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.

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.

Publications


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Aucott L (2011) Effects of lifestyle interventions and long-term weight loss on lipid outcomes - a systematic review. in Obesity reviews : an official journal of the International Association for the Study of Obesity
Brown T (2009) Systematic review of long-term lifestyle interventions to prevent weight gain and morbidity in adults. in Obesity reviews : an official journal of the International Association for the Study of Obesity
Mavromaras K (2008) Economics and Obesity in The Australian Economic Review
 
Description Effectiveness of interventions to prevent obesity
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in systematic reviews
 
Description Scottish Obesity forum
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description NPRI
Amount £250,000 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom of Great Britain & Northern Ireland (UK)
Start 11/2008 
End 07/2011
 
Description Aberdeen Centre for energy regulation and obesity 
Organisation University of Aberdeen
Department Aberdeen Centre for Energy Regulation and Obesity (ACERO)
Country United Kingdom of Great Britain & Northern Ireland (UK) 
Sector Academic/University 
PI Contribution One of the study team is a member of this group and this has facilitated links between this project team and the Aberdeen Centre for energy regulation and obesity
Collaborator Contribution Access to wider network with experience of key policy and research issues in the area
Impact As a consequence of this link further work addressing policy relevant questions is being developed. A further application funded by NIHR involving clinical and economic collaborators will start shortly
Start Year 2007
 
Description Econometrics research link with University of Melbourne 
Organisation University of Melbourne
Country Australia, Commonwealth of 
Sector Academic/University 
PI Contribution A formal link with the University of Melbourne was established. One element of the work was led by researchers in Melbourne and leadership of another element was shared between Melbourne and Aberdeen. four other elements were led from Aberdeen but all members of the project team contributed.
Collaborator Contribution Researchers in melbourne led one element of the research and contributed to 5 other distinct elements of the project
Impact Publications involving researchers from this insitution. bibliographic details entered elsewhere
Start Year 2006
 
Description HTA: management of obesity in men 
Organisation Newcastle University
Department Institute of Health and Society
Country United Kingdom of Great Britain & Northern Ireland (UK) 
Sector Academic/University 
PI Contribution Research team has designed and prepared the whole application for fundign and will complete all the work
Collaborator Contribution It has helped perpetuate existing fruitful collaborations
Impact not as yet - work just commenced
Start Year 2011
 
Description Information and Statistics Division, NHS Scotland 
Organisation NHS Health Scotland
Department Information Services Division (ISD) Scotland
Country United Kingdom of Great Britain & Northern Ireland (UK) 
Sector Public 
PI Contribution This collabortion has stemmed from a related NPRI funded project. The work for this project has helped develop links between the reseach team and the ISD.
Collaborator Contribution Access to and understanding off data collected by ISD and linked to survery data used in econometric and economic evaluation modelling
Impact Outputs will include econometric peer review papers which are in preparations. These paper report analyses that will be used in economic evaluation modelling papers. Disciplines incvolved are: Health economic and statistics
Start Year 2010
 
Description Press release 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Press releases by the Universities of Aberdeen and Melbourne. radio interviews for the BBC

Articles were written in all the main national newspapers and the local press. project was highlighted to policy groups and otehr research groups and information about the project and its outputs disseminated.
Year(s) Of Engagement Activity 2006