Social Incentives and Gamification to Promote Weight Loss: The LOSE IT Randomized, Controlled Trial

Background Social networks influence obesity patterns, but interventions to leverage social incentives to promote weight loss have not been well evaluated. Objective To test the effectiveness of gamification interventions designed using insights from behavioral economics to enhance social incentives to promote weight loss. Design The Leveraging Our Social Experiences and Incentives Trial (LOSE IT) was a 36-week randomized, controlled trial with a 24-week intervention and 12-week follow-up. Participants One hundred and ninety-six obese adults (body mass index ≥ 30) comprising 98 two-person teams. Interventions All participants received a wireless weight scale, used smartphones to track daily step counts, formed two-person teams with a family member or friend, and selected a weight loss goal. Teams were randomly assigned to control or one of two gamification interventions for 36 weeks that used points and levels to enhance collaborative social incentives. One of the gamification arms also had weight and step data shared regularly with each participant’s primary care physician (PCP). Main outcome measures The primary outcome was weight loss at 24 weeks. Secondary outcomes included weight loss at 36 weeks. Key results At 24 weeks, participants lost significant weight from baseline in the control arm (mean: − 3.9 lbs; 95% CI: − 6.1 to − 1.7; P