Taxing sugar-sweetened beverages and eliminating unhealthy snacks in schools are cost-effective
ways to reduce obesity.
Plenary speaker Steven Gortmaker, PhD, presented these findings Monday from the Childhood
Obesity Intervention Cost-Effectiveness Study (CHOICES), which he co-directs.
“If we want to reduce population obesity levels, we need to move beyond asking simply
what is effective and also consider the cost of interventions and their likely impact
on population health,” said Dr. Gortmaker, professor of the practice of health sociology
at Harvard School of Public Health.
The CHOICES research examined more than 40 obesity programs, conducted systematic
reviews of 130,000 peer-reviewed publications and created a computer simulated model
for projecting the impact of interventions over a decade.
Researchers found an excise tax on sugar-sweetened beverages of 1 cent per ounce could
prevent 576,000 cases of childhood obesity and save $14.2 billion in health care costs
over 10 years. Such a tax would save about $30.80 for every $1 invested.
“There’s strong evidence about the effect of the tax on consumption,” Dr. Gortmaker
said. “If you raise the price, people purchase less.”
The savings doesn’t include the $12.5 billion a year in additional tax revenue that
could be used for other obesity initiatives. In addition, the tax would discourage
adult consumption and could prevent an additional 1.9 million cases of obesity.
The Smart Snacks in School program, part of the Healthy Hunger-Free Kids Act that
eliminates unhealthy food outside of school meals, is estimated to prevent 344,649
childhood obesity cases and save $792 million over 10 years. It saves about $4.60
per $1 invested on implementation, according to Dr. Gortmaker.
A third cost-effective obesity prevention strategy the research found is to eliminate
tax breaks for companies that advertise unhealthy food to children. This would prevent
129,061 cases of childhood obesity and save $260 million in health care costs over
a decade. Each dollar invested would save $32.50 in health costs.
These health interventions also would improve health equity, as low-income minority
populations tend to consume more sugar-sweetened beverages. The impact of the beverage
tax would be 1.32 times greater for Hispanic and 1.35 times greater for black children
compared to white youths.
Dr. Gortmaker compared the interventions to bariatric surgery, which would cost $303
million for 49,000 youths to have surgery over 10 years. Furthermore, bariatric surgery
doesn’t prevent obesity.
“We cannot expect to treat our way out of the obesity epidemic,” Dr. Gortmaker said.
“Treatment makes relatively small impact on obesity prevalence. It’s kind of too little,
He encouraged pediatricians to advocate for prevention programs in their communities.
“We need multiple strategies if we’re going to turn around the obesity epidemic in
the United States,” Dr. Gortmaker said. “So, I urge you to get involved and think
about what you can do with your community, but also think about what’s effective,
what kind of population reach or impact that intervention could have and what is the