Keep Your Eye on the Money

Better Obesity Care Need Not Cost More

Three recent publications are telling us that better obesity care doesn’t have to cost more. Adult primary care, family-based therapy for obesity of children and parents, and bariatric surgery each present opportunities for cost-effective therapy.

A group of researchers randomized 390 adult patients with severe obesity in Louisiana to standard care or intensive medical obesity treatment. The intervention included a 12-week liquid diet, followed by four months of group behavior therapy, structured diet, and optional pharmacotherapy. Another 16 months of maintenance strategies followed. Costs were calculated from medical claims data five years after the intervention.

They found that non-drug medical costs for the intensive intervention were no greater than usual care. Drug costs were significantly reduced, largely because the medical consequences of obesity were likewise reduced.

In families with excess weight in both parents and children, researchers compared the costs of family-based therapy versus individual treatments for parents and children. For 12 months of treatment, they found that costs-effectiveness was as much as five times better for family-based therapy versus individual therapy.

And finally, economists with the Bariatric Outcomes and Obesity Modeling Collaborative examined the cost-effectiveness of open bypass, laparoscopic bypass, and laparoscopic banding procedures for surgical obesity treatment. They found similar cost-effectiveness for the two laparoscopic procedures, which were both substantially more cost-effective than the open bypass procedure. All three procedures cost substantially less than the often-quoted threshold of $50,000 per quality-adjusted life year (QUALY).

Quality care for obesity is not free. The subsequent costs of neglecting obesity are even higher. It’s time to raise the standard of care and coverage.

Click here to read the randomized study in Louisiana, here to read the study of family-based therapy, and here to read the analysis of bariatric surgery cost-effectiveness.

Keep Your Eye on the Money, photograph © Darin House / flickr

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