An Open Letter To The Government Of Dubai

Dubai’s obesity crisis has prompted a “weight loss for gold” public health campaign. It’s an innovative start, and should be expanded.

Just over a week ago, Dubai launched its much talked-about “Your Weight In Gold” weight-loss campaign. Put simply, participants earn gold for each kilogram lost over a 30-day time frame. The idea is to jump-start some healthier habits in response to an alarmingly sharp rise in obesity over the past few decades.

And alarming it is: as a region, the Middle East/North Africa now has one of the highest diabetes prevalence rates in the world, in part a byproduct of their rapid economic development, massive influx of fast food, and aging population.

In fact, 66% of men and 73% of women within the UAE are considered overweight or obese. What’s more, the comparative prevalence rate of diabetes is 19%, and some forecasts warn that by 2030, an estimated 41 percent of the adult population will have either prediabetes or type 2 diabetes.

The program’s critics have offered some valid concerns, including the more obvious debates about the merits of intrinsic versus extrinsic rewards, the emphasis on initial weight loss over enduring lifestyle change, and of course, the simple fact that any crash diet (which the scheme’s setup might inadvertently endorse) tends to be itself inherently unhealthy.

That said, I still see it as genius. In many ways, one can’t help but admire the moxy of Dubai’s approach, especially when you consider that the initiative fastidiously obeys the three hallmarks of any successful campaign, weight-loss or otherwise:

1. It’s simple. 1 kilogram = 1 gram of gold. The initial offer itself was both unmistakable and delightfully crisp to explain to others. Due to popular response, the government has since upped the ante, now standing at 2 or even 3 grams of gold per kilogram, depending of whether participants hit the threshold of 5 and ten kilograms respectively. Either way, it stands in rather stark contrast to so many US-based initiatives that tie themselves in knots with complicated bonus points or reward schemes.
2. It’s bold. There’s a refreshing aggression to the offer, which itself helps to underline the urgency of the health crisis facing the UAE. Dubai prompted a long-overdue conversation, admirable in a country where only 30% of the population is at a healthy weight, but 75% believe they are. Not to mention the fact that the campaign has earned column inches all across the world — an outcome most government-backed weight-loss programs could only dream of.
3. It’s on brand. At least from an outsider’s perspective, the offer feels entirely in line with the majesty and scale one expects from Dubai. Offering the cash equivalent — roughly $20 per pound lost — just doesn’t carry the same metaphoric gravitas in a city-state known for building only the biggest, tallest, or most opulent version of nearly everything. Culturally speaking, the idea fits. It’s playful.

That being said, we think they can make it even more powerful — having spent the past two years neck-deep in the science of behavior change, we see three important ways they might build on their approach going forward:

1. Address the process, not just the outcome. The Diabetes Prevention Program (DPP) was a breakthrough clinical trial in the US that showed that relatively modest weight loss (say, 15 lbs for a 200 lbs person) could significantly reduce the chances that someone with prediabetes would go on to develop type 2 diabetes. But key to its success was that each participant was guided through a lifestyle-related curriculum to help them internalize critical lessons about nutrition, fitness, and the psychological underpinnings of successful weight loss. Follow-on studies showed that the participants who attended more lifestyle sessions lost more weight, suggesting that an on-going, in-context learning process itself is critical to success. Going forward, Dubai might reward the learning process even more than the weight loss itself, since the former more concretely ensures the latter can be sustained over time.
2. Think collaboration, not just competition. While the program director has described the initiative as a “healthy competition”, nudging people towards “healthy collaboration” might work even better. Some studies show that tackling weight loss challenges as part of an explicit group can be more effective psychological strategy. One study recruited participants to do a weight loss program alone, or with 3 friends or family members. Participants with greater social support were more likely to complete the 4-month program and maintain their weight loss after 10 months. Another study showed that group therapy produced significantly greater reductions in weight and body mass than individual therapy. Dubai has an interesting opportunity not only to reward individual accomplishment, but potentially incentivize households, businesses, or other social groups to compete as a “weight loss team”, thereby encouraging them to root each other on.
3. Include the mind, not just the body. Any weight-loss attempt carries with it figurative as well as literal weight. There are valid and consistent emotional reasons people struggle with weight, and these must be addressed head on and actively managed over time. When designing Preventnow.com (our 16-week-online program to help people lose weight and reduce their risk of type 2 diabetes), we noticed that our participants were routinely crediting the psychological support as being most critical in helping them finally prioritize and then maintain better lifestyle habits. The research literature suggests that only 20% of individuals maintain their weight loss, so addressing psychological factors, such as thinking patterns and emotional regulation, plays an important part in long-term success. If Dubai can find ways to help participants examine — or even acknowledge — potential psychological barriers, odds are the extrinsic motivation (free gold!) will be quickly superseded by more meaningful and robust intrinsic desire.

The bottom line is that Dubai is addressing their obesity crisis with more innovation, urgency, and cultural sensitivity than many other countries. We all could learn a thing or two here. If this boldness could be coupled with a more nuanced and evidence-based approach, this could quickly become the gold standard in public health obesity efforts. Pun intended.