title: Three Interventions That Reduce Childhood Obesity Are Projected To Save More Than They Cost To Implement.
abstract: Policy makers seeking to reduce childhood obesity must prioritize investment in treatment and primary prevention. We estimated the cost-effectiveness of seven interventions high on the obesity policy agenda: a sugar-sweetened beverage excise tax; elimination of the tax subsidy for advertising unhealthy food to children; restaurant menu calorie labeling; nutrition standards for school meals; nutrition standards for all other food and beverages sold in schools; improved early care and education; and increased access to adolescent bariatric surgery. We used systematic reviews and a microsimulation model of national implementation of the interventions over the period 2015-25 to estimate their impact on obesity prevalence and their cost-effectiveness for reducing the body mass index of individuals. In our model, three of the seven interventions--excise tax, elimination of the tax deduction, and nutrition standards for food and beverages sold in schools outside of meals--saved more in health care costs than they cost to implement. Each of the three interventions prevented 129,000-576,000 cases of childhood obesity in 2025. Adolescent bariatric surgery had a negligible impact on obesity prevalence. Our results highlight the importance of primary prevention for policy makers aiming to reduce childhood obesity.
authors.affiliation: Steven L. Gortmaker (sgortmak@hsph.harvard.edu) is a professor of the practice of health sociology at the Harvard T.H. Chan School of Public Health, in Boston, Massachusetts.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Gortmaker
authors.affiliation: Y. Claire Wang is an associate professor at the Mailman School of Public Health, Columbia University, in New York City.
authors.forename: Y Claire
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Michael W. Long is an assistant professor at the Milken Institute School of Public Health, the George Washington University, in Washington, DC.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Long
authors.affiliation: Catherine M. Giles is a program manager at the Harvard T.H. Chan School of Public Health.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Giles
authors.affiliation: Zachary J. Ward is a programmer analyst at the Harvard T.H. Chan School of Public Health.
authors.forename: Zachary J
authors.initials: ZJ
authors.lastname: Ward
authors.affiliation: Jessica L. Barrett is a research assistant IV at the Harvard T.H. Chan School of Public Health.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Barrett
authors.affiliation: Erica L. Kenney is a postdoctoral research fellow at the Harvard T.H. Chan School of Public Health.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Kenney
authors.affiliation: Kendrin R. Sonneville is an assistant professor at the University of Michigan School of Public Health, in Ann Arbor.
authors.forename: Kendrin R
authors.initials: KR
authors.lastname: Sonneville
authors.affiliation: Amna Sadaf Afzal is an assistant professor at the Albert Einstein College of Medicine, in New York City.
authors.forename: Amna Sadaf
authors.initials: AS
authors.lastname: Afzal
authors.affiliation: Stephen C. Resch is deputy director of the Center for Health Decision Science at the Harvard T.H. Chan School of Public Health.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Resch
authors.affiliation: Angie L. Cradock is a senior research scientist at the Harvard T.H. Chan School of Public Health.
authors.forename: Angie L
authors.initials: AL
authors.lastname: Cradock
mesh_terms: D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D063766:Pediatric Obesity / Q000517:prevention & control*; D011050:Policy Making; D014481:United States
keywords: Children’s Health; Health Promotion/Disease Prevention