Three Interventions That Reduce Childhood Obesity Are Projected To Save More Than They Cost To Implement

• Published in: Health Affairs Vol. 34; no. 11; pp. 1932 - 1939
• Main Authors: Gortmaker, Steven L, Wang, Y Claire, Long, Michael W, Giles, Catherine M, Ward, Zachary J, Barrett, Jessica L, Kenney, Erica L, Sonneville, Kendrin R, Afzal, Amna Sadaf, Resch, Stephen C, Cradock, Angie L
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01.11.2015
• Subjects: Access; Adolescent; Beverages; Body mass; Body mass index; Body size; Child; Childhood; Children; Cost analysis; Cost-Benefit Analysis; Deduction; Early intervention; Effectiveness; Excise taxes; Food; Health care; Health care expenditures; Health care policy; Health Promotion - economics; Humans; Implementation; Initiatives; Investments; Labeling; Longitudinal studies; Meals; Nutrition; Obesity; Pediatric Obesity - prevention & control; Policy Making; Prevention; Restaurants; School meals; Schools; Studies; Sugar; Surgery; Taxation; Teenagers; United States; United States > US; Children’s Health; Health Promotion/Disease Prevention
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.2015.0631

Policy makers seeking to reduce childhood obesity must prioritize investment in treatment and primary prevention. We estimated the cost-effectiveness of seven interventions high on the obesity policy agenda: a sugar-sweetened beverage excise tax; elimination of the tax subsidy for advertising unhealthy food to children; restaurant menu calorie labeling; nutrition standards for school meals; nutrition standards for all other food and beverages sold in schools; improved early care and education; and increased access to adolescent bariatric surgery. We used systematic reviews and a microsimulation model of national implementation of the interventions over the period 2015-25 to estimate their impact on obesity prevalence and their cost-effectiveness for reducing the body mass index of individuals. In our model, three of the seven interventions--excise tax, elimination of the tax deduction, and nutrition standards for food and beverages sold in schools outside of meals--saved more in health care costs than they cost to implement. Each of the three interventions prevented 129,000-576,000 cases of childhood obesity in 2025. Adolescent bariatric surgery had a negligible impact on obesity prevalence. Our results highlight the importance of primary prevention for policy makers aiming to reduce childhood obesity.