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Comment & Response
October 15, 2014

Commitment Devices to Improve Unhealthy Behaviors—Reply

Author Affiliations
  • 1Harvard Kennedy School, Harvard University, Boston, Massachusetts
  • 2Wharton School, University of Pennsylvania, Philadelphia
  • 3Philadelphia VA Medical Center, UPENN Center for Health Incentives and Behavioral Economics, Philadelphia, Pennsylvania
JAMA. 2014;312(15):1592-1593. doi:10.1001/jama.2014.10173

In Reply Our Viewpoint described commitment devices and argued that they should be more widely used in health care. Commitment devices enforce voluntarily imposed restrictions on people until they have accomplished their goals or enforce voluntarily imposed penalties if they do not accomplish their goals.

Taking disulfiram in the morning so a person with alcoholism will be sick if he or she drinks alcohol in the evening is an example of a commitment device. Scheduling workouts with a partner to increase the cost of skipping the gym (ie, disappointing friends) is another example of a commitment device. Recent behavioral science research finds significant demand for commitment devices and that such devices can improve health outcomes ranging from weight loss to smoking cessation.

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