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Paying obese people to lose weight doubles rate of weight loss (jamanetwork.com)
35 points by aryan14 on Dec 5, 2022 | hide | past | favorite | 27 comments



I'd expect that simply paying people would also improve rate of weight loss.

If you buy and eat less processed food with higher levels of protein, fiber, and fat, you're likely to manage your appetite far better than if you just smash loads of donuts and crisps.

It's cheaper to eat nonfood though, particularly if you take preparation into account.


Obesity rate is completely uncorelated to poverty, in the US we're talking 40%+, 70%+ overweight

It's not cheaper to eat junk food, it's just more convenient, I never spent so little on food than when I switched to vegetarian/bio, and I've never been so healthy in general. I very often make soup/stew that last 2-3 days for me and my gf for less than 15$


That doesn't seem right? https://www.cdc.gov/mmwr/volumes/66/wr/mm6650a1.htm sounds like the general trend is obesity declines with income and education, although more strongly for some demographics and negligibly for others


Obesity declining with income doesn't mean less calorically intense food is cheaper, it just means that higher income better educated people eat less calories.


That still creates a correlation between income and obesity.


So you just eat stew constantly all the time and that means junkfood isn't cheaper? I have to imagine it only lasts 2-3 days because you're just having a bowl each or something. If you and her ate just that, you'd still be spending $120/month on just stew and probably undereating by a good amount, and also regretting full commitment to stew.

You may still be right but it's a narrow example that sort of entirely depends on the season and region. What's cheaper? Canned stew. 3 days on canned stew and in the U.S it's probably less and way faster. Add in $3 worth of fried chicken from Walmart and that's a day's worth of food, and a fuck ton of salt.

I don't think it's really an argument that holds up, but I would agree that it's a way better use of money to get good stuff if you can afford it and spend the time making it. I'm not where you are but a small bag (5lb) of potatoes at Safeway costs $6, add in something like 5 apples and you're already at $15. Bag of frozen fruit, another $6. It adds up quickly and goes away even quicker.


Around me I think on average a single cheap donut costs about the same as a couple pounds of carrots.


I agree wholeheartedly that cooking healthy food is less expensive than buying ready made crap.

The like-for-like example is high quality takeaway food vs cheap takeaway food, or high quality snacks (e.g. a premade chicken sandwich) vs nonsense like donuts.


> The like-for-like example is [...]

I mean, you did say

> It's cheaper to eat nonfood though, particularly if you take preparation into account.

So I took it as saying nonfood already comes prepared, while real food generally doesn't. IOW, comparing cooking healthy vs buying ready-made crap.

But ok, I guess you're saying, ignoring the possibility of cooking oneself, healthy food is more expensive than junkfood. I agree with that.

Kind of feels weird to act like people can't cook or prepare their own food from cheap ingredients, but I guess homeless people, for example, can't really.


> Kind of feels weird to act like people can't cook or prepare their own food from cheap ingredients, but I guess homeless people, for example, can't really.

This is a good start to understanding the correlation. Going further, poor people are often time- and energy-poor as well, whether working irregular hours or multiple jobs or simply doing themselves and their families what people with greater means might pay for. Add that being poor doesn’t afford the best kitchen conditions (space, cookware and other equipment, fuel/electricity), and working around those limitations is added drain on any available time and energy one might afford… like so many other things, it’s expensive to be poor. While it may be objectively possible to eat healthy, it’s often an unrealistic or at least demanding expectation given the circumstances.


> While it may be objectively possible to eat healthy, it’s often an unrealistic or at least demanding expectation given the circumstances.

Wow. wow. Let's recap most expensive to least: ready-made healthy > ready-made junkfood > cooking. We're talking about the poor, and we're talking about whether they prefer ready-made junkfood over cooking.

You're telling me that they're too tired and lacking of resources to cook, to eat healthy.

Now, the bar to cooking more healthy than junkfood is very low, very easy. Cooking is a very flexible activity. You can even just make sandwiches and you're beating junkfood in both cost and healthiness. That takes no energy and no resources (maybe a fridge, though one can buy ham just for the day and keep it in a cool place for a single-meal day). If they can have a stove (which can be cheap and even portable), they don't need a fridge and eggs take like 5 minutes no matter the quantity of people they have to cook for.

Like, what are you arguing?

It's expensive to be poor, but cooking is not expensive. It's the cheapest option.


I’m exhausted just … not wanting to explain what I already explained, but okay. I’m not even poor, just finally about to eat my microwave leftovers after getting settled in after almost two months on the road trying to make sure my parents are cared for. I’m not arguing anything but I’m not cooking anything either, I’m tired and that’s all I’ve got to say.


My argument is basically that ready to eat nonfood is cheaper than ready to eat food.

I mean, you can eat just apples, uncooked carrots, etc, but realistically that's not a diet.

Healthy frozen meals exist here in the UK. They're just way more expensive than the crap.

Protein is more expensive than carbs is basically the entire thing.


