Cash for weight loss? Experts say yes to NHS savings (diabetes, heart disease) but mental health risks complicate. Pexels

The NHS offers financial incentives of up to £400 to obese men participating in a weight loss program that includes supportive text messages.

The "Game of Stones" trial provides daily text message tips to participants, including suggestions like "walk a different route home to avoid the kebab shop" and "don't treat your body like a skip."

The significant weight loss encouraged researchers to believe the program can be rolled out across the NHS. This approach is more effective than traditional slimming classes. Funded by the government, the study recruited 585 men in Bristol, Glasgow, and Belfast through local GP surgeries.

The program challenged participants to lose 10 percent of their body weight within a year and ensure they maintained the loss for a chance to win a £400 cash incentive. On average, men lost 4.8 percent of their body weight, receiving a proportional reward (averaging £128). Currently, 27 men have achieved the full 10 percent weight loss target and were awarded the full £400 incentive.

The program's success hinged on messages written "by men, for men," which resonated better than traditional classes, where men reported feeling talked down to. The incentive structure also played a key role.

Participants received £50 for achieving a 5% weight loss within three months, with an additional £150 for reaching the 10% mark by six months. To further encourage long-term weight management, participants could earn an additional £200 by maintaining their 10 percent weight loss for another six months.

NHS Considers Cash Rewards for Weight Loss

The program included four weigh-ins throughout the year to track progress. The promising results of this ongoing trial, presented at the European Congress on Obesity in Venice, have also prompted researchers to explore its effectiveness with women.

According to some experts, financial incentives for weight loss could be a cost-effective strategy for the NHS in the long term. They believe this approach can significantly reduce healthcare costs associated with obesity-related conditions like diabetes and heart disease.

However, a 2023 study by the Medical University of Vienna adds another dimension. The study found that obesity significantly increases the risk of developing mental disorders, suggesting a potential need for a more comprehensive approach beyond just weight loss.

Professor Pat Hoddinott, from the University of Stirling in Scotland and the study's lead author, expressed confidence in the program's scalability, stating it's "ready to scale up now, and we're confident it can be done."

"The weight lost was greater than for a lot of the behavioural weight management services that are currently offered across the UK. They tend to be very intensive, and we found they don't appeal to men," she noted.

Professor Hoddinott acknowledges the multifaceted benefits of weight loss, including improved well-being, reduced risk of chronic diseases like diabetes, and alignment with the NHS's focus on men's health.

However, she recognises the challenge of traditional weight loss groups for men, which is why this program's tailored approach is promising. "The research showed that offering cash incentives was a popular and effective way of helping men to lose weight," she added.

The "Game of Stones" initiative presents a potentially cost-effective solution for the NHS. It requires minimal resources, Professor Hoddinott said. Notably, financial rewards are only provided upon achieving milestones – in this case, losing over 5 percent of starting body weight. This approach incentivises successful weight loss while minimising upfront costs for the health service.

Researchers found the program attractive for GPs, potentially superior to the current recommendation of attending 12 weight-loss sessions.

"Attendance drops off a lot for those [slimming classes]– it is good at the start, but people stop going. As a GP, I saw that all the time, so I wanted to design something easier for the NHS. Texts alone were not enough – the financial incentives were that extra little motivator," Professor Hoddinott said.

Statistics Show a Significant Rise in Obesity Rates

Professor Hoddinott expressed optimism that the program could be self-sustaining in the long term. Reduced treatment needs for participants would lead to cost savings for the NHS.

Research highlights the significant cost disparity between caring for obese patients and those with a healthy weight. The NHS spends an average of £979 to £1,375 more per year on obese patients due to the higher prevalence of chronic illnesses like heart disease, type 2 diabetes, and joint pain.

The President of the British Obesity Society, Jane DeVille-Almond, suggests that cash rewards could be more cost-effective for the NHS than staffing intensive weight loss clinics.

"This is exciting news and we 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," she said.

The urgency of addressing obesity is underscored by a recent study published in the Lancet medical journal. The research reveals a staggering statistic: over one billion people worldwide now suffer from obesity, a more than fourfold increase since 1990. This alarming trend coincides with efforts like the NHS program, which explores innovative ways to tackle this global health crisis.