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Which Obesity Prevention Strategies Offer Most Bang for the Buck? :

August 9, 2017

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

The childhood obesity epidemic continues to confound policymakers, physicians and the public.

Despite the implementation of myriad programs, policies and interventions to help children and teens achieve and maintain a healthy weight, about 17% of U.S. youths ages 2-19 years are obese, and 16.2% are overweight, according to the 2013-2014 National Health and Nutrition Examination Survey. Furthermore, little is known about whether such efforts are cost-effective.

Researchers involved in the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) have been working to identify initiatives that provide the most bang for the buck. The study and initial results will be presented by Steven Gortmaker, PhD, during a plenary session titled “The 5 Most Cost-Effective Strategies to Prevent Childhood Obesity (P3072)” from 10:30-10:50 am Monday, Sept. 18.

“One of the big challenges is that few public health professionals have been trained to consider cost, effect, reach and cost-effectiveness of policy changes,” said Dr. Gortmaker, professor of the practice of health sociology at Harvard School of Public Health. “This is changing, however, as decision-makers all want to make ‘best value for money’ decisions.”

Dr. Gortmaker began studying childhood obesity in 1985. He and his colleagues conducted the first longitudinal study linking excess television viewing to increased obesity prevalence, the first study that showed increasing obesity among U.S. children and youths, and the first longitudinal study linking increases in sugar-sweetened beverage intake to increased obesity incidence in youths.

Dr. Gortmaker is co-director of CHOICES, which is looking at how many people would benefit from programs that are high on the public policy agenda, how these programs would affect health (e.g., body mass index, dietary intake, physical activity) and how much they would save in health care costs. 

Researchers developed a computer model to simulate the costs and effect on obesity prevalence if the following interventions were implemented nationally from 2015-2025:

  • an excise tax of 1 cent per ounce on sugar-sweetened beverages;
  • eliminating the tax deduction for the costs of TV ads that promote unhealthy food to children;
  • listing calories on restaurant menus;
  • implementing nutrition standards for school meals;
  • implementing nutrition standards for all other food and beverages sold in schools;
  • improving nutrition, physical activity and screen time practices in child care and early education programs; and
  • increasing access to adolescent bariatric surgery. 

Results published in the November 2015 issue of Health Affairs showed three of the interventions saved more in health care expenditures than it cost to implement them — the excise tax, eliminating the tax deduction for TV ads and implementing school nutrition standards for food and beverages other than meals.

The authors noted that more than one strategy will be necessary to combat the obesity epidemic, and prevention is more effective than treatment.

“Treatment is too little, too late and too expensive,” Dr. Gortmaker said.

For more stories on educational sessions and events at the 2017 AAP National Conference & Exhibition in Chicago, visit To register for the conference, visit

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