Here’s Another Commitment Device for Weight Loss

We recently wrote about the use of commitment devices in weight loss, particularly the recent spike in bariatric surgery. While advocates can make a strong argument in favor of the surgery, especially for the morbidly obese, it is obviously a pretty drastic resort.

An article in the current Journal of the American Medical Association highlights a far less invasive commitment device: the pedometer. It turns out that if you give someone a pedometer, especially if you give them a goal for how many steps they should be taking in a day, the results are pretty wondrous:

The results suggest that the use of a pedometer is associated with significant increases in physical activity and significant decreases in body mass index and blood pressure.

There is, however, a strong qualifier:

Whether these changes are durable over the long term is undetermined.

Ah, but that’s always the rub with commitment devices and weight loss, isn’t it? It’s a lot easier to commit and improve in the short term, especially when someone’s watching your behavior. The long term, unobserved, is another matter entirely. Which is probably why bariatric surgery, which is as close to a permanent commitment device as you can get, will continue to rise.

Maybe a newfangled pedometer is called for — something like an electronic ankle bracelet (think Disturbia, if you must) that not only measures your steps but also gives a little electric shock when you spend too much time on the couch.


pdm

I have designed and have patent pending on a commitment device for weight loss. It is a travel club that requires its members to lose a designated weight to travel. Members sign up and weigh in. Members are grouped with about 4 other dieter/travelers. Each member purchases a share of a travel voucher and signs a contract for weight loss. Each might buy a $300 share of $1500 voucher. Now the members must lose a designated weight in a set time - say 15 lbs in 4 month. At the end of the 4 months members are again weighed. The voucher is divided among those members who made weight. The voucher can be then augmented and used to purchase travel through the travel service. The service serves as a referee for the group. It performs the weigh ins and bundles the groups. It may also help with other elements of weight loss. Profit is made through the sale of travel and dues.
The degree of commitment is leveraged by a number of factors: dieters would feel the reward for the weight loss would be the whole trip - not just $300. Travelers usually travel with friends - the friends would also be invested in the weight loss. This commitment serves as a carrot and a stick- there is obvious reward but there is the possible negative reenforcement that other people would be traveling with your money while you are left behind.
Procrastination is the dieters biggest enemy. Dieters don't choose to stop dieting. They just postpone their weight loss. The time limit in this device prevents the procrastination.
Dieters usually gain back their losses. This device could also be used for maintaining weight. The game could be played again with a 1 year period to keep the weight off.

It is not a winner take all contest. Ideally everyone wins by losing. The travel service sells more travel to more people if the success rate is high.

Read more...

PMA

Obesity, what a terrible word that is, for most of my life I have been heavy, big boned, chubby, solid and even fat. Though the one term, to me that dehumanises the condition of being overweight is obese.

We don't plan to get fat or obese, it seems to happen all on its own. The result of this problem is lower self esteem and feelings of guilt, which often is the root cause of the problem in the first place.

I found the answer to my weight problem was not diets or exercise programs, it was being a little kinder to myself, understanding that the problem of being over weight was not who I am, it is just a condition that I needed to come to terms with and tackle like I would any other emotional problem.

Once I made this choice, I started to fell better about myself immediately, I started to go for a walk five or six times a week, I now my walk about an hour or so each day. Baby steps to start. Remember “Inch by Inch everything's a cinch”.

The one thing I do try to focus on is who I am, and picture what I want to become. It works! The new you us not a destination, it is a journey, so you can be a success as soon as you commit to a change. You may fall off the rails occasionally, that's OK. We are mistake makers, that's our nature. We are also Mistake Breakers and can rise above anything so long as we never give up.

Take heart, I know how you feel, really I do, you can do it.
theteam@awareness-guide.com

Read more...

JS

Weight loss surgery - I think we are going to be astounded when the long term success rates are revealed.

Ryan

Maybe we could take the ankle bracelet idea a step further (no pun intended) and place an RFID tag in it. Every day you do not step on a RFID-readable treadmill for a predetermined amount of time you get a shock. At the very least, you would get some use out of that Gold's Gym membership you bought for your New Year's resolution.

Angeline Duopu

I can't believe she had to buy the lifelike plastic models of human body fat just to help her with her weight lost process. I thing if she really want to lose weight, than she will work harded by going to the gym to work out and washing what she eat, how much of it that she eats and what time she eats it.

Angeline Duopu

I think it's very inportant that people in general but mostly women are concerned about there health, body and how other people think about them yet than still, who really care where you are size one or size two? I think those who truly loves you will still loves you no matter how you look, or how many pounds you weigh. Knowing your self and staying healthy is the mayjor thing that I think any teenager should think about and not wanteing to be like other celebrates in magnizes.

Michael Vanderdonk

While the shocking bracelet is a good idea, I don't think that will work any better long term either.

