Incentivizing Behavior Change Skills to Promote Weight Loss

In this study, community outpatients will participate in an effective, 24-week, low-carbohydrate weight loss program delivered via biweekly group classes. An innovative information technology (IT) solution will collate dietary self-monitoring data (input by patients via a mobile phone dietary application) and weight loss data (input by patients via remote scale). An algorithm will classify participants as achieving adequate or inadequate dietary self-monitoring and weight loss to earn intermittent rewards of varying value in real-time. Participants will be notified of earning rewards via text messaging.

Inclusion criteria

• desire to lose weight;
• agree to attend visits per protocol;
• access to telephone and transportation;
• English speaking;
• able to complete study measures;
• smart phone with data and texting plan;
• body mass index 30 kg/m2 or greater

Exclusion criteria

• pregnancy, breastfeeding, or lack of birth control if premenopausal
• dementia, excessive alcohol use, or psychiatric illness
• weight loss >4.5 kg in month prior to screening
• weight > 380 lb (due to limit of cellular scale)
• enrollment in other weight loss program
• residing in nursing home or receiving home health care
• unable to attend weight loss group at scheduled times
• impaired hearing
• medication other than metformin, incretin mimetics and incretin enhances for type 2 diabetes
• unstable heart disease in 3 months prior to screening
• furosemide 40 mg or higher (or equivalent)
• chronic kidney disease
• 2 or more errors on cognitive screener
• blood pressure ≥160/100 mmHg