> I buy ready made food all of the time, I just try to go for high protein options and limit bullshit. It's a lot more expensive.

But you do it because you can afford it. People that find it expensive would first cook for their meals rather than eat junkfood for meals. Do you think they wouldn't cook because it takes time? When you're low on income, money is more valuable than time. Cooking saves money over junkfood.

> Protein is more expensive than carbs is basically the entire thing.

There's cheap sources of protein, too, like beans. Not sure how it fits with the rest of the argument though. Are you talking about people getting their protein mainly from chocolate protein bars or something like that?


I am talking exclusively about ready to eat food.

There are many reasons for a person to struggle to be able to cook.

I agree that in most cases these are solvable. Usually via money, which brings us back to... money helps.

A direct example I can give is that I have many friends who live in shared accommodation with shitty kitchens because they're shared amongst 4 people or more and inevitably someone is a cretin.

In that case invariably people end up "cooking" stuff like pizzas in order to minimize time in the shitty environment.


> A direct example I can give is that I have many friends who live in shared accommodation with shitty kitchens because they're shared amongst 4 people or more and inevitably someone is a cretin.

Ok, that makes more sense. I guess housing is so bad that not even shitty apartments that people can rent individually are available?

I'm not familiar with such arrangements, so I'm not sure how bad it can get. I guess it's an issue with the dishes, a permanently filled sink? Why not just use disposable dishes and have very few shared cookware so it's not possible to fill the space in the sink?

If home is totally useless for cooking for whatever reason, one might be able to make a kitchen portable enough to fit in a backpack by getting a single-burner portable stove. If you get a gas one, you won't depend on an electrical outlet. For cookware, a small pan and a small wooden spatula takes you far. Eggs, canned food, etc. don't need refrigeration. If one avoids using too much oil/fat, one should be able to skip needing water to wash the cookware by wiping with a paper towel. This ought to be cheap enough even for students. Park in the daily commute? There's the kitchen. Just do breakfast, and snack on e.g. carrots for other times of the day.

Who am I kidding. We're talking about people in general and not anyone in particular. That's quite awful...


I mean, this is fun problem solving, I also enjoy camping and can make healthy meals whilst I'm in the woods.

> Why not just use disposable dishes and have very few shared cookware so it's not possible to fill the space in the sink?

Your flatmates, who you can't evict, never clean up after themselves and they block the sink. The worktops are covered in dirty stuff. The oven is dirty so that you personally have to clean it each time, so in the end you give up and get takeaways.

The actual solution is to have enough capital or at least an income source in order to not have to deal with bullshit poverty world people.


> The actual solution is to have enough capital or at least an income source in order to not have to deal with bullshit poverty world people.

Ha. Being poor might not be the thing to focus on, since they're all in the same arrangement. The actual problem is that they're badly raised and don't know how to behave properly. People wouldn't have a problem with how poor they may be if they were more considerate to their flatmates.


lol i'd like you to eat 2 lbs of donuts one day for a single meal, wait a week, then eat 2 lbs of carrots for one meal .. and report back to here how you felt


I don't get the point of comparing the same quantities, nor of putting them in a single meal. It's an example. The price comparison holds for other forms of junkfood and veggies. And the other point is that 2lbs of carrots are going to last me more than a single donut, for the same price.


> A total of 1280 adults with obesity ... could earn up to $750.

A financial incentive to lose weight is also a financial incentive to qualify for the incentive program. If it becomes a policy instead of a one-off study, and you could qualify by gaining a few pounds, you can justify your next binge as a duty to your family.

As a champion binge-justifier I can testify that this is an easy one. Advanced justifiers can do it from just a palindrome in the current date, in the Babylonian calendar.


As a person who lost 100 lbs this year, I can testify if you do this you deserve the money.


Congratulations. I've been there, and I'd rather have the weight loss than a million dollars. A billion dollars wouldn't be an easy choice.


As someone who struggled with weight for decades, and finally has it under control, I cannot relate to your logic at all. I’ll take my stable weight and skip the cash incentives thanks. Granted I also don’t need the cash so acutely. I hope incentives like this will help others though.


If this were true, insurance companies would already be doing this.

There are many medical issues that could be lessened if people could be convinced to stop eating so much.


If you look into it insurance companies are paying people to be healthier.

Even the crappiest insurance companies are offering discounted at home fitness companies, my previous insurance offered free peloton basic, my elderly mother's insurance is willing to give her up to 30 dollars a month on her AARP insurance to complete various health and doctor tasks each month.

But the best I've seen is UHC Motion on my current insurance. Up to 3 dollars a day/1095 dollars a year for connecting my Fitbit to it and reaching the step goals I'm already trying to reach.


Insurance companies are not paragons of reason. They’re certainly not motivated by reducing medical risk to their customers. Among the many things they objected to in recent healthcare reforms, preventive care requirements ranked very high. They penalize high risk customers so it’s easy to conclude they view those customers negatively, but in reality they just want to extract value from the risk and from their market capture wherever they can.




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