stella
ObesityJuly 2021Summary reviewed June 2026

A Fitness Tracker With Cash Penalties Got Veterans Walking 1,200 Extra Steps Daily

Veterans with obesity or overweight used fitness trackers with game features and weekly cash penalties if they missed step goals. Those with cash penalties walked about 1,200 more steps per day during the 12-week program compared to basic tracker users, but the benefit disappeared once penalties stopped.

What the trial was testing

The trial enrolled 180 patients with obesity. The study was sponsored by VA Office of Research and Development and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

Researchers followed patients through treatment and into recovery, tracking the outcomes that mattered most for the disease being studied.

What the results showed

Adding cash penalties to a game-like fitness app helped veterans walk 1,200 more steps daily.

JAMA network open · 2021 · NCT03563027

These findings — that game features plus weekly cash penalties increased daily walking vs. basic trackers — were published in the JAMA network open and represent the headline result of the study.

Researchers tracked outcomes across 180 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with obesity, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Game-like fitness apps with social support and financial penalties can help increase daily walking in the short term, but the effect may not last once the program ends. If you're interested in digital tools for weight management, ask your doctor about structured programs that include accountability features.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.

Open obesity trials

RecruitingInterventional study

OBESIAL: A Prospective Interventional Real-world Study of a Multidisciplinary Obesity Management Programme

The OBESIAL (Obesity Structured Intervention in Algeria) study aims to evaluate the clinical, metabolic, and organisational impact of a structured multidisciplinary obesity care pathway implemented under real-world conditions.

Algiers, Algeria
RecruitingTesting effectiveness

Fasted vs. Fed State Exercise

Although many medications exist for both heart disease and obesity, cost, lack of access for all people, side effects and the desire for a more natural solution have left many people seeking lifestyle treatments such as exercise. Scientists know that exercise is highly beneficial for heart health. When exercise also produces weight loss, these benefits are much improved. Although using exercise to treat or prevent heart disease / obesity is recommended, not all people respond well. Some see significant weight loss and health improvements while others see little changes. For these reasons, new strategies surrounding the use and design of an exercise program are needed. One such strategy could be performing aerobic exercise before breakfast (fasted exercise). When exercising fasted, food/energy stores are low, and one relies on stored body fat for energy. This may help heart health and weight loss. This has never been tested in a program long enough to see such changes. This study will, for the first time, assess the effects of a 16-week aerobic exercise program performed fasted compared to after eating. Outcomes will include blood fats, blood pressure, fat-burning abilities and weight loss. Starting an exercise program can also make people to eat more. This limits the success of exercise. The study will also evaluate ways fasted exercise could change eating, as it possible that fasted exercise could also cause people to eat more, which would limit weight loss and health improvements.

Fort Smith, Arkansas, United States