title: A low-cost reinforcement procedure improves short-term weight loss outcomes.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Connecticut School of Medicine, Farmington, CT, USA.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Petry
authors.forename: Danielle
authors.initials: D
authors.lastname: Barry
authors.forename: Linda
authors.initials: L
authors.lastname: Pescatello
authors.forename: William B
authors.initials: WB
authors.lastname: White
mesh_terms: D000328:Adult; D001290:Attitude; D015992:Body Mass Index; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics; D015444:Exercise; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008019:Life Style; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy / Q000191:economics; D009765:Obesity / Q000191:economics / Q000523:psychology / Q000628:therapy*; D050177:Overweight / Q000191:economics / Q000523:psychology / Q000628:therapy*; D014040:Token Economy; D015431:Weight Loss