Weight Wins and Public Health
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“Our ambition is to be the first major nation to reverse the rising tide of obesity and
overweight in the population . . .”
– HM Government, ‘Healthy Weight, Healthy Lives – A Cross Government Strategy for England’ (2008)
The obesity epidemic has become a leading public health challenge in much of the world. The World Health Organisation estimates that 1 billion adults are overweight, with 300 million obese. In Europe, the UK is European leader in overweight, with 31 million overweight adults – 63% of the adult population; 12 million (24%) are obese. The cost to society is £16 billion annually, and the direct cost to the National Health Service in treating obesity and consequences – Type 2 diabetes, heart disease, and cancer – is £4 billion.
In 2008, the UK government announced a major policy initiative to stem obesity, with £372 million in funding. The Department of Health’s ‘Healthy Weight, Healthy Lives’ strategy calls for outsourcing of obesity services to the private sector and individual financial incentives to lose weight.
Incentives are a good investment for everybody when they encourage people to change their behaviour and learn to lead a healthy lifestyle. Incentives appeal to people, especially men, who do not respond to traditional invitations to join weight loss programmes or improve their lifestyle.
Weight Wins is among the first to respond to the government’s call, designing a behaviour change service for Primary Care Trusts built around its Pounds for Pounds programme. The service has been found to deliver the most successful outcomes for long-term weight loss of any behavioural programme. The monthly weigh-ins offer much greater programme accountability. Finally, the emphasis on financial rewards attracts ‘hard-to-reach’ members of the population. NHS Eastern and Coastal Kent was the first to commission the service from Weight Wins.
NHS Eastern & Coastal Kent
The PCT has a rate of adult obesity above the England average, and undertook the first public trial by the NHS of weight loss incentives. The PCT recruited the initial cohort of 300 men and women (later expanded to 400) in January 2009 using Health Trainers, referrals, workplace health programmes and public advertising. A total of 2,300 applications were received. Most participants applied via a dedicated website.
“We are very pleased with the response to the Weight Wins trial. . . . It appears to have motivated people across east Kent to think about losing weight. Weight Wins have managed the programme very effectively and efficiently . . .”
– Claire Martin, Public Health Specialist
Evidence
Randomised control trials have already established the short-term effectiveness of financial incentives in weight loss. (Finkelstein, Journal of Occupational and Environmental Medicine, September 2007; Volpp, JAMA Journal of the American Medical Association, December 2008). The Weight Wins programme is the first to produce significant long-term outcomes, with approximately 50% of individuals maintaining a weight loss of at least 5% of body weight.
“The NOF believes that the Pounds for Pounds programme from Weight Wins is a revolutionary approach to encouraging long term behaviour change among overweight and obese individuals. Based on promising early results, the NOF believes the programme and others like it could play a large role in personal wellness and public health. We will be watching for successful results and further evidence of efficacy.”
- The Trustees, National Obesity Forum
