An Economic Evaluation of Obesity Prevention for UK Adults
Lead Research Organisation:
University of Aberdeen
Department Name: School of Medical Sciences
Abstract
Obesity is a major contributor to the development of some of the most serious chronic diseases affecting the UK population, such as diabetes, coronary heart disease and cancer. Overweight and obese people suffer higher disease risks than their lower weight counterparts. The chances of suffering diabetes for a woman who is 167cm tall and weighs 70kgs are five times those of a woman who is just 9kgs lighter (at 61kgs). For a woman that weighs 84kgs the chances are 28 times higher, and at 97kgs they become 93 times higher. Given the seriousness of diabetes, these numbers are staggering. Similar increases in the risk of other major chronic diseases have been documented for both men and women. Because of the very slow and progressive nature of obesity, the serious health damage is often slow to take effect. Unfortunately, a lot of the damage can be very long lasting and often fatal. Even the most conservative projections on the future development of obesity-related chronic diseases show that a massive health problem is currently being built and stored, with serious human suffering and financial cost implications.
Although there is plenty of evidence that obesity can be influenced through changing lifestyles, there is little evidence about how to go about promoting such changes at the population level in a cost-effective way. Our aims are to
(i) create and analyse new evidence on how obesity, associated risks, prevention and related lifestyles are perceived and valued stakeholders.
(ii) analyse existing information from large surveys, NHS hospitalisation and cost records.
(iii) combine information using health economics techniques to rank alternative lifestyles interventions in terms of their attractiveness, cost and expected take up rates.
(iv) Recommend lifestyle interventions.
The preventive nature of the project is reflected by its concentration on UK adults aged 18-50 who are either overweight or slightly obese (BMI 25-35), and three common, preventable, and serious diseases (diabetes, coronary heart disease and cancer). A substantial strength of this project is its down-to-earth, tangible research objective accompanied by an unique mix of practitioner skills and advanced research skills to form a strong multidisciplinary team. The team contains specialists in clinical nutrition, discrete choice experiments, statistics, econometrics, economic evaluation, epidemiology, public health and sociology. Public Engagement is essential to conduct this research. Thus, a lay summary of the findings will be sent to all involved in the interviews, questionnaires along with representatives of key patient groups.
Although there is plenty of evidence that obesity can be influenced through changing lifestyles, there is little evidence about how to go about promoting such changes at the population level in a cost-effective way. Our aims are to
(i) create and analyse new evidence on how obesity, associated risks, prevention and related lifestyles are perceived and valued stakeholders.
(ii) analyse existing information from large surveys, NHS hospitalisation and cost records.
(iii) combine information using health economics techniques to rank alternative lifestyles interventions in terms of their attractiveness, cost and expected take up rates.
(iv) Recommend lifestyle interventions.
The preventive nature of the project is reflected by its concentration on UK adults aged 18-50 who are either overweight or slightly obese (BMI 25-35), and three common, preventable, and serious diseases (diabetes, coronary heart disease and cancer). A substantial strength of this project is its down-to-earth, tangible research objective accompanied by an unique mix of practitioner skills and advanced research skills to form a strong multidisciplinary team. The team contains specialists in clinical nutrition, discrete choice experiments, statistics, econometrics, economic evaluation, epidemiology, public health and sociology. Public Engagement is essential to conduct this research. Thus, a lay summary of the findings will be sent to all involved in the interviews, questionnaires along with representatives of key patient groups.
Technical Summary
This study will allow policy makers to choose from alternative obesity-reducing interventions, which aim to reduce diabetes, coronary heart disease (CHD) and cancer through lifestyle changes in the population. The study will involve the collaborative effort of specialists from the disciplines of economics, public health, clinical nutrition, epidemiology and sociology. The main objective is to perform a Cost-Benefit Analysis (CBA) to compare alternative lifestyle interventions. The data required to perform the CBA will be generated within six Phases of this co-ordinated, tightly focussed, multidisciplinary research project. Phase 1 (systematic reviews) will place the project within the existing literature regarding lifestyles and interventions. Phase 2 (qualitative analysis) will investigate in depth the perceptions of lay persons, NHS professionals and policy makers on obesity and its prevention. Phases 1 and 2 will feed crucial and indispensable information into all subsequent phases. Phase 3 (health economics analysis) will perform a Discrete Choice Experiment (DCE) to estimate monetary values and expected take-up rates of alternative lifestyle plans aimed at preventing obesity. Phase 4 (econometric analysis) will perform large panel data set estimations to establish the sensitivity of obesity outcomes to lifestyle levels and changes at the population level. Phases 3 and 4 will be linked, in that the design of the DCE will reflect the structure of the survey data sets variables. DCE and survey estimates will be combined to perform counterfactual analysis and generate predictions on alternative lifestyle interventions based on population characteristics. Phase 5 (analysis of cost) will use unique NHS Scotland hospitalisation data to estimate lifetime costs and benefits based on changes in the onset of diabetes, CHD and cancer attributed to changes in lifestyles and obesity levels. Phase 6 (CBA) will use all the data generated by Phases 1-5. This CBA will provide incremental net benefits for alternative lifestyle interventions. The output will inform policy on the development and implementation of optimal lifestyle interventions for the future prevention of obesity. The multivariate nature of the analysis will enable specific targeting according to specific population characteristics.
