A 12-month incentive based weight loss study aimed to reduce weight and improve overall health of Singaporeans. Conducted by Duke-NUS Graduate Medical School and the LIFE Centre at SGH to improve the 4-month Obesity Management program (OBM) at LIFE. Funded by NIHA (NUS Global Asia Institute). Obesity is a critical public health problem in Asia. Prevalence of Overweight (BMI > 25) in Asia 60% 50% 40% 30% 20% 10% 0% Singapore S. Korea Malaysia Thailand Philippines Indonesia Males Females Vietnam Among Asians, BMI > 23 increases disease risk Based on a BMI of 30, obesity rates in Singapore increased from 5% in 1992, to 7% in 2004, to roughly 11% in 2010 Source: WHO Global NCD Info Database https://apps.who.int/infobase/CountryProfiles.aspx (Data: Indonesia 2001; Vietnam 2002; Philippines 2003; Thailand, Singapore 2004; Malaysia 2006; S. Korea 2007) Obesity leads to several serious health problems such as heart disease and stroke, diabetes, osteoarthritis etc. Activity Goals Monthly Weight Loss Target: Lose 1kg or more or BMI<23.5 Step Target per Month: 10,000 steps on pedometer on at least 20 days. (1st month: target 8000 steps for at least 20 days) Significant Weight Loss Target: Weight loss of 5% and 8% of baseline weight or if BMI<23.5 Guarantee d Payments Lottery Payments (1 in 10 chance) $20 $200 $20 $200 Month 4: $100 Month 4: $1000 Month 8: $200 Month 8: $2000 1 individual consultation with a physician 2 individual sessions with a clinical coordinator 2 individual and 3 group sessions with dieticians 1 supermarket visit with a dietician 1 fitness assessment 4 supervised gym sessions Hours: Mondays to Fridays 8:30am-5:30pm Baseline CONTROL (NO INCENTIVE) GUARANTEED PAYMENT 4 mo. 12 mo. 4 mo. PROGRAM No Incentives No Incentives No Incentives TRADITIONAL INCENTIVES ($20/month) No Incentives BEHAVIORAL INCENTIVES ($200/month) No Incentives 4 mo. PROGRAM TRADITIONAL INCENTIVES ($20/month) LOTTERY PAYMENT (1 in 10 chance) 8 mo. 4 mo. PROGRAM BEHAVIORAL INCENTIVES ($200/month) YOU CANNOT CHOOSE WHICH STUDY GROUP TO JOIN AND CANNOT SWITCH GROUPS. YOU’LL BE RANDOMALLY ALLOCATED TO ONE OF THE TWO GROUPS AFTER YOUR STUDY STATUS IS CONFIRMED •A Pedometer: It is a step counter that records and displays the number of step you take per day •Best worn on the hip above the thigh. Can be used with clip included; clip can be attached to clothing or to a belt •Automatically resets to zero at midnight every night Pressing MEMO button will show step activity over past 7 days Pass an health assessment screening. Pay $234 in cash or check payable to ‘Duke-NUS Graduate Medical School’ to enroll in the OBM program (50% off standard rate). Pay $165 in cash to the study team to enroll in the incentive programme. This amount will be refunded to participants allocated to the control arm. Participants must attend follow up sessions at 4, 8 and 12 months. $20 will be paid for attendance. There is also a lottery to win an Apple ipod at each session. Ask the study team any questions Sign the consent form Pay the enrollment fee Complete a questionnaire Sign the OBM indemnity form Make your first appointment for the OBM program