To avoid exercise and gain 100 pounds, you have to ignore many messages from your body. Some of these are in the form of pain. Bariatric surgery works on the idea that a small stomach forces less food intake, but their stomach was smaller to start with! So while it might work short term, long term that small shock can be 'ignored'.

Terry

How about instead of an electric shock, the pedometer would send a text message to all of your friends and family with the amount of "steps" taken and whether or not you met your daily goal. (Sort of like a virtual weight watcher buddy system.)

You might be more determined to continue using the pedometer just to save face, or to walk more "steps" to beat yout friend in a competition.

Tammy

The 10,000 steps program is encouraged in workplaces around Australia: http://www.10000steps.org.au/
It is not necessarily about obese people reducing their weight, although it can help, but about every day people maintaining a healthy lifestyle.

Gene Shiau

In the interest of journalistic fairness, let's look at a different opinion on the weight loss issue. CBC Radio recently interviewed Gary Taubes, the author of Good Calories, Bad Calories, who argues that it's not how much you eat or exercise but what you eat (white flour and sugar, for example) that makes you fat (http://www.cbc.ca/quirks/archives/07-08/nov17.html). Using that reasoning, no commitment devices, be it pedometer and ankle bracelet or lipoplasty and bariatric surgery, are going to provide permanent solution; on the other hand, you could potentially be a lean couch potato (!?) so long as you eat right.

Am I more inclined to accept Taubes's dietary argument or Freakonomics author's belief on the commitment devices? Ah, that would be an interesting question to ask. But the Wizard of Oz needs to give me a brain before I can answer that one.

www.reddoorhomeloans.com

If a device were developed that could be inserted internally, health insurance premiums come into play. If a person voluntarily agreed to insert the device, the individual could be eligible for reduced insurance premiums (rate of premium reduction dependent upon how many steps they took each day).

Allogene

I am curious why most health solutions especially weight loss programs are geared only on the physicality of problem. Some attempt to mix in the psychological, as poster #6 mentioned and there are a few that add an economic element into the mix. Some of the programs require membership fees or offer prepackaged meals add an economic element but I have rarely seen one that adds real economic incentive to lose weight.

Poster #10 mentions an economic incentive from premium discounts but I do not think that is enough. Not to go beyond the scope of the post too much but why is it that health care coverage is universal? Everyone has different health needs and obese people require more than a fit person or so that is the main concern today. Why should a fit person be required to offset the true costs of healthcare for obese people. If economic theory teaches us anything, it is that money is a powerful motivator for both supplier and those in demand. If obese people were required to pay for the full true costs of their healthcare they may have second thoughts about eating an entire pizza or a 12 oz steak with garlic mashed potatoes (with extra butter and sour cream) and not eat the vegetables.

Why does it cost me, a fairly healthy person, almost $1200 a year to buy insurance for services I barely use? (I do it in case of an emergency) Perhaps if the government removed themselves from the healthcare business and let true market forces establish the true cost of healthcare procedures people would see how expensive it is to be obese. Another step would be to stop calling bleached flour flavored with HFCS, salt and hydrogenated oils (AKA fat) food people would stop eating it. Maybe if we called it, unhealthy, artery clogging, fat adding, not going to fulfill your hunger crap people would understand what they are putting into their bodies. Anyone ever wonder why these "food" items cost cents on the dollar? It is not because they were grown and required labor to produce them. Ever wonder why we do not provide these "food" items to countries that are starving? It is not because these items are healthy and will actually prevent starvation.

OK done with that. I could go on but to sum it all up focusing solely on the individual is not the entire answer. It is one part of a much bigger problem.

Read more...

Ryan Drew

Allogene,

I greatly enjoyed your extreme examples, but believe there is merit in health care providers offering incentives for maintaining (and tracking) a healthy lifestyle. As competition requires more product/offering differentiation, a 'take it or leave it' offer will be just that, left on the table in favor of better pricing/incentives.

Such an idea/offering would never succeed if customers believed sharing information led to their data being reviewed to find loopholes to deny coverage.

Allogene

I agree with your correlation of personal data and coverage denial being a factor in competition but I believe that idea is already in use in many other industries and each industry works to balance the use of data in exchange of service.

My issue is where the control is, and moving towards equilibrium with the suppliers. Basic economics no? Our healthcare system is a poorly regulated oligopoly, leaving consumers fewoptions to purchase a healthcare solution which suits their needs. These "commitment devices" offer nothing to the consumer except higher dependency (less negotiation power and higher switching costs) on the existing system. In a true free market system their would be a perfect healthcare solution each consumer, probably unfeasible due to costs of management but a system that has more flexibility and allows the consumer more control of the specific services they require would be part of an overall solution that would lead to a more healthy populace.

