Do fat people really want to lose weight?
Do smokers want to stop?
Proper economists, i.e. not the accountants who call themselves health economists, don’t set much store by what people say. They tell you what you want to hear, what makes them look good, or what gives them them the best chance of getting laid. If you want to know what people really want, look at their actions.
A fat person who claims to want to lose weight but then goes large on a Big Mac is not telling the truth. Smokers who claim to want to give up, obviously don’t. That’s why telling people to diet, or stop smoking is generally a dead loss. But doctors still have to get fat smokers out of the door. Here’s an idea.
There is a grain of truth in the claim that I really don’t want to do something that I carry on doing. The benefits of eating and smoking come now, while those of stopping are in the future. We prefer good things now.
A commitment contract brings forward the pain of not stopping. You agree to give up a sum of money large enough to hurt, and only get it back if you achieve your goal. It works. Proven by randomised trials (Volpp et al. 2008, John et al. 2011).
You can strengthen the effect by agreeing to give the money to your enemies if you fail, or dividing it among other contractors who succeed. Anyone can do it. The rich just need to put a larger sum at risk. There are websites to take care of the arrangements. e.g. StickK.com.
Go on. Join up.
Or else shut up. Obviously you don’t want to give up.
Volpp KG et. al. Financial incentive-based approaches for weight loss: a randomized trial. JAMA 2008; 300: 2631-7.
John LK et al. Financial incentives for extended weight loss: a randomized, controlled trial. J Gen Intern Med 2011; 26: 621-6.