A Low-Cost Reinforcement Procedure Improves Short-term Weight Loss Outcomes

OBJECTIVE: Reinforcement-based treatments, based on behavioral economics models, can improve outcomes of medical conditions with behavioral components. This study evaluated the efficacy of a low-cost reinforcement intervention to produce initial weight loss. METHODS: Overweight individuals (n = 56) were randomized to one of two 12-week treatments: Lifestyle, Exercise, Attitudes, Relationships, Nutrition manual with supportive counseling or that same treatment with opportunities to win $1 to $100 prizes for losing weight and completing weight-loss activities. RESULTS: Patients receiving reinforcement lost significantly more weight (6.0% +/- 4.9% baseline bodyweight) than patients in the non-reinforcement condition (3.5% +/- 4.1%; P = .04). Moreover, 64.3% of patients receiving reinforcement achieved weight loss of >= 5% baseline bodyweight versus 25.0% of those in the non-reinforcement condition (P = .003). Proportional weight loss was significantly related to reductions in total cholesterol and 24-hour ambulatory heart rate. CONCLUSION: This reinforcement-based intervention substantially enhances short-term weight loss, and reductions in weight are associated with important changes in clinical biomarkers. Larger-scale evaluation of reinforcement-based treatments for weight loss is warranted. (C) 2011 Elsevier Inc. All rights reserved. . The American Journal of Medicine (2011) 124, 1082-1085