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Purpose: This study aims to determine latent classes of study participants using baseline characteristics, explore the patterns within the groups, and determine whether the intervention had differential effects on weight loss across the groups., Design: Secondary analysis of a completed randomized clinical trial., Setting: Participants in a gamification intervention with social incentives who were recruited as pairs and given an intervention for 24 weeks. Participants were randomized to control, gamification, or gamification with primary care physician sharing arms., Participants: All 196 participants in the Lose It trial (recruited as 98 pairs)., Measures: Outcome variable-participants' weight change after 24 and 36 weeks. Factors-intervention arm and latent class., Analysis: Latent class analysis on both participants' and teams' characteristics. This was followed by 1-sample t tests of weight at 24 and 36 weeks, stratified by latent class., Results: Three groups of participants were identified: "Kin teams," "Distant teams," and "Married teams." "Kin teams" lost more weight after the intervention in the gamification and gamification with PCP sharing arms. The "Distant teams" lost similar amounts of weight in all 3 arms but did not keep it off during maintenance. The "Married teams" lost the most weight across all 3 arms and kept it off following the intervention., Conclusions: Patient phenotypes can identify variations in response to a gamification weight loss intervention. Future intervention studies may benefit from leveraging this during participant recruitment and allocation.

Purpose: To test the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally available weight management program., Design: A randomized trial tested the impact of employer subsidy: 100%; 80%, 50%, and a hybrid 50% subsidy that could become a 100% subsidy by attaining attendance targets., Trial Registration: NCT01756066., Setting and Participants: Twenty three thousand twenty-three employees of 2 US companies., Measures: The primary outcome was the percentage of employees who enrolled in the weight management program. We also tested whether the subsidies were associated with differential attendance and weight loss over 12 months, as might be predicted by the expectation that they attract employees with differing degrees of motivation. Analysis and Results: Enrollment differed significantly by subsidy level ( P < .0001). The 100% subsidy produced the highest enrollment (7.7%), significantly higher than each of the lower subsidies (vs 80% subsidy: 6.2%, P = .002; vs 50% subsidy: 3.9%, P < .0001; vs hybrid: 3.7%, P < .0001). Enrollment in the 80% subsidy group was significantly higher than both lower subsidy groups (vs 50% subsidy: 3.9%, P < .0001; vs hybrid: 3.7%, P < .0001). Among enrollees, there were no differences among the 4 groups in attendance or weight loss., Conclusion: This pragmatic trial, conducted in a real-world workplace setting, suggests that higher rates of employer subsidization help individuals to enroll in weight loss programs, without a decrement in program effectiveness. Future research could explore the cost-effectiveness of such subsidies or alternative designs.