An Economic Analysis of Traditional and Technology-Based Approaches to Weight Loss

Background: The financial burden and human losses associated with noncommunicable diseases necessitate cost-effective and efficacious interventions. Purpose: An economic analysis of the Lifestyle Education for Activity and Nutrition (LEAN) Study; an RCT that examined the efficacy of traditional and technology-based approaches to weight loss. Methods: Economic analyses from an organizational perspective were conducted for four approaches: standard care control (SC); group weight-loss education (GWL); a multisensor armband (SWA); and the armband in combination with group weight-loss education (GWL + SWA). Data were collected in 2008-2009. Weight loss was the primary outcome. Total costs, costs per participant, costs per kilogram lost, and incremental cost-effectiveness ratios (ICERs) were calculated in 2010-2011. All costs are the actual expenses (i.e., staff time and materials) incurred by the LEAN study (except where noted) and reported in 2010 U.S. dollars. Results: In the sample population of 197 sedentary, overweight, and obese adults (mean [+/- SD] age = 46.9 +/- 0.8 years, BMI = 33.3 +/- 5.2, weight = 92.8 +/- 18.4 kg), the GWL + SWA was the most expensive intervention in costs/participant ($365/partic) while yielding the greatest weight loss/partic (6.59 kg). The GWL was next in cost/partic ($240), but the SWA was less expensive in cost/partic ($183) and more efficacious (3.55 vs 1.86 kg/partic). The SC did not achieve significant weight loss. The SWA was the most cost effective ($51/partic/kg lost), followed by the GWL + SWA ($55) and GWL alone ($129). The ICER suggests that for each additional kilogram lost, the GWL + SWA cost $60 more than the SWA alone. Conclusions: The SWA was the most cost-effective intervention ($51/partic/kg lost). The addition of the GWL increased the efficacy of the SWA intervention but increased costs by $60/partic for each additional kilogram lost. The technology-based approaches were more cost effective and efficacious than traditional approaches in promoting weight loss via lifestyle changes in sedentary, overweight, and obese adults. (Am J Prev Med 2012; 43(2): 176-182) (C) 2012 American Journal of Preventive Medicine