An economic evaluation of obesity prevention for UK adults
The prevalence of obesity has been rising continuously in the UK with a major impact on mortality, morbidity and well-being. Achieving and maintaining a lower weight significantly reduces the risk of developing many diseases, especially diabetes, coronary heart disease (CHD) and some cancers. The investigation of the acceptability, effectiveness and cost-effectiveness of alternative preventive interventions is necessary for the design and targeting of evidence-based policy.
The study was based on six interlinked work packages: (i) systematic reviews of interventions’ effectiveness and prognostic outcomes of obesity; (ii) qualitative research investigating the causes and possible preventative remedies for obesity-related conditions from the perspective of the public, healthcare practitioners and policy makers; (iii) a discrete choice experiment (DCE) to estimate preferences for alternative lifestyle interventions; (iv) and (v) used econometric techniques to estimate the effectiveness and costs of lifestyle changes and (vi), informed by previous packages, the cost-effectiveness of alternative interventions was assessed.
Outcome and Translation
The systematic reviews showed that diet and exercise interventions providing support to individuals with BMI ≤ 35kg/m2 would lead to an average weight loss of more than 2kg persisting for at least for two years. Diet and exercise and/or behaviour therapy demonstrated significant reduction in hypertension and improvement in the risk of metabolic syndrome and diabetes compared with no treatment control. The qualitative research identified that stakeholders had different views of where responsibility lay – individuals focused on their own actions while health professionals and policy makers viewed obesity as a socio-ecologically-determined problem. Findings from these two work packages informed the DCE which found that there was a general preference for maintaining current lifestyles, together with a sensitivity to costs which suggests financial incentives could be used to help maximise up-take of healthy lifestyle interventions. Econometric analysis was used to inform the economic evaluation model. This model is now being used in early modelling of potential obesity prevention and treatment interventions to inform the design of new empirical evaluation studies.
External collaborators: M Sutton (University of Manchester); L Aucott, E van Teiljingen, F Douglas, J Greener, L Vale (Population Health, University of Aberdeen); A Goode, A Scott (University of Melbourne) and K Mavromaras (University of Adelaide)
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