Food for Thought: Will Diet For Money (Update)

Turns out the BBC article I linked to yesterday didn't tell the whole story of Italian mayor Gianluca Buonanno's health initiative of paying his overweight residents to lose weight.

One of my critiques was that this concept seemed like a cheap reality show stunt -- lose six and a half pounds in one month and you'll get $70. Where was the nutrition education, I asked? The outreach to get people to exercise?

Well, Dr. Domingo Pinero of New York University's Department of Nutrition, Food Studies, and Public Health dug up some more information and was kind enough to share it with me.

Guess what? This health initiative is better than I thought!

First of all -- once these overweight patients get a note from a doctor verifying they do need to lose weight, they are provided a personalized diet, rather than left to their own accord.

And, even better -- the town offers free exercise lessons in local parks.

Interestingly, I also learned that women get the cash if the lose six and a half pounds, but men need to lose eight pounds in one month in order to "win".

That is the one part of this initiative I still have a problem with. If a man loses six pounds in 4 weeks, that should still be commended and rewarded, especially if it is the result of a personalized meal plan and regular exercise.

I say take away the cash prize and subsidize these people's initial consultations with a dietitian. As for the $15,000 budget put aside for this initiative, look into implementing nutrition education in schools. It's never too early.

Public health nutrition authorities agree.

Earlier today I e-mailed the always resourceful Marion Nestle and asked her if she knew of any thorough studies on external motivators in relation to weight loss and management.

"Mostly on social factors -- strong family and peer support. Recent studies of single interventions don't show much (how could they?) although some school interventions look promising," she replied.

Food for Thought: Will Diet For Money

I found this article from BBC News to be rather interesting.

The mayor of Varallo Sesia -- a small town in Northern Italy -- is offering his overweight citizens (they need a doctor's note identifying them as such) $70 if they lose six and a half pounds in one month.

Those who can keep the weight off for an additional five months will receive $140.

The purpose behind this? Motivation, the mayor says.

He even has the Italian Health Minister's support, commending him for starting an initiative other towns should follow.

I'm not so sure.

Motivation is key, no doubt, but it needs to be self-produced.

An overweight person can read every magazine article under the sun about weight control, watch endless reruns of The Biggest Loser and be told by countless doctors that their weight puts them at risk for a myriad of health complications, but until they are ready to manage their weight, they'll very likely go on two or three-week-long diets that are quickly abandoned.

I'm glad the mayor wants to do something about his overweight residents (he himself is one, and is dieting, although not expecting to pick up any cash prizes for doing so), but why not attempt to offer some nutrition education in schools, or subsidize fruits and vegetables? Even better -- how about subsidizing visits to nutritionists?

Whenever I hear of bets or contests concerning weight loss, I fear people will do anything to "win", whether it's consuming very few calories, eliminating necessary food groups, or even developing binging-purging behaviors.

I also don't like having a specific number attached to this goal. What if someone loses five and a half pounds? Should this effort not be recognized?

Making any sort of concerted effort towards a healthier lifestyle should be commended, and it should be taken into account that some people might take it off slowly. After all, shedding three and a half pounds a month for six months adds up to twenty-one pounds -- no small feat!

I see this as a case of good intentions with less than favorable execution.