The childhood obesity epidemic continues to confound policymakers, physicians and
Despite the implementation of myriad programs, policies and interventions to help
children and teens achieve and maintain a healthy weight, about 17% of U.S. youths
ages 2-19 years are obese, and 16.2% are overweight, according to the 2013-2014 National
Health and Nutrition Examination Survey. Furthermore, little is known about whether
such efforts are cost-effective.
Researchers involved in the Childhood Obesity Intervention Cost-Effectiveness Study
(CHOICES) have been working to identify initiatives that provide the most bang for
the buck. The study and initial results will be presented by Steven Gortmaker, PhD,
during a plenary session titled “The 5 Most Cost-Effective Strategies to Prevent Childhood
Obesity (P3072)” from 10:30-10:50 am Monday, Sept. 18.
“One of the big challenges is that few public health professionals have been trained
to consider cost, effect, reach and cost-effectiveness of policy changes,” said Dr.
Gortmaker, professor of the practice of health sociology at Harvard School of Public
Health. “This is changing, however, as decision-makers all want to make ‘best value
for money’ decisions.”
Dr. Gortmaker began studying childhood obesity in 1985. He and his colleagues conducted
the first longitudinal study linking excess television viewing to increased obesity
prevalence, the first study that showed increasing obesity among U.S. children and
youths, and the first longitudinal study linking increases in sugar-sweetened beverage
intake to increased obesity incidence in youths.
Dr. Gortmaker is co-director of CHOICES, which is looking at how many people would
benefit from programs that are high on the public policy agenda, how these programs
would affect health (e.g., body mass index, dietary intake, physical activity) and
how much they would save in health care costs.
Researchers developed a computer model to simulate the costs and effect on obesity
prevalence if the following interventions were implemented nationally from 2015-2025:
an excise tax of 1 cent per ounce on sugar-sweetened beverages;
eliminating the tax deduction for the costs of TV ads that promote unhealthy food
listing calories on restaurant menus;
implementing nutrition standards for school meals;
implementing nutrition standards for all other food and beverages sold in schools;
improving nutrition, physical activity and screen time practices in child care and
early education programs; and
increasing access to adolescent bariatric surgery.
Results published in the November 2015 issue of Health Affairs showed three of the interventions saved more in health care expenditures than
it cost to implement them — the excise tax, eliminating the tax deduction for TV ads
and implementing school nutrition standards for food and beverages other than meals.
The authors noted that more than one strategy will be necessary to combat the obesity
epidemic, and prevention is more effective than treatment.
“Treatment is too little, too late and too expensive,” Dr. Gortmaker said.