In the study, participants had a one-on-one session, in which they discussed diet and exercise strategies, with a dietitian, and then were on their own. They didn’t have a strict meal plan or detailed exercise routine, and devised their own slim-down plan. Text messages were used to clue in participants regarding their progress.

If they didn’t shed weight, they got a second chance. Lagging participants were given a fresh start each month, plus a chance to win their money back if they did better. Those who exceeded their goals could lose weight at a slower rate.

The second chance for lagging dieters seemed to be a good motivator. Participants were sent a text-message reminder of what they would have won had they shed the weight, which did spur some to take their diet up a notch.

The system could make sense for insurance companies and workplace weight-loss programs, says Dr. Volpp. Text messages are cheaper than a personal trainer.

“A large percentage of people have employer-based or categorical insurance, and there are no tangible incentives for them to get healthy,” says Dr. Volpp.

Obesity is expensive: An April 2008 report from the Conference Board found that obese employees cost businesses an estimated $45 billion a year for medical expenditures and work loss. If all overweight employees had financial incentives to shed weight, businesses might find both their workers and their bank accounts healthier.

With the economy sinking and waistlines swelling, some experts argue that an incentive-based approach to health care could help businesses with their budget while simultaneously putting a little cash back into employees’ pockets.

“It’s very easy to keep procrastinating when it comes to behavior changes,” says Dr. Volpp. “But this gives you a tangible reason not to procrastinate any longer.”

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