2.  A 12-month incentive based weight loss study aimed to reduce weight and improve overall health of Singaporeans.  Conducted by Duke-NUS Graduate Medical School and the LIFE Centre at SGH to improve the 4-month Obesity Management program (OBM) at LIFE.  Funded by NIHA (NUS Global Asia Institute).

3. Obesity is a critical public health problem in Asia. Prevalence of Overweight (BMI > 25) in Asia Among Asians, BMI > 23 increases disease risk Based on a BMI of 30, obesity rates in Singapore increased from 5% in 1992, to 7% in 2004, to roughly 11% in 2010 Source: WHO Global NCD Info Database https://apps.who.int/infobase/CountryProfiles.aspx (Data: Indonesia 2001; Vietnam 2002; Philippines 2003; Thailand, Singapore 2004; Malaysia 2006; S. Korea 2007)

4. Obesity leads to several serious health problems such as heart disease and stroke, diabetes, osteoarthritis etc.

6. Activity GoalsGuarantee d Payments Lottery Payments (1 in 10 chance) Monthly Weight Loss Target: Lose 1kg or more or BMI<23.5 $20$200 Step Target per Month : 10,000 steps on pedometer on at least 20 days. ( 1 st month : target 8000 steps for at least 20 days ) $20$200 Significant Weight Loss Target: Weight loss of 5% and 8% of baseline weight or if BMI<23.5 Month 4: $100 Month 8: $200 Month 4: $1000 Month 8: $2000

7.  1 individual consultation with a physician  2 individual sessions with a clinical coordinator  2 individual and 3 group sessions with dieticians  1 supermarket visit with a dietician  1 fitness assessment  4 supervised gym sessions Hours: Mondays to Fridays 8:30am-5:30pm

8. 4 mo. 4 mo. PROGRAM Baseline8 mo.12 mo. CONTROL (NO INCENTIVE) No Incentives GUARANTEED PAYMENT TRADITIONAL INCENTIVES ($20/month) TRADITIONAL INCENTIVES ($20/month) No Incentives LOTTERY PAYMENT (1 in 10 chance) 4 mo. PROGRAM BEHAVIORAL INCENTIVES ($200/month) BEHAVIORAL INCENTIVES ($200/month) No Incentives YOU CANNOT CHOOSE WHICH STUDY GROUP TO JOIN AND CANNOT SWITCH GROUPS. YOU’LL BE RANDOMALLY ALLOCATED TO ONE OF THE TWO GROUPS AFTER YOUR STUDY STATUS IS CONFIRMED

9. A Pedometer : It is a step counter that records and displays the number of step you take per day Best worn on the hip above the thigh. Can be used with clip included; clip can be attached to clothing or to a belt Automatically resets to zero at midnight every night Pressing MEMO button will show step activity over past 7 days

10.  Pass an health assessment screening.  Pay $234 in cash or check payable to ‘Duke-NUS Graduate Medical School’ to enroll in the OBM program (50% off standard rate).  Pay $165 in cash to the study team to enroll in the incentive programme. This amount will be refunded to participants allocated to the control arm.  Participants must attend follow up sessions at 4, 8 and 12 months. $20 will be paid for attendance. There is also a lottery to win an Apple ipod at each session.

11.  Ask the study team any questions  Sign the consent form  Pay the enrollment fee  Complete a questionnaire  Sign the OBM indemnity form  Make your first appointment for the OBM program