An economic analysis of traditional and technology-based approaches to weight loss.
BACKGROUND
The financial burden and human losses associated with noncommunicable diseases necessitate cost-effective and efficacious interventions.


OBJECTIVE
An economic analysis of the Lifestyle Education for Activity and Nutrition (LEAN) Study; an RCT that examined the efficacy of traditional and technology-based approaches to weight loss.


METHODS
Economic analyses from an organizational perspective were conducted for four approaches: standard care control (SC); group weight-loss education (GWL); a multisensor armband (SWA); and the armband in combination with group weight-loss education (GWL+SWA). Data were collected in 2008-2009. Weight loss was the primary outcome. Total costs, costs per participant, costs per kilogram lost, and incremental cost-effectiveness ratios (ICERs) were calculated in 2010-2011. All costs are the actual expenses (i.e., staff time and materials) incurred by the LEAN study (except where noted) and reported in 2010 U.S. dollars.


RESULTS
In the sample population of 197 sedentary, overweight, and obese adults (mean [±SD] age=46.9 ± 0.8 years, BMI=33.3 ± 5.2, weight=92.8 ± 18.4 kg), the GWL+SWA was the most expensive intervention in costs/participant ($365/partic) while yielding the greatest weight loss/partic (6.59 kg). The GWL was next in cost/partic ($240), but the SWA was less expensive in cost/partic ($183) and more efficacious (3.55 vs 1.86 kg/partic). The SC did not achieve significant weight loss. The SWA was the most cost effective ($51/partic/kg lost), followed by the GWL+SWA ($55) and GWL alone ($129). The ICER suggests that for each additional kilogram lost, the GWL+SWA cost $60 more than the SWA alone.


CONCLUSIONS
The SWA was the most cost-effective intervention ($51/partic/kg lost). The addition of the GWL increased the efficacy of the SWA intervention but increased costs by $60/partic for each additional kilogram lost. The technology-based approaches were more cost effective and efficacious than traditional approaches in promoting weight loss via lifestyle changes in sedentary, overweight, and obese adults.
Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, 29201-3937, USA. archerec@email.sc.edu
Edward
E
Archer
Erik J
EJ
Groessl
Xuemei
X
Sui
Amanda C
AC
McClain
Sara
S
Wilcox
Gregory A
GA
Hand
Rebecca A
RA
Meriwether
Steven N
SN
Blair
D000328:Adult; D020811:Biomedical Technology / Q000191:economics / Q000295:instrumentation; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics / Q000628:therapy*; D050177:Overweight / Q000191:economics / Q000628:therapy*; D010353:Patient Education as Topic / Q000191:economics / Q000379:methods; D057185:Sedentary Behavior; D016896:Treatment Outcome; D015431:Weight Loss