Researchers have looked at the use of financial incentives or rewards for promoting health behavior change, including weight loss, going beyond the behavioral components of weight loss therapies (Haggar et al., 2013; Lynagh, Sanson-Fisher, & Bonevski, 2013; Schwartz, 2009). It's not a new concept to include financial incentives in employee health programs (Moller et al., 2012). According to a 2008 survey of significant American firms, 70% of employee wellness programs employed financial incentives to boost either participation or performance (Moller et al., 2012). Although it is a fairly typical practice in wellness programs, there is still debate over the effectiveness of financial incentives in weight loss interventions. While it seems that using financial incentives may help people lose weight during the intervention period (Jeffery, Wing, Thorson, & Burton, 1998; Moller et al., 2012; Tucker, May, Bennett, Hymer, & McHaney, 2004; Volpp et al., 2008), there has been evidence of an inverse relationship between the incentive and weight loss maintenance (Moller et al., 2012; Paul-Ebhohimhen & Avenell, 2007; Volpp et al., 2008). A thorough evaluation of weight loss material incentives (such as cash rewards, prizes from lotteries or deposits, or non-monetary rewards like food vouchers or gifts) came to no firm conclusions concerning their efficacy (Burns et al., 2012).
Although results for weight loss are ambiguous, using rewards has shown some success in changing behavior (Paul-Ebhohimhen & Avenell, 2007). The analyses revealed a few sluggish tendencies in favor of financial incentives, with the following as the main objective: a) employing rewards that are more than 1.2% of personal disposable income; b) rewarding behavior change rather than weight loss; and c) rewarding depending on group success.
instead of a person's performance (Paul-Ebhohimhen & Avenell, 2007). It's interesting to note that the lackluster results about the effectiveness of a financial incentive in changing behavior may have less to do with the quantity of motivation provided and more to do with the quality of the motivation.
Once the incentive is gone, it has been suggested that the lack of sustainability may be caused by the incentive's "undermining influence" on intrinsic motivation (Deci, Ryan & Koestner, 1999; Haggar et al., 2013; Moller et al., 2012). The role of financial incentives in a behavioral intervention to promote a healthy lifestyle was examined by Moller et al. in 2012. The financial incentive was found to be unrelated to behavior change during the intervention and to become negatively associated with behavior change once the incentive was removed by Moller et al. (2012), providing the first evidence for the undermining effect in the context of a healthy living intervention (Moller et al., 2012). Haggar et al. (2013) added that in addition to the social and environmental elements that affect human behavior, researchers should take into account the functional relevance of incentive-based behavior modification (i.e., the autonomous vs. controlling character of the reward).
Motivation
It has been discovered that applying theory to health behavior change research is helpful for locating key concepts, boosting predictive power, and making theoretical improvements (Sharma, 2007). Despite this understanding, a review of behavioral interventions aimed at treating or preventing adult obesity found that the majority of programs lacked constructs related to established theories of health behavior (Sharma, 2007). Additionally, clinical reviews indicate that compliance with
The primary factor determining behavioral approaches to weight control is treatment regimens (Teixeira, Carraca, Markland, Silva, & Ryan, 2012a). There have been calls for the intervention attempts to address weight control to incorporate motivational theory (Teixeira, Silva, Mata, Palmeira, & Markland, 2012b).
However, Powell et al. (2007) noted that motivation in whatever capacity (amount or quality) is conspicuously lacking from their list of essential elements in their study of successful obesity therapies. Teixeira et al. (2012b) issue a warning that the success of a weight loss intervention may be hampered by the omission of motivational variables. They go on to say that a better strategy should include how different levels of motivation affect the results of interventions.
Theory of Self-Determination
Self-Determination Theory (SDT), developed by Deci and Ryan in 2002, is a general theory of human motivation, emotion, and personality that has been used in behavior change research to describe and explain the mechanisms underlying both initial and ongoing participation (Ryan, Patrick, Deci, & Williams, 2008). SDT is predicated on the idea that people have a natural tendency to have a unified sense of self (i.e., of being more self-determined; Deci & Ryan, 2002). Although this propensity is a basic aspect of human life, a variety of events can have a positive or negative impact on it (Deci & Ryan, 2002). Persuasive evidence for the effectiveness of SDT in understanding and predicting PA behavior and weight reduction was established by a comprehensive evaluation of the PA and SDT literature (Teixeira et al., 2012a). Strong evidence was found to support the relationship between more autonomous behavioral rules, exercise, and the more intrinsic types of motivation that predict involvement across a variety of populations (Teixeira et al., 2012a).
