# Enhancing Weight Loss with Financial Incentives in Teens with Severe Obesity

> **NIH NIH R01** · UNIVERSITY OF MINNESOTA · 2020 · $692,660

## Abstract

Abstract
Severe obesity is the fastest growing category of pediatric obesity, with a reported prevalence near 6% in the
United States. Unfortunately, conventional treatment approaches rarely result in sufficient weight loss in
adolescents with severe obesity; therefore, innovative and effective strategies are desperately needed. The
financial incentive model has been used successfully in adult obesity trials to address suboptimal adherence to
lifestyle modification therapy and improves weight loss outcomes. Although yet to be investigated as a weight
loss intervention among adolescents, financial incentives have been shown to improve many health-related
behaviors in teenagers. Owing to the refractory nature of pediatric severe obesity, financial incentives are
more likely to be effective if used in concert with a structured dietary plan such as meal replacement therapy
(liquid shakes and frozen entrées). In a recent trial, meal replacement therapy produced promising short-term
weight loss in adolescents with severe obesity; however, initial weight lost by participants was regained after 4
months, owing to diminished adherence to the meal replacement regimen over time. Our concept is to
capitalize on the synergy of meal replacement therapy and financial incentives to optimize weight loss and
improve cardiometabolic risk factors and vascular health in teens with severe obesity. This study will afford a
unique opportunity to address another key unanswered question related to the treatment of pediatric severe
obesity: how much weight loss is necessary to elicit clinically-meaningful improvements in cardiometabolic risk
factors and vascular health? Although evidence-based benchmarks have been established for adults, no such
thresholds have been identified for youth with severe obesity. Therefore, we plan to conduct a 12-month
randomized, controlled clinical trial to evaluate the effects of meal replacement therapy plus financial incentives
on weight loss and cardiometabolic/vascular outcomes among 142 adolescents with severe obesity and to
identify thresholds of weight loss required to achieve clinically-meaningful cardiometabolic/vascular
improvements in this patient population. This research targets a significant public health problem, will utilize an
innovative treatment concept and approach, and will generate new knowledge to guide selection of treatment
type and intensification, ultimately exerting a powerful and sustained influence on the field of pediatric obesity.

## Key facts

- **NIH application ID:** 9891050
- **Project number:** 5R01DK113631-04
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** Aaron S Kelly
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $692,660
- **Award type:** 5
- **Project period:** 2017-04-15 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9891050

## Citation

> US National Institutes of Health, RePORTER application 9891050, Enhancing Weight Loss with Financial Incentives in Teens with Severe Obesity (5R01DK113631-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9891050. Licensed CC0.

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