Obese men, SMS and weight loss incentives

Feasibility study of how to best engage obese men in narrative SMS (short message system) and incentive interventions for weight loss, to inform a future effectiveness and cost-effectiveness trial


Being obese causes 5% of deaths worldwide and puts people at greater risk of diseases like diabetes or some cancers. In 2013, 26% of UK men were obese, but men rarely participate in weight loss programmes. This project was a two-phase feasibility study. Phase 1 (i) built on an existing narrative SMS intervention with embedded behaviour change techniques for men using qualitative co-design, and (ii) developed an endowment incentive drawing on insights from behavioural economics, existing evidence and men’s preferences for delivery based on survey/DCE evidence. An iterative mixed-methods approach was used including a systematic review of the evidence, theory and learning from recent UK behaviour change trials to refine the interventions through PPI and user testing. Phase 2 was a 12-month feasibility RCT with three arms: SMS only; SMS and incentive; usual practice with waiting list for SMS intervention. Iterative mixed-method data collection and analysis helped to refine the intervention parameters, design and processes in preparation for a potential, full, pragmatic effectiveness and cost-effectiveness RCT.

Outcome and Translation

The developed interventions were shown to be feasible.  An application has been submitted to progress to a full trial.

HERU researchers involved in this research project: Marjon van der Pol and Hannah Collacott

External Collaborators: P. Hoddinott, B. Williams, S. Dombrowski, M. Grindle (University of Stirling); A. Avenell (HSRU, University of Aberdeen); C. Gray (University of Glasgow); F. Kee, M. McKinley (The Queen's University of Belfast); C. Jones (University of Dundee); A. Elders (Glasgow Caledonian University) and P. Carroll (Waterfood Institute of Technology).


Dombrowski, S.U., McDonald, M., Pol, M. van der, Grindle, M., Avenell, A., Carroll, P., Calveley, E., Elders, A., Glennie, N., Gray, C.M., Harris, F.M., Hapca, A., Jones, C., Kee, F., McKinley, M.C., Skinner, R., Tod, M. and Hoddinott, P. (2020) 'Game of Stones: feasibility randomised controlled trial of how to engage men with obesity in text message and incentive interventions for weight loss', BMJ Open, 10(2), e032653.


Pol, M. van der (2017) 'Designing financial incentives for weight loss: the role of behavioural economics and preference elicitation', London School of Economics and Political Science, Health and Social Care Seminar, LSE, London, 10 May 2017.

Pol, M. van der (2018) 'Designing financial incentives for weight loss: the role of behavioural economics and preference elicitation', Workshop on the Economics of Health Behaviours and Health Information, University of Bath in London, London, 15-16 March 2018.