'Game of Stones' trial saw some obese people lose weight for £400

A trial has found that sending text messages offering cash incentives to overweight people could help them shed more pounds.

Researchers believe this method could be a cost-effective alternative for the health service compared to traditional weight management programmes, as it requires fewer staff and can reach people from more deprived areas. The year-long study, dubbed 'Game of Stones', involved 585 men from Bristol, Belfast and Glasgow with an average body mass index (BMI) of 37.7, divided into three groups.

One group was informed that £400 was set aside for each participant in an account, which would be transferred at the end of the trial. However, if they failed to meet their weight loss targets, money would be deducted from the total, reports Bristol Live.

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This group also received daily texts containing motivational messages, lifestyle change tips, links to online information, and access to a study website on weight management featuring local services and an online tracker to monitor weight changes. The second group received the same messages but without the financial incentive, while the third group only had access to the weight management information.

At the end of the study, 426 men logged their weight after 12 months. The financial incentives group saw an average weight loss of 4.8%, compared to 2.7% in the group who received the same messages but without any financial rewards, and 1.3% in the third group.

The study was led by Professor Pat Hoddinott from the University of Stirling's nursing, midwifery and allied health professions research unit and was presented at the European Congress of Obesity (ECO) in Venice. She explained that the study was inspired by "behavioural economic theory which proposes that people are more motivated by the prospect of losing money than the prospect of gaining money".

"However, not everyone can afford to deposit their own money, so we designed the Game of Stones trial, which uses an endowment incentive, where the money is put in an account at the start, allowing men on low incomes to join. A text message-based programme, meanwhile, costs less and is less labour-intensive than a traditional weight loss programme.

"Men who were living with obesity helped design the structure of the incentives and helped us write the text messages." Prof Hoddinott also highlighted that the study managed to recruit participants from areas "normally under-represented in weight management trials".

She added: "Some 39% of the men lived in less affluent areas, 71% reported a long-term health condition, 40% reported two or more long-term conditions and 29% reported that they were living with a disability. In addition, 25% of the men told us they had a doctor-diagnosed mental health condition and a further 24% reported low mental health scores."

Men in the group receiving financial incentives pocketed an average of £128 each by the study's conclusion, with 27 bagging the full £400. Prof Hoddinott said: "We reached an underserved group of men who seldom take part in health promotion activities.

"Weight management programmes are traditionally intensive, often with a weigh-in every week or two. In Game of Stones, there are just four brief ten-minute weigh-ins over a year.

"No intervention is delivered by the staff at the weigh-ins, so minimal staff training is required. No referral is needed to join. Men and NHS staff really valued this low-burden approach and it has the potential to address health inequalities. It was a win-win for all."

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