An economic evaluation of obesity prevention for UK adults

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.

HERU researchers involved in this research project: Dami Olajide, Anne Ludbrook, Mandy Ryan, and Deokhee Yi.

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)

Publications

Brown, T., Avenell, A., Edmunds, E., Moore, H., Whittaker, V., Avery, L., Summerbell, C. for the PROGRESS group (Ryan, M. and Vale, L. members of this group) (2009) 'Systematic review of long-term lifestyle interventions to prevent obesity in adults', Obesity Reviews, 10 (6), 627-638.

Aucott, L., Gray, D., Rothnie, H., Thapa, M., Waweru, C. for the PROGRESS group (Ryan, M. and Vale, L. are members of this group), (2011) 'Effects of lifestyle interventions and long-term weight loss on lipid outcomes – a systematic review', Obesity Reviews, 12(5), e412-e425.

Olajide, D. and Ludbrook, A. (2012) 'Diet, risk of obesity and socioeconomic circumstances of individuals in the UK: a seemingly unrelated approach', Nordic Journal of Health Economics, 1(2), 99-118.

Ryan, M., Yi, D., Avenell, A., Douglas, F., Aucott, L., van Teijlingen, E. and Vale, L. (2015) 'Gaining pounds by losing pounds: preferences for lifestyle interventions to reduce obesity', Health Economics, Policy, and Law, 10(2), 161-182.

Olajide, D. and Ludbrook, A. (2014) 'Effects of income, education and occupation status on diet and risk of obesity', HERU Briefing Paper, University of Aberdeen, December 2014.

Ryan, M., Yi, D., Avenell, A., Douglas, F., Aucott, L., Van Teijlingen, E. and Vale, L. (2015) 'Gaining pounds by losing pounds: research finds financial incentives could help reduce obesity', HERU Policy Brief, University of Aberdeen, March 2015.

Presentations

Vale, L. (2006) ‘Economic evaluation of obesity prevention’, National Prevention Research Initiative, Medical Research Council, London, February 2006.

Vale, L. (2006) ‘Economic evaluation of obesity prevention’, Obesity Research Group, University of Aberdeen, Aberdeen, February 2006.

Ludbrook, A. (2006) ‘What really works?’ Childhood Obesity Conference, Edinburgh, December 2006.

Ludbrook, A. (2007) ‘Obesity: treatable condition or lifestyle choice?’ Northern Ireland Health Economics Group, Belfast, October 2007.

Goode, A.J., Mavromaras, K.G. and Smith, MD. (2008)Intergenerational transmission and healthy eating behaviour’, Scottish Economic Society Annual Conference, Perth, April 2008.

Olajide, D. and Smith, MD. (2009) ‘Obesity-related disease incidence modelling using hospitalisation records: correcting for sample selection bias’, Scottish Economic Society Annual Conference, Perth, April 2009.

Olajide, D. and Ludbrook, A. (2010) ‘A multilevel analysis of the influence of households on sedentary behaviour among children in Scotland’, European Conference on Health Economics (ECHE), Helsinki, Finland, July 2010.

Ryan, M., Yi D., Avenell, A., Douglas, F., Aucott, L., van Teijlingen, E. and Vale, L. (2010) ‘Understanding preferences for lifestyle interventions to reduce obesity: should we pay people to live well?’ UK Society for Behavioural Medicine 6th Annual Scientific Meeting, University of Leeds, December 2010.

Ryan M. (2012) ‘Using Discrete Choice Experiments to understand preferences for lifestyle interventions: should we pay people to live well? Invited Plenary presentation’, British Psychological Society, Division of Health Psychology Annual Conference, University of Glasgow, February 2012.

Ryan M. (2012) ‘Discrete Choice Experiments in health economics: an application to lifestyle interventions’, Seminar, Community Health Sciences, Centre of Health Economics Research, University of Southern Denmark, Denmark, April 2012.

Ryan M. (2012) ‘Discrete choice experiments in health economics: an application to lifestyle interventions’, Seminar, Community Health Sciences, University of Calgary, Canada, April 2012.

Olajide, D., Ludbrook, A. and Vale L. (2012) ‘Variations in costs of hospital admissions for obesity-related diseases: a mixed effects mixed distribution approach’, European Conference on Health Economics, Zurich, July 2012.

Pol, M. van der, Ludbrook A. and Ryan M. (2012) ‘Incentives in health promotion: taxing people for unhealthy behaviours or paying people for healthy behaviours?’ British Science Festival, Aberdeen, September 2012.

Vale, L., Yi, D. on behalf of the PROGRESS Group (Ludbrook, A. and Ryan, M. are members of group) (2014) 'Ib for £: an economic evaluation of obesity prevention for UK adults', Health Economics and Health Technology Assessment (HEHTA) Seminar, Glasgow University, Glasgow, 30 October 2014.

Ryan, M. (2016) 'Gaining pounds by losing pounds: preferences for lifestyle interventions to reduce obesity', Scottish Economic Society Annual Conference, Perth, 20 April 2016.

Vale, L., Yi, D., Lee, K. W. on behalf of the PROGRESS Group (Ludbrook, A. and Ryan, M. are members of group) (2016) 'Ib for £: an economic evaluation of obesity prevention for UK adults', Institute of Applied Health Research, Birmingham University, Birmingham, England, October 2016.