tokamak discharges in order to investigate the adverse effects of multiple saturated magnetic islands driven by neoclassical tearing modes ͑NTMs͒. Simulations are carried out with a predictive model for the temperature and density pedestal at the edge of the high confinement mode ͑H-mode͒ plasma and with core transport described using the Multi-Mode model. The ISLAND module, which is used to compute magnetic island widths, includes the effects of an arbitrary aspect ratio and plasma cross sectional shape, the effect of the neoclassical bootstrap current, and the effect of the distortion in the shape of each magnetic island caused by the radial variation of the perturbed magnetic field. Radial transport is enhanced across the width of each magnetic island within the BALDUR integrated modeling simulations in order to produce a self-consistent local flattening of the plasma profiles. It is found that the main consequence of the NTM magnetic islands is a decrease in the central plasma temperature and total energy. For the DIII-D and JET discharges, it is found that inclusion of the NTMs typically results in a decrease in total energy of the order of 15%. In simulations of ITER, it is found that the saturated magnetic island widths normalized by the plasma minor radius, for the lowest order individual tearing modes, are approximately 24% for the 2 / 1 mode and 12% for the 3 / 2 mode. As a result, the ratio of ITER fusion power to heating power ͑fusion Q͒ is reduced from Q = 10.6 in simulations with no NTM islands to Q = 2.6 in simulations with fully saturated NTM islands.