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Plenary Speaker: Obesity Interventions Can Be Cost-Effective :

September 19, 2017

Editor's note: The 2017 AAP National Conference & Exhibition will take place from Sept. 16-19 in Chicago.

Taxing sugar-sweetened beverages and eliminating unhealthy snacks in schools are cost-effective ways to reduce obesity.

Plenary speaker Steven Gortmaker, PhD, presented these findings Monday from the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES), which he co-directs.

“If we want to reduce population obesity levels, we need to move beyond asking simply what is effective and also consider the cost of interventions and their likely impact on population health,” said Dr. Gortmaker, professor of the practice of health sociology at Harvard School of Public Health.

The CHOICES research examined more than 40 obesity programs, conducted systematic reviews of 130,000 peer-reviewed publications and created a computer simulated model for projecting the impact of interventions over a decade.

Researchers found an excise tax on sugar-sweetened beverages of 1 cent per ounce could prevent 576,000 cases of childhood obesity and save $14.2 billion in health care costs over 10 years. Such a tax would save about $30.80 for every $1 invested.

“There’s strong evidence about the effect of the tax on consumption,” Dr. Gortmaker said. “If you raise the price, people purchase less.”

The savings doesn’t include the $12.5 billion a year in additional tax revenue that could be used for other obesity initiatives. In addition, the tax would discourage adult consumption and could prevent an additional 1.9 million cases of obesity.

The Smart Snacks in School program, part of the Healthy Hunger-Free Kids Act that eliminates unhealthy food outside of school meals, is estimated to prevent 344,649 childhood obesity cases and save $792 million over 10 years. It saves about $4.60 per $1 invested on implementation, according to Dr. Gortmaker.

A third cost-effective obesity prevention strategy the research found is to eliminate tax breaks for companies that advertise unhealthy food to children. This would prevent 129,061 cases of childhood obesity and save $260 million in health care costs over a decade. Each dollar invested would save $32.50 in health costs.

These health interventions also would improve health equity, as low-income minority populations tend to consume more sugar-sweetened beverages. The impact of the beverage tax would be 1.32 times greater for Hispanic and 1.35 times greater for black children compared to white youths.

Dr. Gortmaker compared the interventions to bariatric surgery, which would cost $303 million for 49,000 youths to have surgery over 10 years. Furthermore, bariatric surgery doesn’t prevent obesity.

“We cannot expect to treat our way out of the obesity epidemic,” Dr. Gortmaker said. “Treatment makes relatively small impact on obesity prevalence. It’s kind of too little, too late.”

He encouraged pediatricians to advocate for prevention programs in their communities.

“We need multiple strategies if we’re going to turn around the obesity epidemic in the United States,” Dr. Gortmaker said. “So, I urge you to get involved and think about what you can do with your community, but also think about what’s effective, what kind of population reach or impact that intervention could have and what is the cost.”

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