Dr Norman Swan cautions against radical idea to PAY people to lose weight

ABC health guru Norman Swan has cautioned against a radical proposal to pay people to lose weight to help reduce the obesity epidemic.

Explaining a recent study from the US on the ABC, the Scottish-born doctor said that paying people from disadvantaged groups to shed fat ‘can be helpful’ but often isn’t sustainable long term.

Around two in three adults in Australia are overweight or obese, with Anthony Albanese’s government under increasing pressure to tackle the public health crisis.

ABC health guru Norman Swan has provided a note of caution about a radical proposal to pay people to lose weight to help reduce the obesity epidemic

Speaking on Tuesday, Dr Swan explained that in ‘countries like the US and Australia obesity is dominant’ in poorer and more disadvantaged groups while reflecting on research about paying people to lose weight.

‘They paid you to attend a weight loss programme and change your behaviour according to the programme.

‘Or they paid you for the amount of weight you lost, a bit like the Biggest Loser,’ he added, referring to the hit TV weight loss show.

‘What they found was if they paid you to lose weight you did, but it wasn’t sustainable.

Dr Swan was referring to researchers who provided financial incentives to some of 668 morbidly obese adults in New York City and Los Angeles with losing 10 pounds (or 4.5kgs) within six months (stock image)

‘If they paid you to do a programme that changed your behaviour, that was much more sustainable’.

The doctor was referring to researchers who tasked 668 morbidly obese adults in New York City and Los Angeles with losing 10 pounds (or 4.5kgs) within six months.

Over six months, up to half of the people given cash incentives hit that target compared with 22 percent of study participants given no monetary motivation.

What were the different financial strategies?

Researchers randomized morbidly obese adults into three different groups.

All groups were offered training in weight loss, membership to WW Freestyle (formerly Weight Watchers), scales and a FitBit to help.

But only two were offered cash incentives to get them to hit the target of losing five percent of their weight, or about 10lbs (4.5kg) in six months.

Cash linked to behaviour changes:

$150 in month one only for registering and attending half of weekly weight management sessions;
$60 a month from months two to six for attending at least half of weekly weight management sessions;
$30 a month in the study for filling in at least five days of their food journal per week and recording their bodyweight at least three days per week;
$20 a month in the first three months for 75 minutes of exercise per week, and in the next three for 150 minutes of exercise per week.

Cash linked to weight loss. All percentages are compared to weight at the start of the study:

$50 in month one for losing 1.5 to 2.5 percent of weight, or $100 for losing more than 2.5 percent;
$50 a month for losing 2.5 to 5 percent of body-weight, or $100 a month for losing more than five percent of weight in months two to three;
$100 a month for losing 2.5 to 5 percent of body-weight, or $150 for losing more than five percent in months four to six.

Dr Melanie Jay, a medic at NYU Langone, said her study provided ‘firm evidence’ that cash incentives could help solve America’s bulging waistline.

Despite this, Dr Swan said it was a ‘simplistic approach’ and that ‘financial motivations don’t work’.

‘It works to some extent but you have to be careful what you pay for,’ he warned.

His comments come after one of Australia’s top Covid-19 experts said lockdowns have drastically affected the health of children as a study shows two years of coronavirus restrictions have made people fatter and unhealthier.

Professor Peter Collignon, an influential infectious diseases physician with the Australian National University, shared a medical study on his Twitter last year in which American experts researched the link between the pandemic response and obesity in children and adolescents.

‘Lockdown measures affected healthy lifestyle behaviors through modification of dietary habits, reduction of physical activity and alteration of sleep patterns, and also increased the levels of stress and anxiety, overall promoting weight gain and obesity,’ Prof Collignon wrote on Twitter.

‘Paediatric overweight/obesity—an alarming epidemic of increasing proportions, before Covid-19, has been demonstrated to be the most important independent risk factor for the development of severe infections in youths, requiring admission to hospital/ICUs,’ Prof Collignon said.

Estimates show four in 10 American adults are obese.

In the study — published in December in JAMA Internal Medicine — scientists recruited 668 people between November, 2017 and May, 2021.

Participants weighed 218 pounds (lbs) (98.8kg) on average at the start of the study, with a BMI of nearly 38 — placing them in the morbidly obese range.

They were all from low-income households earning below $40,000 [$58,000AUD] a year, with more than eight in 10 being female and aged 18 to 70 years old. The majority were from Hispanic backgrounds.

They were split into three groups, with each tasked to lose about five percent of their body weight — or 10lbs (4.5kgs) — within six months.

All participants were enrolled in a weekly local weight management program meeting and given a one-year membership to the WW Freestyle commercial weight loss program.

They were also handed a digital scale, food journal and FitBit tracking device to help monitor their progress.

Dr Jay said: ‘New tools are needed beyond encouragement and education to help some people struggling to cope with obesity.’

‘There is no single solution to America’s worsening weight problem. Our national approach has to include multiple approaches, including incentives tailored to the different needs of groups most profoundly impacted by illness and disease tied to obesity, such as type 2 diabetes, heart disease, and some cancers.’

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