A Low-Cost Reinforcement Procedure Improves Short-term Weight Loss Outcomes - 20/10/11

Doi : 10.1016/j.amjmed.2011.04.016

Nancy M. Petry, PhD ^a,^⁎ , Danielle Barry, PhD ^a, Linda Pescatello, PhD ^b, William B. White, MD ^a
^a Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Conn
^b Department of Kinesiology and Human Performance Laboratory, University of Connecticut, Storrs, Conn

Requests for reprints should be addressed to Nancy M. Petry, PhD, Professor of Medicine, Calhoun Cardiology Center, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-3944

Abstract

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.

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Keywords : Behavioral economics, Obesity, Reinforcement, Weight loss

Plan

Materials and Methods

LEARN+Supportive Counseling

LEARN+Supportive Counseling and Reinforcement

Results

Discussion

Conclusions

	Funding: The research and preparation of this report were supported by University Connecticut Health Center/Storrs Regional Campus Incentive Grants P30-DA023918, R01-DA024667, and M01-RR006192.
	Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript.
	Authorship: All authors had access to the data and played a role in writing this manuscript.