Date of Award
Master of Public Health (MPH)
School of Public Health
RESEARCH OBJECTIVE: To evaluate the cost-effectiveness and impact on 10-year health care expenditure of Bright Bodies (BB), a high-intensity, family-based pediatric weight management program. In a randomized control trial (RCT), BB demonstrated the greatest magnitude of mean reduction in body mass index (BMI) in children and adolescents with obesity among U.S.-based interventions evaluated in the 2017 U.S. Preventive Task Force Report.
STUDY DESIGN: We developed a discrete event simulation model to project 10-year BMI trajectories of children ages 8-16 with obesity (BMI > 95th percentile for age and sex), using National Longitudinal Survey data and Centers for Disease Control and Prevention growth charts to determine BMI cut-off points. We validated the model using data from the BB RCT. We used this model to estimate the average cost per BMI unit reduction of the BB intervention compared to a clinical control that represented the status quo. Costs were estimated in 2020 US dollars from a health system perspective and included expenses to implement BB. The major cost items included staff time (dietitian, exercise physiologist, and social worker), exercise equipment, and medical consultation. We used results from two prior studies using Medical Expenditure Panel Survey data to estimate annual individual obesity-related medical expenditures.
POPULATION STUDIED: Children ages 8-16 with obesity (BMI [kg/m2] > 95th percentile for age and sex) enrolled in BB or the clinical control during the RCT.
PRINCIPAL FINDINGS: Over the 10-year simulation horizon, the overall cost of the 24-month duration of the Bright Bodies intervention was $1,517 (95% Uncertainty Interval (UI): $1,505, $1,530) per person, the total cost for the same duration of the clinical control was $1,377 (95% UI: $1,366, $1,388) per person, and the expected savings in obesity-related health care expenditures was $83 (95% UI: $49, $124) per person. The incremental effect of BB compared to control was a 0.66 kg/m2 (95% Confidence Interval (CI): 0.66, 0.66) reduction in BMI per person over a 10-year duration, with the highly conservative assumption of no maintenance of effect post-intervention and follow-up. We estimated the average incremental cost of BB per BMI unit reduction at $211 (95% CI: $193, $230) compared to clinical control.
CONCLUSIONS: Bright Bodies was effective in reducing BMI at a marginally higher cost per person compared with the clinical control.
IMPLICATIONS FOR POLICY OR PRACTICE: Nearly 1 in 5 children have obesity in the United States. Effective interventions for the treatment of obesity in childhood can potentially lower the percentage of today’s children that will have obesity at age 35, which is projected at 57% in a recent simulation study. Our findings add to the existing research on the potential cost-effectiveness and long-term health care expenditure savings of weight management programs for children and adolescents with obesity.
Pryor, Sydney Paige, "Projected Cost-Effectiveness And Long-Term Savings Of Bright Bodies Pediatric Weight Management Program" (2020). Public Health Theses. 2086.