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$50 000 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.

Edmonton, Alberta