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      Economics of Obesity — Learning from the Past to Contribute to a Better Future

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          Abstract

          The discipline of economics plays a varied role in informing the understanding of the problem of obesity and the impact of different interventions aimed at addressing it. This paper discusses the causes of the obesity epidemic from an economics perspective, and outlines various justifications for government intervention in this area. The paper then focuses on the potential contribution of health economics in supporting resource allocation decision making for obesity prevention/treatment. Although economic evaluations of single interventions provide useful information, evaluations undertaken as part of a priority setting exercise provide the greatest scope for influencing decision making. A review of several priority setting examples in obesity prevention/treatment indicates that policy (as compared with program-based) interventions, targeted at prevention (as compared with treatment) and focused “upstream” on the food environment, are likely to be the most cost-effective options for change. However, in order to further support decision makers, several methodological advances are required. These include the incorporation of intervention costs/benefits outside the health sector, the addressing of equity impacts, and the increased engagement of decision makers in the priority setting process.

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          Most cited references64

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          'Traffic-light' nutrition labelling and 'junk-food' tax: a modelled comparison of cost-effectiveness for obesity prevention.

          Cost-effectiveness analyses are important tools in efforts to prioritise interventions for obesity prevention. Modelling facilitates evaluation of multiple scenarios with varying assumptions. This study compares the cost-effectiveness of conservative scenarios for two commonly proposed policy-based interventions: front-of-pack 'traffic-light' nutrition labelling (traffic-light labelling) and a tax on unhealthy foods ('junk-food' tax). For traffic-light labelling, estimates of changes in energy intake were based on an assumed 10% shift in consumption towards healthier options in four food categories (breakfast cereals, pastries, sausages and preprepared meals) in 10% of adults. For the 'junk-food' tax, price elasticities were used to estimate a change in energy intake in response to a 10% price increase in seven food categories (including soft drinks, confectionery and snack foods). Changes in population weight and body mass index by sex were then estimated based on these changes in population energy intake, along with subsequent impacts on disability-adjusted life years (DALYs). Associated resource use was measured and costed using pathway analysis, based on a health sector perspective (with some industry costs included). Costs and health outcomes were discounted at 3%. The cost-effectiveness of each intervention was modelled for the 2003 Australian adult population. Both interventions resulted in reduced mean weight (traffic-light labelling: 1.3 kg (95% uncertainty interval (UI): 1.2; 1.4); 'junk-food' tax: 1.6 kg (95% UI: 1.5; 1.7)); and DALYs averted (traffic-light labelling: 45,100 (95% UI: 37,700; 60,100); 'junk-food' tax: 559,000 (95% UI: 459,500; 676,000)). Cost outlays were AUD81 million (95% UI: 44.7; 108.0) for traffic-light labelling and AUD18 million (95% UI: 14.4; 21.6) for 'junk-food' tax. Cost-effectiveness analysis showed both interventions were 'dominant' (effective and cost-saving). Policy-based population-wide interventions such as traffic-light nutrition labelling and taxes on unhealthy foods are likely to offer excellent 'value for money' as obesity prevention measures.
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            The cost of overweight and obesity in Australia.

            To assess and compare health care costs for normal-weight, overweight and obese Australians. Analysis of 5-year follow-up data from the Australian Diabetes, Obesity and Lifestyle study, collected in 2004-2005. Data were available for 6140 participants aged >or= 25 years at baseline. Direct health care cost, direct non-health care cost and government subsidies associated with overweight and obesity, defined by both body mass index (BMI) and waist circumference (WC). The annual total direct cost (health care and non-health care) per person increased from $1472 (95% CI, $1204-$1740) for those of normal weight to $2788 (95% CI, $2542-$3035) for the obese, however defined (by BMI, WC or both). In 2005, the total direct cost for Australians aged >or= 30 years was $6.5 billion (95% CI, $5.8-$7.3 billion) for overweight and $14.5 billion (95% CI, $13.2-$15.7 billion) for obesity. The total excess annual direct cost due to overweight and obesity (above the cost for normal-weight individuals) was $10.7 billion. Overweight and obese individuals also received $35.6 billion (95% CI, $33.4-$38.0 billion) in government subsidies. Comparing costs by weight change since 1999-2000, those who remained obese in 2004-2005 had the highest annual total direct cost. Cost was lower in overweight or obese people who lost weight or reduced WC compared with those who progressed to becoming, or remained, obese. The total annual direct cost of overweight and obesity in Australia in 2005 was $21 billion, substantially higher than previous estimates. There is financial incentive at both individual and societal levels for overweight and obese people to lose weight and/or reduce WC.
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              The economics of childhood obesity.

              In the past few decades, obesity rates among American children have skyrocketed. Although many factors have played a part in this unhealthy increase, this paper focuses on how economic policies may be contributing to our children's growing girth and how these policies might be altered to reverse this trend. It examines the economic causes and consequences of obesity, the rationales for government intervention, the cost-effectiveness of various policies, and the need for more research funding.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                14 April 2014
                April 2014
                : 11
                : 4
                : 4007-4025
                Affiliations
                [1 ]Deakin Health Economics, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia; E-Mails: marj.moodie@ 123456deakin.edu.au (M.M.); rob.carter@ 123456deakin.edu.au (R.C.)
                [2 ]WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia; E-Mail: gary.sacks@ 123456deakin.edu.au
                Author notes
                [* ] Author to whom correspondence should be addressed; E-Mail: jaithri.ananthapavan@ 123456deakin.edu.au ; Tel.: +61-3-9251-7181; Fax: +61-3-9244-6624.
                Article
                ijerph-11-04007
                10.3390/ijerph110404007
                4025046
                24736685
                fece665b-9dc1-4271-b80c-b25a335fa20a
                © 2014 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                : 01 February 2014
                : 28 March 2014
                : 28 March 2014
                Categories
                Article

                Public health
                obesity,prevention,economic evaluation,priority setting,interventions
                Public health
                obesity, prevention, economic evaluation, priority setting, interventions

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