Obese men sent texts like 'avoid the kebab shop' and paid cash rewards for losing weight in 'Game of Stones'
15 May 2024, 06:36
Obese men have been taking part in a medical trial where they were paid money for losing weight.
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The trial, nicknamed 'Game of Stones', saw dozens of men from Bristol, Belfast and Glasgow with an average body mass index (BMI) of 37 told they would get £400 each if they met weight-loss goals.
They were also told they would lose some of the money if they failed to meet their targets.
Researchers said that the trial showed that a similar approach could be cheaper for the NHS than traditional weight management programmes as it requires fewer staff.
It could also help reach people from poorer areas, they added.
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The men were texted lifestyle advice messages every day of the 12-month trial, including to change their route home to avoid the kebab shop, as well as weight management information.
A second group was given the same messages but without the financial incentive. A third group was just given weight management information.
The first group lost 4.8% of their body weight on average, compared to 2.7% in the second group and 1.3% in the third group.
Professor Pat Hoddinott, of the nursing, midwifery and allied health professions research unit at the University of Stirling led the study.
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She said it was inspired by "behavioural economic theory which proposes that people are more motivated by the prospect of losing money than the prospect of gaining money
"However, not everyone can afford to deposit their own money, so we designed the Game of Stones trial, which uses an endowment incentive, where the money is put in an account at the start, allowing men on low incomes to join."
Prof Hoddinott also stressed the study was able to recruit people from areas "normally under-represented in weight management trials".
"A text message-based programme, meanwhile, costs less and is less labour-intensive than a traditional weight loss programme."
Men who were living with obesity helped design the structure of the incentives and helped us write the text messages."
She added: "Some 39% of the men lived in less affluent areas, 71% reported a long-term health condition, 40% reported two or more long-term conditions and 29% reported that they were living with a disability.
"In addition, 25% of the men told us they had a doctor-diagnosed mental health condition and a further 24% reported low mental health scores."
Men included in the financial incentives group received £128 each on average at the end of the study, with 27 receiving the full £400.
Prof Hoddinott said: "We reached an underserved group of men who seldom take part in health promotion activities.
"Weight management programmes are traditionally intensive, often with a weigh-in every week or two.
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"In Game of Stones, there are just four brief ten-minute weigh-ins over a year.
"No intervention is delivered by the staff at the weigh-ins, so minimal staff training is required. No referral is needed to join.
"Men and NHS staff really valued this low-burden approach and it has the potential to address health inequalities. It was a win-win for all."
Jane DeVille-Almond, from the British Obesity Society, said: “This is exciting news and we definitely need an easy and cost-effective way of getting society to lose weight.
“Men are a particularly difficult group to engage in our healthcare system, so texts and financial incentives is a great way forward.”
