Willpower apparently can be bought. The chance to win or lose $20 a month enticed dieters in a yearlong study to drop an average of 9 pounds — four times more weight than others who were not offered money to pass up the doughnuts.

Many employers, insurers and Internet programs dangle dollars to try to change bad habits like smoking or not exercising, but most studies have found this doesn’t work very well or for very long.

The new study, done with Mayo Clinic employees, was the longest test yet of financial incentives for weight loss. Doctors think it succeeded because it had a mix of carrots and sticks — penalties for not losing weight, multiple ways to earn cash for succeeding, and a chance to recoup lost money if you fell off the “diet wagon” and later repented.

Incentives are “not like training wheels where people learn healthy habits and then will continue them on their own” — you have to continue the motivation to achieve success, said one study leader, Dr. Steve Driver of Mayo in Rochester, Minn.

In setting up such a system at work or among friends, the key is to make it self-sustaining, Driver said. The Mayo study did so by having people who didn’t lose weight put penalties into a fund to reward those who did.

It’s also a good idea to make people pony up in advance. One woman flew into a tizzy when she stepped on a scale at a weigh-in and was told she’d have to pay.

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“She headed for the door” but later came back and paid, Driver said. “People in Minnesota are pretty honest.”

Driver will discuss the study this weekend at an American College of Cardiology conference in San Francisco. The group released results Thursday. Mayo paid for the study and Driver owns stock in Gympact, a company with an Internet program that gives financial incentives for exercising.

The diet study involved 100 obese employees at Mayo Clinic but was not a workplace wellness program. Half were given weight-loss counseling, monthly weigh-ins and a three-month gym membership. The others had those things plus financial incentives.

The aim was to lose 4 pounds a month up to a goal that depended on their starting weight. If they failed, they paid $20 into a kitty. If they succeeded, they got a voucher to collect $20 when the study ended. Part of the kitty was used to pay the rewards. The rest was put into a lottery that anyone could win, whether they had made their weight-loss goals or not.

“People saw that if they stuck with it, they had a chance at winning more than they had lost,” Driver said.

Participants in the financial incentives group also earned $10 a month and lottery “tickets” for coming to monthly weigh-ins and texting their weights to study leaders each week, said Dr. Don Hensrud, preventive medicine chief at Mayo.

Overall, people could have lost as much as $240 or won as much as $360, plus what built up in the lottery fund.

 


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