Abstract
Background:Pre-commitment strategies can encourage participants to commit to a healthy food plan and have been suggested as a potential strategy for weight loss. However, it is unclear whether such strategies are cost-effective.Objective:To analyse whether pre-commitment interventions that facilitate healthier diets are a cost-effective approach to tackle obesity.Methods:Effectiveness evidence was obtained from a systematic review of the literature. For interventions demonstrating a clinically significant change in weight, a Markov model was employed to simulate the long-term health and economic consequences. The review supported modelling just one intervention: grocery shopping to a predetermined list combined with standard behavioural therapy (SBT). SBT alone and do nothing were used as comparators. The target population was overweight or obese adult women. A lifetime horizon for health effects (expressed as quality-adjusted life years (QALYs)) and costs from the perspective of the UK health sector were used to calculate incremental cost-effectiveness ratios (ICERs).Results:In the base case analysis, the pre-commitment strategy of shopping to a list was found to be more effective and cost saving when compared against SBT, and cost-effective when compared against ‘do nothing' (ICER=£166 per QALY gained). A sensitivity analysis indicated that shopping to a list remained dominant or cost-effective under various scenarios.Conclusion:Our findings suggest grocery shopping to a predetermined list combined with SBT is a cost-effective means for reducing obesity and its related health conditions.
Highlights
Recent European Union statistics revealed that the United Kingdom has more obese women (24%) than any other member state.[1]
Recent findings suggest that behavioural economics may offer alternative approaches to improving everyday decisions people make about the foods they consume, exercise habits and their health more generally.[4,5]
Results show that the standard behavioural therapy (SBT) þ list pre-commitment intervention dominates the SBT intervention in the base case, producing greater health gains at a lower cost
Summary
Recent European Union statistics revealed that the United Kingdom has more obese women (24%) than any other member state.[1]. Pre-commitment strategies can encourage participants to commit to a healthy food plan and have been suggested as a potential strategy for weight loss. It is unclear whether such strategies are cost-effective. The review supported modelling just one intervention: grocery shopping to a predetermined list combined with standard behavioural therapy (SBT). RESULTS: In the base case analysis, the pre-commitment strategy of shopping to a list was found to be more effective and cost saving when compared against SBT, and cost-effective when compared against ‘do nothing’ (ICER 1⁄4 d166 per QALY gained). CONCLUSION: Our findings suggest grocery shopping to a predetermined list combined with SBT is a cost-effective means for reducing obesity and its related health conditions
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