in another company were selected at random to receive a bonus of $550 to lose weight. They were no more successful than employees not offered a bonus.
The timing of when the bonus is given appears to affect behavioral change. People who receive payments separately (not lumped in with their paycheck) and repeatedly (every month rather than at the end of the trial period) are more responsive to incentives.
How the incentive is provided may also affect a person’s response. For example, over three months, employees in one company were given a positive incentive to walk: $2 every day they walked 7,000 steps. Others were given a negative incentive for not walking. They received a “bank account” that contained all the money they might earn if they walked 7,000 steps each day. They then had $2 taken away every day they did not walk 7,000 steps. Both types of incentive worked better than no incentive at all. But the negative incentive — losing money you could have won — was a more powerful stimulus to regular walking.
There is some evidence that incentives work better when offered to groups of people, rather than on an individual basis. These programs usually involve financial incentives that are tied to the group’s success. When an individual fails to meet his or her personal goal, it reduces the bonus that all other members of the group will receive. If you fail to meet your personal goal, the others in the group suffer a financial hit — and they will know that you are the reason for it. It’s a powerful incentive not to miss your personal goal.
Even if it turns out that financial incentives do generally help people to adopt a healthy lifestyle, it remains to be seen how lasting this change in behavior will be. And it also remains unclear whether the savings to employers from reduced medical expenses due to healthier lifestyles will be greater than the money spent on the incentives themselves.
But as far as I’m concerned, it’s worth a look. Our lives are filled with incentives and disincentives designed to encourage actions that benefit both us and the people around us. From traffic lights to auto insurance premiums that drop if we avoid accidents or traffic tickets, our society tries to channel our behavior. I see nothing wrong with it — if it works.