Financial incentives for weight management in adolescents and young adults: A systematic review and meta-analysis of randomized controlled trials.

PubMed15 Apr 2026·Obesity research & clinical practice● 4/10i

Financial incentives for weight management in adolescents and young adults: A systematic review and meta-analysis of randomized controlled trials.

Farooque U, da Silva ABN, Campos LR, de Farias Santos ACF, Gadelha MSM et al.

Financial incentives showed no statistically significant effects on weight loss, BMI, or blood pressure in young people with obesity across three randomized controlled trials. Meta-analysis of 408 participants with high heterogeneity (I² > 84%) and low to very low certainty evidence. This challenges assumptions about behavioral economics approaches in youth obesity interventions, where pharmaceutical companies are increasingly investing in digital health platforms and value-based care models. The small evidence base limits definitive conclusions about effectiveness.

Strategic signal

This finding may prompt pharmaceutical companies developing obesity treatments to reconsider digital health partnerships that rely heavily on financial incentive models for adolescent populations. Companies like Novo Nordisk and Eli Lilly, who are expanding into digital therapeutics and behavioral interventions to complement their GLP-1 therapies, may need to pivot toward alternative engagement strategies for younger patients. The lack of efficacy data could strengthen the clinical value proposition for pharmacological interventions in adolescent obesity, where regulatory pathways remain challenging but market potential is substantial.

Weight lossOther

Original Abstract

BACKGROUND: The global burden of obesity and suboptimal dietary patterns among adolescents and young adults has highlighted the urgent need for effective interventions to improve metabolic health. With over 50% of adolescents meeting criteria for overweight or obesity, and the associated risks of cardiometabolic diseases, financial incentives have been proposed as a potential strategy to promote healthier behaviors. METHODS: This systematic review and meta-analysis, conducted in accordance with Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, evaluated the impact of financial incentives on weight management and cardiometabolic outcomes in adolescents and young adults with obesity. RESULTS: Three Randomized Controlled Trials (RCTs) involving 408 participants were included. Pooled results showed no significant effects of financial incentives on systolic blood pressure (mean effect size: 0.17, 95% CI: -0.61-0.96), diastolic blood pressure (-0.01, 95% CI: -0.54-0.52), weight loss (-2.12 kg, 95% CI: -6.22-1.98), percentage weight loss (-1.49, 95% CI: -3.92-0.94), or Body Mass Index (BMI) (-2.10, 95% CI: -6.08-1.89). High heterogeneity (I² > 84%) and low to very low certainty of evidence suggest considerable variability and uncertainty in the effectiveness of financial incentives. CONCLUSIONS: Financial incentives showed no statistically significant improvements in weight or cardiometabolic outcomes in young people with obesity. Certainty was low to very low and small evidence base raises the risk of Type II error, so effectiveness is inconclusive; larger standardized, age-specific trials are needed.

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