Incentivizing Behavior Change Skills to Promote Weight Loss

In this study, community outpatients will participate in an effective, 24-week,
low-carbohydrate weight loss program delivered via biweekly group classes. An innovative
information technology (IT) solution will collate dietary self-monitoring data (input by
patients via a mobile phone dietary application) and weight loss data (input by patients via
remote scale). An algorithm will classify participants as achieving adequate or inadequate
dietary self-monitoring and weight loss to earn intermittent rewards of varying value in
real-time. Participants will be notified of earning rewards via text messaging.

Inclusion Criteria:

- desire to lose weight;

- agree to attend visits per protocol;

- access to telephone and transportation;

- English speaking;

- able to complete study measures;

- smart phone with data and texting plan;

- body mass index 30 kg/m2 or greater

Exclusion Criteria:

- pregnancy, breastfeeding, or lack of birth control if premenopausal

- dementia, excessive alcohol use, or psychiatric illness

- weight loss >4.5 kg in month prior to screening

- weight > 380 lb (due to limit of cellular scale)

- enrollment in other weight loss program

- residing in nursing home or receiving home health care

- unable to attend weight loss group at scheduled times

- impaired hearing

- medication other than metformin, incretin mimetics and incretin enhances for type 2
diabetes

- unstable heart disease in 3 months prior to screening

- furosemide 40 mg or higher (or equivalent)

- chronic kidney disease

- 2 or more errors on cognitive screener

- blood pressure ≥160/100 mmHg