Given rising rates of obesity in the U.S. and the many associated health problems, researchers have tested various strategies for weight loss. Both financial incentives and environmental changes — such as providing easy access to healthful foods and building in exercise opportunities — have shown promise. But which strategy works better? Do they work best when combined? And how do the results compare to those in people who receive only the “usual care” that many employers offer: yearly biometric screenings and reimbursements for fitness and weight management program participation? No randomized clinical trial had examined these questions, until now. 

A team lead by Karen Glanz, PhD, MPH, looked at weight loss in 344 racially diverse, obese employees of three different Philadelphia companies. The team found that participants in all three experimental groups lost weight. The financial incentives group lost slightly more weight, but none of the strategies netted significantly greater weight losses than the others — suggesting that employees with obesity may benefit from more intensive and individualized weight loss strategies. These results of the Healthy Weigh Study, which was conducted from 2015 to 2019, appeared recently in JAMA Network Open.