ReachMDStudy Evaluates Treatment Interventions for Severe Obesity in Adolescents

Financial Incentives Enhance Meal Replacement Therapy’s Effectiveness in Adolescent Severe Obesity Treatment

A recent study published in JAMA Pediatrics demonstrates that combining meal replacement therapy (MRT) with financial incentives leads to greater body mass index (BMI) reduction in adolescents with severe obesity compared to MRT alone. This research, co-authored by Justin Ryder, PhD, from Northwestern University, offers insights into potentially more effective interventions for a condition affecting approximately 20% of US children and adolescents.

Key Points:

• The study enrolled 126 adolescents with severe obesity, divided equally into two groups: MRT plus financial incentives and MRT alone.
• Treatment duration was one year.
• MRT consisted of pre-portioned meals totaling 1,200 calories per day.
• Financial incentives were provided based on reduction in body weight from baseline.
• After 52 weeks, the MRT plus financial incentives group showed:
  • A greater BMI reduction (6 percentage points more)
  • A greater reduction in total body fat mass (4.8 kilograms more)
• The combined approach proved cost-effective despite additional expenses for meal replacements.
• Severe obesity in adolescents is defined as having a BMI at or above the 95th percentile for age and sex.
• The condition is linked to increased risks of adult obesity, cardiovascular disease, and type 2 diabetes.
• Previous research has shown MRT to be more effective than traditional lifestyle modifications for BMI reduction in severely obese adolescents.
• The study was inspired by adult literature supporting the use of financial incentives to increase adherence in weight loss and physical activity programs.
• Researchers emphasize the need for longer-term interventions beyond one year, given the chronic nature of obesity.
• Treatment withdrawal is likely to result in BMI increase, highlighting the importance of sustainable, long-term strategies.

“Using a cost-effectiveness analysis, we looked at mean fat mass lost between the two treatments and found that despite providing the additional meal replacements for per pound lost, it was cost-effective to do so.”
– Justin Ryder, PhD, Associate Professor of Surgery in the Division of Pediatric Surgery and of Pediatrics, Northwestern University

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