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Diet and Exercise Will Not Reduce the Cost of Obesity



Diet and exercise are often presented in public health messaging as the panacea for reducing the burden of obesity, thereby reducing the cost of obesity related conditions like stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer, or kidney cancer.

But will promoting diet and exercise really prove to be cost-effective in reducing the cost of these conditions?

This question was now explored by Megan Forster and colleagues from the University of Queensland, Australia, in a paper just published online in the International Journal of Obesity.

For their analyses, the researchers modeled two weight loss interventions that have been shown to reduce body weight (the dietary approaches to stop hypertension (DASH) program and a low-fat diet program) to determine if they would be cost-effective in Australia and to assess their potential to reduce the disease burden related to excess body weight.

The target population was the overweight and obese adult population in Australia in 2003, whereby costs and effects were calculated over a lifetime.

According to their calculations, the incremental cost-effectiveness ratios (ICERs) per disability adjusted life year (DALY) averted ranged between AUS$ 12,000 and 13,000 for cost of the programs (ICERs under AUS$50‚ÄČ000 per DALY are considered cost-effective).

However, when the total impact of the rather modest weight loss, post-intervention weight regain and low participation rates (generally less than 5% of the target population) are taken into account, these interventions would likely reduce the body weight-related disease burden at the population level by less than 0.1%.

Thus, although for participating individuals, these diet and exercise interventions to reduce obesity may potentially be cost-effective (although not cheap), they are likely to have a negligible impact on the total body weight-related disease burden at the population level.

Clearly, till we come up with more effective treatments for obesity and succeed in delivering these to a substantial proportion of the millions who would need such treatments, the cost burden of obesity is unlikely to decrease anytime soon.

AMS
Edmonton, Alberta

4 Comments

  1. I’m wondering if one of the first things we need to do is change the daily food recommendations. We are eating too much and the wrong things. For instance, people still eat a lot of bread, rice, potatoes and processed foods that are labelled as low fat. They are in fact low fat but isn’t it the case that they all affect insulin levels and therefore fat storage? People need to shift to a diet that is more based on vegetables and beans/lentils etc. I have made chili, tacos, and spagetti with the tofu replacement for ground beef and my family didn’t know! So portions too big. Eating too much food that raises insulin levels (even on diets). Need way more roughage. Lots of non-starchy veggies. No sugary pop. Careful with the wine and beer (carbs).

    These messages are needed to override the McDonalds message and the ones for chocolate bars and Gatorade.

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  2. wonder what the ICERs for Bariatric Surgery is … any research done on this one?

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  3. I suspect that your own research, APPLES ( or perhaps An Apple a day , or Apples to Apples),
    will show that the RNY is far and away more cost effective than any other intervention including the lap band

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  4. I don’t know why the unhealthy food is more tasty than the health food, for example one pizza is better than some apples, maybe this is not common for everyone but for the fat people it is.

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