How should we measure obesity?

What is the correct economic model to assess benefits and costs associated with obesity? Is the right data being captured? The headlines are cautioning about risk factors for cancer but how would we get the right granularity to distinguish between the myriad of exposures and their broad downstream impact on health outcomes. 

We have measures but do we have the models to describe their role in declining health specific to a lifestyle choice? Sick days, obesity research, food depletion, physical activity levels, diet patterns, patient self-reported food diaries demographic measures captured in EHR/EMR and mobile health technology such as recent advances by Apple and fitbit.

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The World Cancer Research Fund estimates that about one quarter to one third of all cancers in the United States can be attributed to diet and insufficient physical activity, as well as overweight and obesity

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Cost consequences outlined by the Affordable Health  Care Act approved as comparative effectiveness research (CER) typically measure benefits that accrue due to reducing obesity. 

CER is used "to inform health-care decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options. 


The evidence is generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver health care. "outcome" of fundamental interest, is how long people live or how much life (survival) increases by reducing obesity." 

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Obesity and risk of cancer

Research has shown an association between obesity and increased risk for many cancers. Although additional research is ongoing the relationship between weight loss and cancer risk is limited. Preliminary studies do suggest that weight loss may reduce the risk of certain cancers.

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Economics of Obesity

Research to evaluate cost-effective interventions that address obesity are shown in the figure. ACE interventions are mapped to a continuum of key determinants and solutions to the obesity epidemic. 

Upstream factors related to economic systems to downstream factors affecting the physiology of individuals highlight three preventive interventions that targeted the obesogenic environment (reduction of advertising of unhealthy food and beverages to children, front-of-pack traffic light nutrition labelling and a 10% tax on unhealthy food and beverages) were all cost-saving. Associated with potentially difficult political support or integration many of these strategies are not likely to be implemented. 

This figure represents the link between society based solutions and measures directed at individual behavior and outcomes. The balance of non-pharmacologic intervention and potential pharmacologic solutions are an important highlight of the studies as we strive to manage the risk factors that continue to drive escalating healthcare costs.

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