BWHealthy Weight Pilot Study: A randomized controlled trial to improve weight-loss maintenance using deposit contracts in the workplace

Abstract Objective Deposit contracts, where participants “bet” on achieving a goal and get their money back only if successful, have been shown to be effective for short-term weight-loss. This pilot study examined their effect on weight-loss maintenance. Methods From 2016-2018, we conducted a pilot, 50-week randomized controlled trial among 42 hospital employees (19 intervention and 23 control), in Boston, Massachusetts, who lost ≥10 pounds (4.5 kg) in the two years prior to enrollment. Participants were recruited primarily in-person. Both control and intervention participants were asked to attend a weigh in weekly and received weekly email communication. Intervention participants also entered into a deposit contract to maintain baseline weight within ≤2 pounds (0.9 kg). We examined weight change from baseline to 50 weeks (primary outcome) and maintenance of baseline weight at 50 weeks (secondary outcome; binary – yes v. no). Participants completed baseline and follow-up surveys and received incentives for completion. Results At baseline, mean (SD) weight was 83.2 (15.5 kg) among intervention and 80.7 (14.5 kg) among control participants. After 50 weeks, intervention participants had slightly greater, nonsignificant decreases in weight (adjusted β -1.12 kg; 95% CI -5.28, 3.05); 73.7% of intervention v. 39.1% of control participants met their weight-loss maintenance goal by study end (adjusted OR 4.78; 95% CI 1.01, 22.71). Conclusions A deposit contract was not associated with differences in continuous weight but led to more participants meeting their weight-loss maintenance goals; it should be tested in a full-scale intervention. Most intervention participants viewed the deposit contract as acceptable.