Adolescents with severe obesity who received meal-replacement therapy along with financial incentives saw a greater decrease in body mass index compared to those who only had meal replacement therapy, as per recent research published in JAMA Pediatrics.
Dr. Justin Ryder, Vice Chair of Research for the Department of Surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and Associate Professor of Surgery and Pediatrics at Northwestern University Feinberg School of Medicine, was one of the study’s co-authors.
Severe obesity affects around one in five children and adolescents in the U.S., according to the Centers for Disease Control and Prevention, and is defined as having a body mass index (BMI) at or above the 95th percentile for age and sex. This condition is linked to a higher risk of adult obesity, cardiovascular disease, type 2 diabetes, and other health issues.
Prior studies have shown that meal replacement therapy (MRT) is more effective than traditional lifestyle changes in lowering BMI in adolescents with severe obesity.
In this study, researchers wanted to see if pairing MRT with financial incentives for adolescents with severe obesity would enhance the effectiveness of MRT and lead to a greater reduction in BMI compared to MRT alone.
“There is evidence in adults showing that offering financial incentives for weight loss or physical activity programs boosts adherence. So we wanted to see if adding financial incentives to a behavioral/nutrition weight loss program utilizing meal replacement therapy would increase adherence and therefore improve the treatment’s effectiveness,” Dr. Ryder explained.
Out of the 126 adolescents in the study, 63 received MRT with financial incentives, while the other 63 received only MRT for a year. MRT consisted of pre-portioned meals totaling 1,200 calories per day, and financial incentives were given based on weight reduction from the initial baseline.
After 52 weeks, the group that received MRT with financial incentives had a more significant reduction in BMI (a 6-percentage point decrease) and a greater loss in total body fat mass (4.8 kilograms) compared to those who only had MRT.
“By conducting a cost-effectiveness analysis, we evaluated the mean fat mass lost between the two treatments and discovered that despite the additional meal replacements provided for each pound lost, it was cost-effective to do so,” Dr. Ryder added.
The authors emphasize the need for further research to develop interventions that extend beyond a year.
“Although financial incentives combined with MRT seem to be a longer-term strategy than MRT alone, stopping the treatment is likely to lead to an increase in BMI. Therefore, research is required to find strategies that are sustainable and practical in the long run given the chronic nature of obesity,” the authors noted.
This research was supported by grants from several organizations including the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institutes of Health National Center for Advancing Translational Sciences. Financial support for the meal program was provided by Healthy For Life Meals.
