A systematic review of the economic value proposition for commercially available nonsurgical weight-loss interventions

Obesity (Silver Spring). 2023 Jul;31(7):1725-1733. doi: 10.1002/oby.23760. Epub 2023 May 25.

Abstract

Objective: The study aim was to review the economic evaluation literature of commercially available and effective nonsurgical weight-loss interventions to investigate whether there is evidence to support claims of cost-effectiveness (i.e., good value for money) or cost savings (i.e., a positive return on investment).

Methods: Relevant databases were systematically reviewed to identify economic evaluations of commercially available weight-loss products and services shown to result in clinically significant weight loss. Five weight-loss medications (orlistat, liraglutide, naltrexone-bupropion, semaglutide, and phentermine-topiramate), two meal replacement programs (Jenny Craig, Optifast), and one behavioral intervention (Weight Watchers [WW]) that met inclusion criteria were identified. After screening, 32 relevant comparisons of cost-effectiveness or cost savings across 20 studies were identified.

Results: Ten of twenty pharmaceutical comparisons showed evidence of cost-effectiveness based on established thresholds. Four of twelve nonpharmaceutical comparisons provided evidence of cost-effectiveness, and five made claims of cost savings. However, methodological concerns cast doubt on the robustness of these claims.

Conclusions: Evidence of cost-effectiveness for commercially available, evidence-based, nonsurgical weight-loss interventions is mixed. There is no evidence for cost-saving weight-loss medications and only weak evidence for behavioral and weight-loss interventions. Results provide a call to action to generate more robust evidence of the economic value proposition for these interventions.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Anti-Obesity Agents* / therapeutic use
  • Cost-Benefit Analysis
  • Humans
  • Liraglutide / therapeutic use
  • Orlistat
  • Weight Loss

Substances

  • Anti-Obesity Agents
  • Orlistat
  • Liraglutide