Projected healthcare costs of obesity and anticipated return on investment in environmental obesity prevention efforts

Introduction: Despite a slowing growth rate among some populations, the obesity problem continues to get worse, both clinically and financially. This study estimated the costs of obesity and the anticipated return on investment (ROI) associated with a set of evidence-based obesity prevention policies/programs in one of the five largest U.S. counties. 

Approach: Using MATLAB 2013 and incorporating county-specific population projections, archival data, and estimates from published research, we simulated a series of healthcare cost projections associated with reductions in obesity over the next 5-25 years.  Using available estimates on the projected persistence of obesity into adulthood, avoided healthcare costs, and potential intervention effectiveness, we further calculated the ROI associated with three prioritized strategies: active transport, structured recess/P.E., and food retail incentives.

Results: Compared to cost projections associated with continuing increases in obesity, holding current obesity rates constant could save $1.03 billion in 5 years and $1.44 billion in 25 years.  A 5% decrease from current county obesity rates could save $550 million in 5 years and $800 million in 25 years.  Interventions that reduce the number of children who become obese adults by 5-25% would be cost effective at expenditures ranging from $2-$2.9 million and $8-$15 million, respectively.

Discussion: Preventing and reducing obesity could save billions in avoided healthcare expenditures. Given the potential scope of effect, structured physical activity efforts may be more cost-effective than active transport strategies. The cost-effectiveness of food retail incentives is uncertain, although concomitant efforts to lower prices of healthier food options may have greater potential.