Cost-effectiveness and the need for coordinated action
A comprehensive set of interventions needs to employ the full set of mechanisms for changing
physical activity and nutritional behavior. Education about the risks of obesity is important; so is
taking personal responsibility for one’s health, fitness, and weight. But all the evidence shows that
these are not sufficient on their own to offset the body’s desire to eat that has been honed over
millennia of evolution. People need help and that means a change in the environment in which they
are making choices – change such as reduced standard portion sizes, changing marketing practices,
and restructuring cities and educational establishments to make it easier for people to exercise.
Our analysis for the UK suggests that almost all the interventions identified are cost-effective for
society – savings on healthcare costs and higher productivity could outweigh the direct investment
required to deliver the intervention when assessed over the full lifetime of the target population. An
integrated program to reverse rising obesity could save the National Health Service about $1.2 billion
a year. It is important to note that not all of the interventions are cost-effective for the specific
stakeholder delivering them. Sometimes the return on investment lands elsewhere in the economy,
the benefits going to households or to healthcare systems, for instance. This misalignment of
economic incentives is one of the major challenges inhibiting concerted coordinated action on
obesity.
Figure 2. Cost-effective interventions to reduce obesity in the United Kingdom include controlling
portion sizes and reducing the availability of high-calorie foods.