title: Insurance coverage and incentives for weight loss among adults with metabolic syndrome.
abstract: OBJECTIVE
  To describe how insured adults with metabolic syndrome respond to various options for insurance coverage and financial incentives for weight management.
  
  
  METHODS
  Insured adults meeting the criteria for the metabolic syndrome were randomly identified through automated medical records and invited to participate in a telephone-based survey of the acceptability of various weight management programs-with different financial incentives and insurance coverage options-in a health maintenance organization. Multivariable logistic regression models were used to test the relationship between participant characteristics and the odds of being motivated by incentives.
  
  
  RESULTS
  One hundred and fifty-three adults with the metabolic syndrome completed the survey (i.e., 79% of telephone contacts). A hypothetical increase in insurance coverage from 10 to 100% led to a threefold increase among women and a sevenfold increase among men in the proportion reporting they were "very interested" in enrolling in a weight management program within the next 30 days. Most participants (76% of women and 57% of men) supported a health plan-sponsored financial incentive program tied to weight loss, and 41% believed such a program would motivate them to lose weight. The mean financial incentive proposed for a 15-pound weight loss was $591 (median: $125).
  
  
  CONCLUSIONS
  Although weight loss is an effective treatment for metabolic syndrome, standard health insurance rarely covers intensive behavioral treatment. The results of this study suggest that providing full insurance coverage and financial incentives for weight management increases the interest in participating in obesity treatment programs. Further research should determine how full coverage and incentives affect participation rates, long-term body weight changes, and costs.
authors.affiliation: Group Health Center for Health Studies, Seattle, Washington, USA. arterburn.d@ghc.org
authors.forename: David
authors.initials: D
authors.lastname: Arterburn
authors.forename: Emily O
authors.initials: EO
authors.lastname: Westbrook
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Wiese
authors.forename: Evette J
authors.initials: EJ
authors.lastname: Ludman
authors.forename: David C
authors.initials: DC
authors.lastname: Grossman
authors.forename: Paul A
authors.initials: PA
authors.lastname: Fishman
authors.forename: Eric A
authors.initials: EA
authors.lastname: Finkelstein
authors.forename: Robert W
authors.initials: RW
authors.lastname: Jeffery
authors.forename: Adam
authors.initials: A
authors.lastname: Drewnowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005260:Female; D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000191:economics / Q000503:physiopathology / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D015431:Weight Loss