Australian Study Explores Relative Cost Effectiveness of Different Treatment Programs: Modelling Suggests Potential Long-term Advantage of Referral to Dedicated Weight Management Program

Silver Spring, Maryland, UNITED STATES

Silver Spring, MD, Aug. 27, 2018 (GLOBE NEWSWIRE) -- New research suggests that cost savings could be realized when patients receive a referral to a commercial weight management program instead of receiving care from their primary care provider alone, according to a study published in the August issue of Obesity. The University of Sydney study is the first to use a modelling approach to predict the potential population cost effectiveness of referral to a dedicated weight management program for weight management.

Based on the outcomes of the simulation, the authors estimate that over a 10-year period, implementation of physician referral to a local Weight Watchers program might help avert as many as 60,500 cases of obesity nationwide and reduce obesity-related healthcare costs by as much as $17 million (Australian dollars).

“Primary care professionals are facing an increasing number of patients with obesity needing treatment,” said Dr. Sharyn Lymer, the study’s lead author and research fellow at the Boden Institute of Obesity Nutrition, Exercise and Eating Disorders at the University of Sydney in Australia. Lymer added that the results of the study suggest another potentially more cost effective treatment opportunity.

The study’s authors explain that the obesity epidemic continues to persist in Australia. More than 63 percent of Australians aged 18 years and older had overweight or obesity in 2014 and 2015. The excess cost of direct healthcare for Australians aged 18 years and older who have obesity was reported at $3.8 billion (Australian dollars) in 2015—equivalent to 2.5 percent of the total Australian healthcare cost.

To determine the potential cost savings with a referred care approach, researchers used microsimulation—a method of modelling real-life events by simulating the actions of individual units that comprise a system. Researchers modelled the Australian population with eligibility for the intervention for those between the ages of 20 to 64 who had a body mass index (BMI) equal to or higher than 27 kg/m2.

In the simulation, it was assumed that 17.5 percent of eligible participants would opt to receive a referral from their primary care physician to attend a weekly community meeting of the Weight Watchers program and that 61 percent of those would complete the one-year program. For those receiving standard care, the model assumed the same participation rate but with a 54 percent completion rate.  The standard care approach included receiving weight management advice and monitoring from their general practitioner or primary care physician for an average of ten 20-minute consultations over a year.  Simulations of both interventions were used to predict population health outcomes after one, five and 10 years.

The model predicted that referral to a commercial program would lead to a one percent decrease in the prevalence of obesity after one year, while use of the standard care approach would generate a half percent decrease.  Both decreases are predicted to continue over the full 10-year period modelled.  The authors also note that the model predicted that the commercial weight management intervention would perform better on every health and economic outcome examined.

The authors note that while simulations predicted that both interventions would reduce the number of adults with obesity, neither approach would allow the country to meet the World Health Organization recommendations for population obesity levels in 2025.

Lymer and Michelle Cardel, PhD, MS, RD, FTOS, an assistant professor in the Department of Health Outcomes and Biomedical Informatics at the University of Florida College of Medicine, both agree that greater access to care is needed, including population-level, cost-effective interventions to address obesity.

“The use of a simulation model to predict cost-savings for the Weight Watchers-based program as an obesity treatment provides interesting and novel data” said Cardel. “While this is exciting news, simulation models are a simplification of the complex reality that can occur when seeking obesity treatment, and thus possesses inherent limitations. Future study is needed to assess if provider referral to Weight Watchers on a large-scale would result in clinically meaningful weight loss over the long-term.”

The development of the microsimulation model used in this study was funded by a National Health and Medical Research Council program grant. Weight Watchers International provided no financial or other support for this study, and the authors declared no research funding or other remuneration from Weight Watchers. Lymer, Deborah Schofield and Stephen Colagiuri have received grants for other research from Novo Nordisk. Nicholas Fuller and Ian Caterson have received research grants from Sanofi, Allergan, Eli Lilly and Novo Nordisk. Caterson was a board member for the SCOUT trial, is on the EXSCEL Operations Committee, and has received payment for lectures from iNova Pharmaceuticals, Pfizer Australia and Servier Laboratories (Australia). Michelle Cunich and Crystal Man Ying Lee declared no conflict of interest.

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The Obesity Society (TOS) is the leading organization of scientists and health professionals devoted to understanding and reversing the epidemic of obesity and its adverse health, economic and societal effects.  Combining the perspective of physicians and other clinicians, scientists, policymakers and patients, TOS promotes innovative research, education, and evidence-based clinical care to improve the health and well-being of all people with obesity. For more information, visit and connect with us on Facebook, Twitter and LinkedIn.


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