Cost-effectiveness of Obesity Interventions: Will We Know It When We See It?

Abstract

* Abbreviations: %OBMI — : percent over BMI FBT — : family-based obesity treatment IC — : information-based control intervention ICER — : incremental cost-effectiveness ratio QALY — : quality-adjusted life year DALY — : disability-adjusted life year In this issue of Pediatrics , Quattrin et al1 present the results of a cost-effectiveness analysis of a family-based obesity treatment (FBT) program relative to an information-based control intervention (IC). The IC educated parents to encourage their children to have a weight loss goal of 0.5 to 1 lb per week. Parents then attended 16 group meetings; each meeting delivered dietary and/or physical activity advice. In between meetings, a health coach telephoned the parents to remind them to attend the meetings. The FBT group attended the same number of group meetings and received the same information. They also received education on parenting techniques both at the group sessions and during brief individual sessions with a health coach, at which time the health coach would also problem solve any concerns raised. Parents in FBT were further instructed to monitor their children’s weight and their own weight twice a week and received additional dietary (1500 and 1800 kilocalories per day for mothers and fathers, respectively), physical activity, and sedentary activity recommendations. Parents were also instructed to record food intake and activity for their children and themselves in a diary by crossing off icons detailing food groups and physical and sedentary activities undertaken. The authors report that after 2 years, child percent over BMI (%OBMI) change decreased by 1.98 U in the FBT group versus an increase of 4.37 U in the IC group. Parents lost 5.95 kg in the FBT group versus 0.16 kg in the IC group. One way to consider the impact of FBT is … Address correspondence to Eric A. Finkelstein, PhD, MHA, Health Services and Systems Research Programme, Duke-NUS Medical School, 8 College Rd, Singapore 169857. E-mail: eric.finkelstein{at}duke-nus.edu.sg