Dr Joseph Chemplavil's novel weight-loss initiative inspired Dieting for Dollars, a Canadian Broadcasting Corporation Television broadcast January 13. Dr Chemplavil, a cardiologist based in Hampton, West Virginia, says patients who join his program must sign a contract: "You lose one pound of your original weight and I give you a dollar. But if you gain a pound you have to give me a dollar." He calls it "reward and punishment at the same time."
How does he make his patients lose weight? "You eat less and do more exercise," the doctor says.
In West Virginia - often called the fattest state in the US - 48 percent children run the obesity risk. It is estimated that one-third of the US population is overweight. Increasing obesity is costing US airlines over quarter billion dollars extra annually on fuel cost alone.
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'Through this one dollar I influence their mind in such a way positively, subconsciously, they are encouraged to do that what they already know that they should have been doing all these years,' Dr Chemplavil said on television.
The broadcast called the impulse to eat a 'child's habit, a child who can't control himself. What Dr Chemplavil is doing he's talking to that little person inside you, negotiating with that little person that can't control.'
Dr Eric Finkelstein, a health economist at the University of North Carolina, was inspired by Dr Chemplavil. They conducted a study, also offering cash incentives for losing weight, and the results were very encouraging.
'The cash incentive definitely is making sure [you] lose the weight,' said Dr Finkelstein, the author of Fattening of the America and The Science of Obesity - Prevention and Treatment.
Dr CBC's Carol McNeil wondered whether $1 for losing 1 lb was incentive enough for people to lose weight. Chemplavil believes it is, and says 80 percent of his patients enrolled in the program - which he started in 2002 - lost an average of 9 lbs over a year. "I had 191 patients enrolled and 151 patients actually completed the one-year program. There was no ceiling imposed as to the amount of weight they must lose. It was simple: Lose one pound and take a dollar from my cookie jar," he said.
"I had said the person who loses the maximum weight within one year will get from me a free three-day trip to Las Vegas, all paid for by me, and that's what I did. One person lost 30 lbs within one year and he got the free trip to Las Vegas that cost me $730 plane fare, hotel accommodation, all included," he added.
The CBC broadcast pointed out that obesity costs the US tens of billions of dollars in terms of health cost, etc. 'The idea of weight loss through cash incentive has caught the attention of some smaller companies in the US as they want to keep the health cost down for their employees,' the program mentioned.
The CBC broadcast carried testimonials by some of the people enrolled in Dr Chemplavil and the University of North Carolina's weight-loss program. 'I am working for something for me. I am going to get that dollar,' said one patient. She said she had enrolled in her own interest, 'and for that someone else is going to reward me!'
Dr Arya Sharma, an obesity specialist at the University of Alberta, reportedly said, 'The question really is do people stop losing weight once the cash incentive stops. This cash incentive works as long as you are providing the incentive. You stop the cash incentive, they fall back to their old behavior.'
Dr Chemplavil is not discouraged by such findings. "I am not going out offering this dollar for pound weight-loss incentive to increase my practice," he says. "I am enrolling in the program my own patients and I am in my own way encouraging them to lose weight through a healthy lifestyle. I am telling them to do what they already know: Eat less and do more exercise. I am not telling them anything new.
"One of my patients," he continues, "was taking four different kinds of blood sugar medicines for diabetes, three kinds of hypertension medicines. She has lost 26 lbs and as a direct consequence she is now taking just one kind of diabetes medicine and only half a pill for hypertension."
Dr Chemplavil said a number of studies have shown "even if you lose 5 to 10 percent of your original body weight, you will enjoy metabolic benefits already - reduced blood sugar level, normalization of blood pressure and cholesterol."
He is lobbying for the adoption of his program by his county, then by his state, and eventually by his country. "I am soon going to see the governor of my state to impress upon him as to how through his program people can be encouraged to lose weight and save the state hundreds of millions of dollar on extra health care cost," Dr Chemplavil says.
Dr Chemplavil has been following the patients who enrolled in his Dieting for Dollars program and will publish a paper on the subject.
"A cursory look at my data shows among those who lost weight, about 10 percent gained weight in one year after they stopped my program," he says, adding that the data needs to be analyzed further.
