A Family Portrait

Counting Pennies for Family-Based Childhood Obesity Care

A new economic analysis published in Pediatrics leaves us with simple questions. Are we willing to pay for childhood obesity care? If we believe in family values, how do we value families?

Cost-Effectiveness of Family-Based Childhood Obesity Care

Teresa Quattrin and colleagues have previously demonstrated the effectiveness of family-based care for childhood obesity. And they demonstrated how it could be delivered in primary care or a patient-centered medical home.

But now in Pediatrics, they took their data analysis one step further to examine costs and cost effectiveness. The control group focused on coaching parents about their children. The family-based program focused on behavioral strategies for both children and their parents.

Not surprisingly, the family-based program was more cost-effective. And that superiority came mainly from big benefits for the children. Benefits for the parents were more modest by comparison.

But What’s the Goal? Saving Money or Saving Health?

In a companion commentary, Eric Finkelstein points out some huge problems with assessing cost effectiveness for childhood obesity care. First and foremost is the problem of finding a good measure. For adults, it’s simpler. How much weight did they lose and how much did it cost?

But kids are growing. So the goal is not weight loss. Rather, it’s to allow kids to grow into a healthier weight status. It’s good in theory, but the measures are tricky.

He also points out a more fundamental problem. Policymakers are always tempted to point to the huge costs that come with obesity and intimate that obesity care will save on those costs. He says:

This is misleading. Cost-effective interventions buy health improvements (eg, QALYs) at a reasonable price, but they do not save money.

The problem is that providing obesity care costs money now. The complications of childhood obesity cost money for years into the future. So if you don’t care about writing off the lives of a whole generation of kids with obesity, you won’t spend that money now. You just put it in the bank and wait for the kids to get sick when they’re into adulthood.

And sadly, we’re doing too much of that.

The answer is that we need to refocus on investing in good health. We must pursue childhood obesity care that offers the best value possible.

Click here for the study and here for the commentary by Finkelstein.

A Family Portrait, watercolor by Pavel Filonov / WiliArt

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August 30, 2017

One Response to “Counting Pennies for Family-Based Childhood Obesity Care”

  1. August 31, 2017 at 11:27 am, Allen Browne said:

    Ted,

    Thank you.

    Allen