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ObesityJuly 2021Summary reviewed June 2026

What Researchers Found Testing Game-Like Apps and Cash Rewards for Weight Loss

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

Michigan Weight Navigation Program (MiWeigh) Study

The main purpose of this study is to determine whether people who participate in MiWeigh lose more weight than people who receive information about weight loss strategies and programs. The researchers also want to learn what parts of the program do and do not work and why. If the program is effective, the researchers want to learn how other health care systems could offer this program. The overarching aim of the MiWeigh Study is to better help patients prevent, manage, or reverse obesity-related chronic conditions.

Ann Arbor, Michigan, United States
RecruitingTesting effectiveness

Transpulmonary Assessment for Individualized Lung Optimization in Obese Patients

This protocol describes a randomized controlled feasibility vanguard study designed to investigate the implementation and effects of esophageal pressure-guided positive end-expiratory pressure (PEEP) titration in patients with high body mass index (BMI) mechanically ventilated patients at the Edmonton Zone. The study will enroll 30 patients with body mass index (BMI) \>=30 kg/m2 who require invasive mechanical ventilation, randomizing them in a 1:1 ratio to receive either esophageal pressure-guided PEEP titration or standard care management. The primary objective focuses on establishing the feasibility of conducting a larger definitive trial, while secondary objectives examine differences in applied PEEP levels, respiratory mechanics, and clinical outcomes between groups. The intervention protocol targets end-expiratory transpulmonary pressure of 0-2 cmH2O.

Edmonton, Alberta, Canada +1 more