Health TEDTalks

The gamification of weight loss

Posted by: Morton Bast
Mick Cornett is the mayor of Oklahoma City. In this talk from TEDMed, he explains why he challenged his city to lose a million pounds.

Mick Cornett is the mayor of Oklahoma City. In this talk from TEDMED, he explains why he challenged his city to lose a million pounds.

In 2007, Mayor Mick Cornett put Oklahoma City on a diet, after the city made a less-than-flattering appearance on a list of the most obese cities in the United States. In today’s talk, Cornett shares the aha moments that led him to create This City Is Going on a Diet, a somewhat unusual mayoral initiative.

Mick Cornett: How an obese town lost a million poundsMick Cornett: How an obese town lost a million pounds“On New Year’s Eve of 2007, I went to the zoo,” Cornett recalls in today’s talk. “I stood in front of the elephants, and I said, ‘This city is going on a diet, and we’re going to lose a million pounds.’ That’s when all hell broke loose.” Watch this talk to find out what happened next.

This week, we’re in the midst of New Year’s resolution mania. And if you’re thinking that a community weight loss challenge sounds like a smart way to help people stick to fitness and nutrition goals, you’re in good company. Over the past few years, plenty of games, challenges and competitions have popped up to promote weight loss and exercise. Going beyond diet gimmicks, what sets them apart is the tendency to be public, and communal.

Once considered a private — even secret — matter, weight loss began to take on a public face with competition shows like The Biggest Loser and Celebrity Fit Club. Now, workplace fitness competitions are even getting built into some insurance policies. Major US insurers like UnitedHealth and Aetna are exploring apps, social media and Xbox Kinect games to gather data on fitness habits (the idea being, of course, that fitter, healthier people are cheaper to insure). Cash incentives are also driving competitive dieting in the workplace. In a program patented in late 2011 by IBM, co-workers could submit their eating and exercise data through an app and get monetary rewards for good habits.

Apps in this space have exploded. DietBet invites people to lay odds on their weight loss, winning money from friends and strangers when they meet goals. HealthyWage is similar, boosting motivation by asking people to place bets on how much weight they’ll lose. Skinnyo creates friend groups to set up fitness challenges. Similarly, GymPact lets friends give a digital pinky swear and commit to workout sessions or eating more vegetables. While some of these apps are controversial, they all turn a personal journey into something communal and game-based.

An initiative even more closely resembling This City Is Going on a Diet: Shape Up Rhode Island, a statewide team-based competition founded by a Brown University medical student in 2005. Over the past seven years, an estimated 70,000 state residents have signed up for the program; participants track the number of steps they take daily and enroll in three eight-week exercise and diet challenges a year. Like insurance companies, state and local governments stand to gain significantly from a fitter, healthier population.

So does this work? Do communal weight loss efforts really trump a more private approach? There have certainly been promising results. In a study tracking Shape Up Rhode Island, clustered weight loss among team members suggested that group influence affected success. In this program it was recognition, rather than rewards, that seemed to matter. Other studies have looked at the efficacy of cash rewards. One published in 2013 in the Annals of Internal Medicine split dieters into three groups — one that got a financial reward for losing weight solo, one that split a pot of money for reaching collective goals, and one that did weigh-ins without financial incentive. While the third group lost about 1 pound, those who’d been given a solo financial reward lost about 4 pounds, and those who’d been part of the team lost about 10 pounds — and were better at maintaining their weight loss.

Peer influence, it seems, is something to keep in mind if you’re looking for ways to stick to weight loss goals this year. While other research shows that digitized and gamified approaches to fitness can be more hype than help, it’s notable that many entries on Healthline’s list of the best weight loss apps include social functions.

As anyone who’s tried to lose weight (or quit smoking, or start flossing, or …) knows, the most difficult part is sustaining will-power momentum after the initial excitement. In Oklahoma City, Cornett focused on infrastructure changes to make a city that “had built an incredible quality of life if you happen to be a car” more walkable and fitness-oriented. To him, the key was cultural change — shaping a city where residents talked about and cared about maintaining healthy weight.