The “carrot and stick” approach of rewarding overweight people with money for weight loss has been around for a few years, but I’m currently seeing some new interest in the topic. A 2008 article on the topic focused on England, where a “Pounds for Pounds” approach was being considered.
The same British paper ran a story over a year later updating the public on the program, touting the results of a loosely-controlled study which claims success. It seems that the program really was pretty successful, because Britain held on to the idea and increased payments that same year in a “Weight Wins” program which had 2,000 applicants for a mere 400 places; participants were paid up to a maximum of £425 for varying amounts of weight lost.
An update on the trial a year later says 45 percent of participants lost 5 percent of their body weight or more, making monetary reward “more successful than traditional diets.”
Now, what are the reasons behind government institutions like the UK’s NHS funding such programs? The reasons don’t lie far from the methods: money. The Western world is seeing a crisis of obesity which is costing institutions a hefty sum of cash; taking care of obese patients puts a strain on government’s finances as surgeries, medications and public services require extra care and readjustment. The US alone spends $168 billion on patients who are overweight or obese — and for every $1 spent on health care, 83 cents is spent on a patient who is overweight or obese.
In fact, some doctors are even closing their doors to obese patients, saying that those over 200 lbs put a strain on their equipment (such as examination tables), placing them at a higher risk of entering into a lawsuit if a patient falls and hurts themselves — a risk they would simply rather not take. Just under 15 percent of doctors polled feel this way, and since there is currently no law stating that doctors must treat all who come to them, they are free to run their business as they see fit, as it is — after all — a business.
The UK is taking this bribing methodology pretty seriously, because they are currently pushing forth a plan to pay GPs for referring their obese and overweight patients to weight management programs and for suggesting they live healthier lifestyles.
In another twist, the state of Arizona wants to chip away at its Medicaid bill by fining obese people $50 (other than parents and/or those with a medical condition).
It surely is good to see some changes in a problem which is known to be growing — just over a quarter of the US population is currently obese, and future prognoses of the situation are looking pretty grim with strains on healthcare costs and resource division (like doctors’ time). But should we really address the problem by paying people for doing one thing or fining them for another? My personal response is a resolute “No”.
Despite the positive changes that such programs may bring, they are a flimsy band-aid at best, and bury the real problem deeper, at worst.
By rewarding people monetarily, this type of program in no way contributes to building individual’s mental strength (that which is required to restrict oneself from over-indulgence in food) while at the same time encouraging materialistic reward for the most priceless of possessions: one’s health. However, it is surely the case that some families will benefit from some added income, although the sums awarded are pretty meager for many to lean on.
There is also the concept that such a program has little way of assessing whether a patient has stuck with the plan or not, and — once again — does not address those individuals suffering from underlying causes of mental illness (ranging from what would be considered mild forms of depression, lack of control or other, more serious and deeper possible concerns).
Although it may be the case that a lot of overweight individuals will benefit from a better diet and exercise plan, monetary reward does not teach a predisposition to these lifestyle choices, and doesn’t seem to have at its heart the desire to instill these values in the target population.
There is also the problem of a large proportion of the overweight population suffering from obesity because there is simply no access to fresh food in their neighborhoods, which are often the poorest ones; not to mention the very striking lack of education about such matters to these same groups.
And on the other end of the spectrum, consumerism rears its ugly head again, with corporations selling us “pretty” food that is absolutely laden with chemicals, yet is advertised so well that most, if not all of us, simply can’t help but salivate at it during commercials.
Monetary rewards are simple, flimsy band-aids that seem to create some positive effects yet get nowhere near the heart of the problem. The organizations behind this monetary scheme no doubt know the complexity of the issue, but there are always new and clever plans surfacing to help individuals lead better lives. But the answer ultimately lies in a re-education of the masses — it will (inescapably) involve the dollar bill, yet will also require some heftier tools.
All images: mahalie/Flickr