Obesity is a complex, multi-factorial chronic disease, affecting 28% of Australian adults in 20151. In 2016, The Australian Obesity Management Algorithm, a practical clinical tool for use in primary care, was released. The Algorithm sets target weight loss for four different sub-groups of persons with obesity. This study aimed to investigate the potential impact if such levels of weight loss could be achieved nationally and the cost implications.
The study used NCDMod2, a microsimulation model that simulates inter-relationships of risk factors (including obesity), chronic disease and health system costs. NCDMod operates in 5 year cycles projecting to 2030. The main scenario simulated 20% of potential patients with obesity achieving their target weight loss and maintaining weight loss for the 15 year simulation. Sensitivity analysis was done including addition of drop-out/failure to lose weight despite starting treatment as set out by the obesity management algorithm. Key health outcomes were: Decrease in body mass index, cardiovascular disease events averted, quality adjusted life years gained and health system cost offsets.
In comparison to weight trajectories remaining at historical levels, implementation of the Obesity Management Algorithm estimates almost 500,000 less persons with obesity in 2030, resulting in a cost offset in the health system over the 15 years to 2030 of Au$12.7 billion to potentially fund the required weight management programs. Even assuming that 40% of those that start the program either drop-out or fail to lose weight, there still would be 280 000 less persons with obesity in 2030 providing health system cost-offsets of Au$7.7 billion.
The need to facilitate multifaceted, intensive weight management programs described in The Australian Obesity Management Algorithm is illustrated in this simulation, showing the potential decrease in persons with obesity over time and the freeing of health system funding to pay for such services.