The cost‐effectiveness of the LighterLife weight management programme as an intervention for obesity in England

Abstract

LighterLife Total is a very low calorie diet total dietary replacement weight reduction programme that provides Foodpacks, behavioural change therapy and group support appropriate for people with a body mass index of 30 kg m(-2) or above. A model was built to assess the cost-effectiveness of LighterLife Total, compared with (i) no treatment, Counterweight, Weight Watchers and Slimming World, as a treatment for obesity in those with a body mass index of 30 kg m(-2) or above, and (ii) no treatment, gastric banding and gastric bypass in those with a body mass index of 40 kg m(-2) or above. Change in body mass index over time was modelled, and prevalence of comorbidities (diabetes, coronary heart disease and colorectal cancer) was calculated. Costs (of intervention and treatment for comorbidities) and quality-adjusted life years were calculated. LighterLife Total was cost-effective against no treatment, Counterweight, Weight Watchers and Slimming World in the 30+ kg m(-2) group (incremental cost-effectiveness ratios: £11 895, £12 453, £12 585 and £12 233, respectively). In the 40+ kg m(-2) group, LighterLife Total was cost-effective against no treatment (incremental cost-effectiveness ratio: £4356), but less effective than gastric banding and bypass.

Lifestyle Interventions to Prevent Type 2 Diabetes: A Systematic Review of Economic Evaluation Studies

“…One study performed the economic analysis of lifestyle changes achieved through e-learning devices [ 32 ]. Another economic evaluation from the United Kingdom was conducted on a program focusing on very low-calorie diets [ 34 ]. Two studies reported on the economic evaluation of interventions consisting solely of physical activity [ 21 , 35 ].…”

“…Sensitivity analysis, which allows assessing the reliability and the generalizability of the results [ 42 ], was performed in all studies except one [ 34 ]. Over half the studies performed univariate sensitivity analysis and eight studies performed bivariate sensitivity analysis.…”

“…Most articles lacked one or several reporting items of the BMJ checklist for quality of economic evaluation studies although this checklist was issued before these studies were conducted. Another limitation observed is the lack of a clear description of the models [ 34 ], while the guidelines recommend transparency in their description [ 47 ]. In some cases, the models did not adequately capture the natural history of the disease, leading to questionable conclusions.…”

A Systematic Review of Methods to Predict Weight Trajectories in Health Economic Models of Behavioral Weight-Management Programs: The Potential Role of Psychosocial Factors

“…Thirty HEMs cited an evidence source for estimated weight loss that reported no measurement of psychosocial variables. [24][25][26][27][28][29][30][31][32][33][35][36][37][38][39][40]42,44,46,[49][50][51][52]55,56,58,59,61,62,68 Psychosocial variables were measured in evidence sources cited in 8 HEMs (Table 3); 4 of these HEMs 43,45,48,53 each based the estimated weight loss on a single trial, but no analyses of the psychosocial variables measured in relation to the intervention or weight change were reported in the trial. Four HEMs 23,34,41,47 cited 5 trials that included some analysis of psychosocial factors.…”

“…Weight loss regained immediately. Eight HEMs [35][36][37][38][39][40][41][42] assumed that the intervention effect ceased after the trial follow-up and that those receiving the intervention immediately returned to the same weight as the control group. From this point onward, there was no weight difference between the intervention and control groups; their weight either remained at that value for the remainder of the time horizon [35][36][37][38][39]42 or followed a natural history trajectory 40,41 (Figure 2b).…”