Theory of Organismic Integration
There are more detailed mini-theories inside the SDT framework that explain the elements of human development, assimilation, and integration of the self within the social world that come together to generate human behavior (Deci & Ryan, 2002; Wilson, Mack & Grattan, 2008). The SDT sub-theory known as Organismic Integration Theory (OIT) provides a multidimensional perspective of motivation and distinguishes between the quantity and quality of motivation (Deci & Ryan, 2002). Deci and Ryan (2002) make the specific argument that lower quality motivation can still result in higher levels of motivation (i.e., quantity) without necessarily producing more desirable results.
According to Deci and Ryan (2002), there are three types of motivation that control behavior: amotivation (lack of action intention), regulated (or external regulation), and autonomous (or intrinsic) motivation. Conceptually distinct types of extrinsic motivation that vary in how much of a cohesive sense of self they present span these extremes. According to Ryan et al. (2008), controlled motivation consists of introjected regulation (motivated to comply with a partially internalized regulation to gain pride/self-esteem or to avoid feelings of guilt or shame) and external behavioural regulation (motivated to obtain a reward or to avoid punishment). Embracing one's own significance and values, integrating those values and aims with other aspects of oneself, and engaging in internal control are all examples of autonomous motivation (engaging in behaviour for the intrinsic satisfaction of the behaviour alone). Deci and Ryan (2002) claim that moving from one form of motivation to the next along the continuum is a constructive step in the integration and internalization process and may lead to improved results for behavior change, increased autonomy in self-control, and feelings of competence (Ryan et al., 2008). While being both directive and
Engagement for autonomous incentives is connected to increased long-term persistence, more adaptive behavior, and well-being across a variety of areas. Autonomous regulations may energize and direct behavior (Deci & Ryan, 2002).
There is a great deal of evidence to support the proposed motivational continuum, according to an evaluation of three PA therapies that used implicit SDT-based components (Fortier et al., 2012). When compared to controls, interventions using SDT-aligned programming have shown greater improvements in measured outcomes (such as PA motivation and behavior) (Fortier et al., 2012; Silva et al., 2010; Teixeira et al., 2012a). Silva et al. (2010) observed that obese women who participated in a one-year weight management intervention based on SDT (Deci & Ryan, 2002) lost more weight and reported more PA at the conclusion of the 12-month period than the controls (Silva et al., 2010). Further, there was a substantial direct relationship between long-term weight loss and autonomous motivation for PA at the two-year point, maintaining the correlation between autonomous regulation and greater PA (Fortier et al., 2012). The use of SDT in the context of PA and weight loss is supported by the favorable correlation between higher levels of autonomous regulation and increased quantities of PA that has been demonstrated (Fortier et al., 2012).
Research Hypotheses and Questions
(1) Does participation in a weight reduction challenge affect weight loss and MVPA over the course of a short (12 weeks) and long (6 months) period when compared to a "do as you do" control group of fitness center members? and (2) What psychological processes underlie modifications in weight loss and MVPA? The following are the hypotheses that underpin these study questions:
H1: Based on studies showing the effectiveness of a 12-week exercise program (Jolly et al., 2011), it was hypothesized that taking part in a 12-week weight loss challenge would result in bigger reductions in weight loss and higher MVPA when compared to a control group.
H2: According to Jolly et al. (2011), weight loss and an increase in MVPA that occurred right after the intervention persisted after six months.
H3: Regardless of condition, those reporting more autonomous regulations for MVPA would report greater weight loss and physical activity than those reporting more controlled motivation, according to theoretical (Deci & Ryan, 2002) and empirical literature (Edmunds, Ntoumanis, & Duda, 2007; Silva et al., 2010; Teixeira et al., 2012a).
H4: In line with Silva et al. (2010), people who are taking part in a weight reduction challenge will show more internalization and integration of the rules for exercising than those who are in the control condition.
