Frequency of contact and monetary reward in weight loss, lipid change, and blood pressure reduction with adolescents

Obese adolescents were assigned randomly to one of four treatment groups in a 2×2 factorial design. The factors were monetary reinforcers (for weight loss vs. caloric change), and frequency of therapeutic contact (five times vs. one time per week). Subjects in all treatment groups participated in classes for 15 weeks to learn behavioral self-management skills taught by health counselors with the aid of videotaped instructional materials. The treatment group receiving rewards for weight loss and coming to the clinic five times per week was the only group to reduce significantly in percent overweight during the treatment program. Treatment effects for this group were maintained over a 6-month follow-up period. Clinically and statistically significant changes in recommended directions in blood pressure, total cholesterol, high density and low density lipoproteins, and triglycerides were correlated with changes in weight. Subjects expressed satisfaction with participation in the program. The results suggest that frequent monetary and social reward help young persons achieve and maintain weight loss.