Britain's 'eat my shorts' diet

Two new episodes of "The Simpsons" are being aired now on Britain's Channel 4 - and not solely for entertainment. The Simpson family, like Michelle Obama, will advocate a healthy diet to minimize the widening proportions of British children.

A joint campaign, launched by the British government and Pepsi-Cola and starring two British soccer stars, will also try to have an impact.

No less than £75 million is invested in the project to combat the plague of obesity in the fattest country in Europe.

At the same time, the possibility of direct action is being investigated in Britain in offering a prize for weight loss. The idea is fairly simple: You managed to lose weight? Receive cash from the government.

There is even proof this works. In December 2008, researchers from the University of Pennsylvania Medical School published the results of what happened when they asked 57 healthy people with excess weight or who were obese to drop on the scales for a financial incentive, according to a contract signed in advance. In another group, the participants were given an incentive that entailed monthly weigh-ins and a third group had monetary prizes raffled off among those who lost weight.

The findings were published in the Journal of the American Medical Association. After four months, members of the group who were only weighed showed a minuscule loss of just 1.76 kg. on average, while those in the group where prizes were raffled off lost 5.9 kg. on average. But the group receiving a financial reward did the best of all - dropping 6.35 kg. on average.

Half of those receiving financial compensation reached the program's goal, as opposed to a 10th of the control group. And seven months after the research stage, those who received financial compensation kept off the weight better than the control group.

The British government took action on the basis of these findings.

It's not surprising the United Kingdom is a pioneer here; it has been battling against weight gain among its citizens, one of the most serious cases in Europe.

Forbes Magazine reports that since 2007, Britain ranks 28th on the list of the fattest countries: Some 63.8 percent of its residents over the age of 16 are overweight. This is still nowhere near the proportion in the United States, where 74.1 percent of the population is overweight and where obesity was declared an epidemic in the 1990s.

But in Europe, only Greece (68.5 percent) and Malta (68.7 percent) surpassed Britain on the list. (In Israel, 57.3 percent of the population is overweight.0

Several regions in Britain are now running a project offering the overweight a government-sponsored financial incentive for losing weight.

The preliminary findings from the project, run by a company called Weight Wins, indicate money is a significant factor in weight loss - far more than diets and information programs. And the amount Britain now spends on treatments for obesity-related illnesses is estimated to be in the neighborhood of a billion pounds annually.

Only if you finish

In the new program, people who want to lose weight sign a 13-month contract and receive payment only if they complete the program.

Every participant is given seven months to lose weight and must maintain their new weight for another six months.

So far, around 2,000 people have signed up for the program, which is funded by the National Health Service.

In January 2009, a new experiment offered a financial reward in accordance with the weight loss. If someone lost 22.7 kg., he would receive £425 in cash or vouchers; if one lost 13.6 kg., he would get £160 and someone who lost 6.8 kg. would get £70.

According to intermediate data, those seeking to lose 15.6 percent of their weight on average, dropped 12.4 percent of their weight in the first months.

The financial cost of obesity to the health systems of Western countries is very high. A study by the Israeli Forum for the Prevention of Cardiac and Vascular Diseases, along with Barzilai Medical Center, Asheklon, the Health Ministry, the Israel Medical Association and the four health maintenance organizations, found two years ago that a national program to prevent weight gain, smoking and high blood pressure could be financially beneficial to the country.

If aimed at Israelis aged 25-64, within 20 years the program would substantially reduce the risk of cardiac and vascular disease among half that group.

In financial terms, the program would save the health system $443.3 million on medical treatment and $ 93.3 million on medications, and would bring in $185 million in profit for the state.

But the study, conducted by Dr. Haim Yosefi, the director of the cardiac clinics at Barzilai Medical Center, did not convince the decision makers; currently no such nationwide program is being promoted.

In August 2006, the National Obesity Prevention Task Force presented its plan to the Health Ministry, including recommendations for containing weight gain in Israel, such as lowering the cost of healthy foods; adding nutritional information to restaurant menus; limiting advertising for foods with little nutritional value; enriching foods with essential vitamins; having regular measurement of school pupils' height and weight; and offering lessons in school on how to cook healthy.

Tax the fat

Imposing a health tax on overweight Israelis was suggested at the beginning of the task force's discussions, but eventually this option was dropped.

However, the HMOs were advised to consider offering bonuses, discounts or incentives in the supplementary insurance fees paid by people who lose weight or exercise regularly.

None of the initiatives, including offering discounts to those who lose weight, was discussed later at the Health Ministry or formulated into a decision.

So far, the usual suspects have not solved the crime. "So we have to welcome every incentive, including the monetary one," says Prof. Eliot Barry of Hebrew University, who heads the medical school's department of metabolism and nutrition and is an adviser to the Health Ministry. "There is no reason to think that offering financial incentives to the overweight will make society more materialistic," says Barry.

He says the most effective incentives for losing weight were found among women who wanted to get pregnant and men facing a prostate gland operation, both conditions that may necessitate weight loss.

"Offering money to people who lose weight is a nice gimmick that can help deal with the extent of obesity," he says.

In contrast, Prof. Reuven Viskoper, the chairman of the Israeli Forum for Cardiac and Vascular Disease, casts doubt on the benefit of handing out money to Israelis who lose weight.

"In my assessment, money won't help here over the long term. Every financial incentive will encourage people to lose weight for the period defined in advance and afterward people will revert to their old ways, because you can't keep on handing out money without limit. Grasping the necessity of losing weight has to come from the inside."