: Just losing weight won’t get most people to exercise — but losing money might

In fact, gamifying the goal of getting active, combined with losing potential reward money for not hitting a daily step goal, motivated U.S. veterans to take an extra 1,200 steps a day on average over 12 weeks, according to a recent study published in the journal JAMA Network Open.

The randomized clinical trial out of the Perelman School of Medicine at the University of Pennsylvania gave 180 vets who were overweight or obese a $100 Fitbit device to track their steps. Every participant also received $25 for enrolling in the study, and $50 upon finishing it. 

But the subjects were then split into three groups to test what would motivate them to move the most. The control group simply got their participation pay, and only received feedback and goal-setting from their Alphabet-owned
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Fitbit device. 

In comparison, the two test groups gamified their experience by earning points and advancing to different levels as rewards for reaching their step goals. And their progress was shared weekly in an email with a buddy whom each person had selected to help encourage them. 

But one of these gamified, social support groups also had an extra financial incentive thrown in. If they managed to meet their step goal every day for 12 weeks, they were rewarded with an extra $120 at the end. But they lost $10 for each week that they didn’t hit their goal. 

Guess which group burned the most shoe leather? 

You guessed it: the ones who ran the risk of watching an extra 120 bucks get whittled away every time they stayed sedentary rather than stepping up. In fact, the researchers found that the group with both the gamified social support and the extra $120 at stake took an extra 1,224 steps per day, on average, compared to the control group. 

And just gamifying the step goal without putting the extra money on the line wasn’t effective, in this case. That group only hoofed it an extra 433 steps a day compared to the control group, which researchers didn’t consider significant.

“Loss aversion is a very powerful motivator,” said senior author Dr. Mitesh Patel, an associate professor of medicine, in a statement. 

This supports a 2016 study, also conducted by Patel, which found that the possibility of losing money got people to exercise more than any other incentive. Almost 300 subjects were split into four groups: one that received $1.40 for each day over 13 weeks that they hit 7,000 steps; one group that was entered into a daily lottery if they hit 7,000 steps; another group that was given $42 upfront each month, but $1.40 was taken away every day that they didn’t reach 7,000 steps; and a control group that received no money, but did get daily feedback. And once again, the group at risk of watching their bonus money get taken away exercised the most. 

Related:This incentive actually gets workers to stick with a wellness program

But the motivational effect often doesn’t last. The subjects in the latest University of Pennsylvania study were tracked for another eight weeks after the games were turned off. And none of the groups sustained the extra physical activity that they’d shown during the gaming period.

“What our study begins to show is that the combination of varying approaches can be effective, but we need to learn more about the duration and ability to sustain an effect over longer periods of time,” wrote the study’s lead author, Dr. Anish Agarwal, an assistant professor of emergency medicine.

That’s the question indeed: How can we make these healthy habits stick? 

While a few studies have suggested that integrating game mechanics or financial rewards into something like exercise can make workout regimens more fun and effective, the positive effects are often short-lived. 

Read more: Start exercising at this age to save up to $1,874 a year on health care costs in retirement: report

A 2018 study published in the Journal of the American Heart Association got 146 sedentary office workers to track their steps using a Fitbit. The control group just used the wearable tracker, while the test group synced their steps with the map-based game MapTrek, which moved each person’s avatar on Google Maps based on how many steps they had taken in real life. And those “racing” their colleagues via the MapTrek game took 2,092 more steps each day compared to the control group. But once the game was over, neither group kept up the spike in steps they had shown during the study. “The effect decreases over time,” the authors wrote. 

A 2017 study published in JAMA Internal Medicine had a similar result; adults who gamified their step-counting took almost 1,700 extra steps each day, but that dropped off during the 12 weeks after the game was over. And a 2019 fitness tracker study with 3,515 participants also found that while people who were paid $.00020 per step (or 50 cents for every 10,000 steps) walked an average of 306.7 more steps each day than those in a control group, they were back to their sedentary selves two weeks after the financial incentive ended.

Read more: We’re so lazy gyms can’t even pay us to work out

Another 2017 study found that you can’t even pay people to go to the gym consistently. Researchers at Case Western Reserve University decided to see if offering rewards, including a $30 or $60 gift cards, would help new gym members commit to getting fit. The subjects simply had to go to the gym nine times over six weeks, or an average of 1.5 times a week, to score their rewards. But after the first week, 14% of all participants did not visit the gym again. Three months later, only a third worked out at the gym more than once a week. And overall, those given the extra incentives only made 0.14 more visits per week than those who weren’t offered a reward at all. And the group given the $60 gift card did not visit the gym any more than those given the $30 gift card or their choice of a prize.

So what can help you stay motivated to be more physically active? We’ve got more tips on sneaking in exercise and finding ways to eat healthier and manage your weight here.

Or if loss aversion motivates you, then consider this: Americans are throwing away $397 million on unused gym memberships each year.