We have erased, to a large extent, our responsibility in our own health and put it in the hands of doctors. The doctors were tired of being sued by people not listening to them or by their own mistakes so they formed companies/partnerships to help mitigate their responsibility and low and behold the responsibility for our health is now in the hands of large corporations. Sorry but I do not need GE telling me what foods I should eat, what doctors I can see (god forbid I want to see some other doctor I need a permission slip from my doctor who charges me for a visit just to get permission to see the other doctor), what medicines I should take, what tests I need and what hospital I can go to.

Am I blind or does anyone else not see this as a problem?

Read more...

Jonathan

If people merely have a smaller stomach then the chances are they'll keep eating a lot of the really bad food they've been taking in. Neither will smaller stomachs stop small regular snacking.

All of which makes me wonder whether there will be any impact on cholesterol and associated ailments, or merely on obesity (and its other associated ailments).

Ryan Drew

Industries are beginning to move away from universal coverage to tailored programs, and performance rewards (Nationwide Insurance rewards for staying out of accidents).

How difficult would it be to include the pedometer feature in a watch, log an individuals daily steps, and report back to the prospective health care insurance company, for review and potential reward? Understandably, it is only one factor towards maintaining a healthy lifestyle, but is permission based and has the potential to be mutually beneficial.

Allogene

Sorry Ryan (post 12) I think that is a horrific idea. Why are you giving the healthcare provider so much control over your health? How long before they tell you you have to walk 50,000 steps before you can eat a cookie. Or sorry you are having a heart attack but you did not walk your daily required steps so we are not required to help you, good luck and we hope you have a good day, oh and if you are going to die, please leave the premises; we do not cover body disposal.

Extreme? Maybe but we need less micromanagement and tell the companies this is how I want to do business with you instead of them telling us this is what we offer take it or leave it. Problem with their approach is they are backed by the government and we have no other options. We need real options and given real options we will find real solutions that benefit us and not the large corporations running everything. (I am not anti-business or anything but I do find it interesting we regulate media companies owning various forms of distribution but have little regulation on large corporations that own farming operations, food processing, food distribution, grocery stores, helathcare companies, insurance companies, medical research companies, drug companies, etc.)

Read more...

Meadehead

A novel legally oriented commitment device

From ATL

http://www.nysun.com/article/66874?page_no=1

pdm

I have designed and have patent pending on a commitment device for weight loss. It is a travel club that requires its members to lose a designated weight to travel. Members sign up and weigh in. Members are grouped with about 4 other dieter/travelers. Each member purchases a share of a travel voucher and signs a contract for weight loss. Each might buy a $300 share of $1500 voucher. Now the members must lose a designated weight in a set time - say 15 lbs in 4 month. At the end of the 4 months members are again weighed. The voucher is divided among those members who made weight. The voucher can be then augmented and used to purchase travel through the travel service. The service serves as a referee for the group. It performs the weigh ins and bundles the groups. It may also help with other elements of weight loss. Profit is made through the sale of travel and dues.
The degree of commitment is leveraged by a number of factors: dieters would feel the reward for the weight loss would be the whole trip - not just $300. Travelers usually travel with friends - the friends would also be invested in the weight loss. This commitment serves as a carrot and a stick- there is obvious reward but there is the possible negative reenforcement that other people would be traveling with your money while you are left behind.
Procrastination is the dieters biggest enemy. Dieters don't choose to stop dieting. They just postpone their weight loss. The time limit in this device prevents the procrastination.
Dieters usually gain back their losses. This device could also be used for maintaining weight. The game could be played again with a 1 year period to keep the weight off.

It is not a winner take all contest. Ideally everyone wins by losing. The travel service sells more travel to more people if the success rate is high.

Read more...

PMA

Obesity, what a terrible word that is, for most of my life I have been heavy, big boned, chubby, solid and even fat. Though the one term, to me that dehumanises the condition of being overweight is obese.

We don't plan to get fat or obese, it seems to happen all on its own. The result of this problem is lower self esteem and feelings of guilt, which often is the root cause of the problem in the first place.

I found the answer to my weight problem was not diets or exercise programs, it was being a little kinder to myself, understanding that the problem of being over weight was not who I am, it is just a condition that I needed to come to terms with and tackle like I would any other emotional problem.

Once I made this choice, I started to fell better about myself immediately, I started to go for a walk five or six times a week, I now my walk about an hour or so each day. Baby steps to start. Remember "Inch by Inch everything's a cinch".

The one thing I do try to focus on is who I am, and picture what I want to become. It works! The new you us not a destination, it is a journey, so you can be a success as soon as you commit to a change. You may fall off the rails occasionally, that's OK. We are mistake makers, that's our nature. We are also Mistake Breakers and can rise above anything so long as we never give up.

Take heart, I know how you feel, really I do, you can do it.
theteam@awareness-guide.com

Read more...