A Question of Scale

The bad news: Massachusetts is facing an obesity crisis. The good news? There’s a way to fix it.

“When trying to get people to lose weight, we’re basically asking them to do less of the things that on some level they enjoy,” Volpp says. Because the pressure of dieting is constant and the rewards are so long-term, the money helps focus the dieter’s mind on something tangible and immediate. Even small incentives, Volpp says, “change the equation.”

He admits there remains much work to be done, especially with regard to how well people keep off the weight. Yet that hasn’t stopped others from seizing on similar ideas as a means to control obesity — and healthcare costs. One Boston startup that recently moved to New Hampshire, Tangerine Wellness, contracts with companies to operate an on-site weight-loss incentive program for employees. (If sales incentives worked, the thinking went, why not weight-loss incentives?) One client, a small Illinois manufacturing company, reports it has saved 10 percent on healthcare costs annually, or $50,000 to $60,000, since launching the program.

There are other firms like Tangerine out there, such as Denver-based Incenta-Health and Weight Wins in the U.K., which contracted with that country’s National Health Service for a pilot program to help 400 obese Britons lose weight. A year in, the Weight Wins dieters have lost an average of 29.2 pounds, or 13.4 percent of initial body weight.

YOU MIGHT ARGUE THAT Massachusetts has no business paying people to shape up. But the fact is, we’re already footing the bill. It’s just happening on the back end of the process, in the form of ballooning medical costs.

I don’t expect the state to start paying schoolkids to lose weight tomorrow, but there’s still plenty we could do. Some insurance companies already build in longer-term weight-loss and health incentives. Why couldn’t they implement shorter-term incentives, too? Better yet, Massachusetts could offer tax breaks to firms that participate in a Tangerine-like program, or even run its own pilot program for state employees, modeled on Great Britain’s.

The carrot doesn’t even need to be money — but it’s got to be something, and it’s got to be a hell of a lot more appealing than, say, a carrot (especially without ranch dressing). Cash just happens to be the one thing we know everybody likes. As for me, toward the end of high school I dropped 60 pounds, several belt sizes, and two chins. I didn’t change my diet and start working out because I stopped liking chicken wings or suddenly discovered that Skittles don’t count as a serving of fruit; it happened because my priorities shifted. I slogged through hours of exercise and gave up my weekly double orders of Chinese food because at college I was hoping to finally, you know, attract girls by means other than my gravitational pull. That simply became more important to me than eating whatever I wanted. It had a lot to do with motivation and very little to do with a new world view of food and exercise. Now, if only there were some way to make me less awkward.             

  • Ashley

    I like the idea of incentivizing behavior (in general, not just this context) and I wonder in this context if it could be applied more proactively. For example health plans offer $150 reimbursements

  • Ashley

    for members who attend the gym. What about adding something like that for people who maintain a healthy weight?