Obesity, Money, and the Mayo Clinic


At first glance, it seems as if media product such as a weight-loss TV show, or a large-scale international public-relations event like Dubai’s “Your Weight in Gold” competition, might tell us something about the relationship between weight loss and the prospect of financial reward. But because of all the complicating factors and conditions, they turn out not to be useful exemplars.

What happens under different circumstances? Marilynn Marchione wrote for Huffington Post about a study whose subjects were 100 obese Mayo Clinic employees. Think about it for a second. We’re talking about one of the world’s foremost medical facilities, and nobody even seems surprised that there were so many obese Mayo Clinic employees from which to choose. But doesn’t that fact, in and of itself, speak volumes about the obesity epidemic’s pervasiveness?


The institution has examined its own situation before, in 2012, and the headline reads, “Obesity outweighs smoking in employer health cost.” That’s right:

Mayo Clinic researchers tracked health care costs of more than 30,000 Mayo Clinic employees and retirees from 2001 through 2007. Obese employees cost the health care organization $1,850 more each year than their nonobese peers, compared to the excess $1,275 spent annually on health care costs of employees who smoked.

Employees who are more than 100 pounds overweight (termed ‘morbidly obese’) cost their employer, on average, $5,500 more than their nonobese peers.

Back to the present

The recent new research has the distinction of being the most lengthy study of the effect of financial incentives on weight loss that had yet been undertaken. For half the participants, the program was “weight-loss counseling, monthly weigh-ins and a three-month gym membership.” The other half were entitled to the same benefits, plus a rather detailed schedule of possible financial rewards and penalties. Pragmatically, the money part had to be self-sustaining, with the slackers’ penalties paying for the rewards of the diligent.

Theoretically, the most a person could win for the year would be $360, plus whatever surplus had built up in the pot. The most a person could lose over the course of the year would be $240. The end result was that those in the financially remunerative half of the study lost four times as much weight as those who were only in it for the counseling and use of the gym. Marchione writes:

The cash was a big motivator for one study participant — Audrey Traun, 29, a lab training specialist who dropped 40 pounds, from 215 pounds to 175.

‘I was impressed. I didn’t think I was quite capable of that,’ said Traun, who lives in Kellogg, Minn. As the study went on, though, the cash became less important, and ‘it was actually more motivating to see my progress — pounds lost and how my clothes were fitting,’ she said.

Unfortunately, Ms. Traun’s experience may have been the exception. One study leader, Dr. Steve Driver, told the reporter that incentives do not function in the same way as training wheels for a novice bicycle rider. (Another type of doctor might have said that incentives do not resemble booster rockets that fall away when the space capsule achieves escape velocity, because it never does.)

Also quoted is a financial expert from King’s College, London, Eleni Mantzari, who said that once the financial motivation has ceased, people often return to their former unhealthful habits. Even worse, it appears that even when the incentives are still being offered, somehow the willingness to participate wears off. Although many conscientious employers and insurers offer rewards to people who quit smoking, start exercising, and so on, apparently these programs don’t live up to their potential.

Your responses and feedback are welcome!

Source: “Weight Loss Bribes: Cash Can Entice Dieters To Drop Pounds,” HuffingtonPost.com, 03/07/13
Source: “Mayo Clinic study: Obesity outweighs smoking in employer health cost,” MayoClinicHealthSystem.org, 05/01/12
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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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