The effectiveness of a monetary reimbursement model for weight reduction via a smartphone application: a preliminary retrospective study

Weight loss for obese populations has been a challenging subject. There are numerous mobile applications to address weight loss, but the low retention rate is a barrier for the intervention. This is a retrospective study, aiming to investigate the effectiveness of financial incentives to achieve weight loss via a monetary reimbursement model on a smartphone application. Participants voluntarily purchased a 16-week mobile weight loss application program, and those who logged food intake three times a day received monetary reimbursement up to the full amount they initially paid. We analyzed health-related information and logged in-app activities from participants (N = 2,803) including age, sex, weight, food intake, and physical activity on their mobile healthcare application called Noom from January 2017 to April 2019. Analysis of covariance (ANCOVA) was used to compare differences between groups who succeeded and failed at food logging, controlling for baseline BMI. The ANCOVA found that participants who completed the food logging successfully for 16 weeks (N = 1,565) lost significantly more weight than those who failed food logging (N = 1,238, F = 56.0, p < 0.001). In addition, participants who were able to log their food intake successfully exercised more (F = 41.5, p < 0.001), read more in-app articles (F = 120.7, p < 0.001), and consumed more quantity of healthy foods (F = 12.8, p < 0.001). Monetary reimbursement is an effective tool for weight reduction by encouraging participants to monitor their health-related behaviors regularly.