Objectivity of the Study
The current study broadens the existing research by taking into account the difficulties with short-term weight loss in for-profit exercise facilities. A thorough investigation indicated that clinical and academic settings have been the primary locations for the majority of weight reduction intervention studies (Shaw et al., 2006). However, there is evidence to suggest that commercial fitness centers are increasingly providing weight loss programming and challenges as part of their services to club members (Thompson, 2011; Tucker et al., 2004). However, there hasn't been much research that attests to the usefulness of these programmed products in business contexts. Due to its site and methodology, the current study is comparatively unique. It was carried out in a commercial, multi-purpose fitness
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Facility. These facilities are open all year to offer exercise and dietary advice to community members trying to get fitter or lose weight. For the typical person, having access to this kind of programming may be more useful and convenient.
Additionally, because the intervention took place in a business rather than a clinic or hospital, the stigma associated with participating in a weight-loss intervention may be diminished (Schwartz, Chambliss, Brownell, Blair, & Billington, 2003). Primary care must better integrate with the community, according to the results of a successful wellness challenge for Type II diabetes patients held in a for-profit fitness facility. This is necessary to successfully reduce obesity and chronic illness (Tucker et al., 2004). Consequently, better access and engagement may be the result of the communal setting.
Research has proven that combining improved PA with a good diet and exercise is more beneficial at helping people lose weight than either diet or exercise alone (Sharma, 2007). According to the Cochrane analysis from 2006, programs incorporating exercise only slightly increased weight reduction; but, when paired with nutritional treatments, weight loss was significantly increased (Shaw et al., 2006). Based on this research, the current trial included weekly one-on-one sessions that included behavioural goal-setting, exercise and food logging, as well as standardized and uniform dietary2 and exercise information. The exercise part entailed balancing aerobic exercise with resistance training and generally increasing both of their intensities. The majority of weight loss programs using enhanced MVPA report significant but small (less than 5 kg) weight reductions right after the intervention, as was previously mentioned (Catenacci & Wyatt, 2007; Yancey et al., 2006). It's been suggested that this might be because doctors only prescribed a small dosage of MVPA to help patients lose weight (Catenacci & Wyatt, 2007). Since both weight loss and elevated MVPA were intended
Following the findings of this study, the participants were urged to increase their PA time in any increment, up to and including 300 minutes per week (Catenacci & Wyatt, 2007; Jakicic, 2009; Jeffery, Wing, Sherwood, & Tate, 2003).
The fact that there were numerous and diverse points of interaction with the participants was another strength of this study. Importantly, each participant in the challenge got weekly 60-minute one-on-one coaching/training sessions because research has shown that interventions that involve face-to-face interaction are more effective at promoting the maintenance of healthy behaviors (Conn et al., 2011; Fjeldsoe, Neuhas, Winkler & Eakin, 2011). Additionally, participants had access to biweekly educational lectures and cooking demos that taught them about nutrition, making nutritious meals, getting the most out of their workouts, managing stress, and changing their behavior.
This study's longitudinal design was created with the goal of identifying the changes and variations in internalization of motivation that participants may have experienced. These changes were then applied to the participants' assessed outcomes in order to suggest an underlying mechanism of change. Longitudinal studies have been suggested as a way to evaluate the internalization process (Edmunds et al., 2007), with changes in reported behavioral motivation being observed to occur following a 12 week intervention (Wilson, Rodgers, Blanchard, & Gessel, 2003). The current analysis took into account how long the intervention-induced change in motivation will last. Few studies on weight loss include a behavioral theory component to evaluate and possibly explain their findings (Sharma, 2007; Teixeira et al., 2012b). However, because the motivations were not deliberately changed, it is outside the purview of this study to interpret and explain the mechanisms leading to the internalization of behavioral rules.
Additionally, 65% of intervention studies (i.e., the majority) fail to collect and provide maintenance outcome data, according to the research (Fjeldsoe et al., 2011). In this review, Fjeldsoe et al. (2011) used a defined duration of at least 3 months post-intervention for the evaluation of maintained behavioral result. The current study monitored and assessed the maintenance of MVPA behavior change and weight loss three months after therapy. More successful behavior change maintenance was reported by behavioral interventions that focused on dietary modifications compared to those that focused on PA, and combination interventions only produced good maintenance when a more condensed definition of maintenance was adopted (Fjeldsoe et al., 2011). Given that significant weight loss typically requires at least six months (Sharma, 2007) and that the consequences of being overweight or obese are a serious health concern in Canada (PHAC, 2011), intervention research aimed at changing health behavior and weight loss should be conducting and reporting maintenance data at the six-month time point.