2004 ASBS Consensus Conference
The costs of nonsurgical and surgical weight loss interventions: Is an ounce of prevention really worth a pound of cure?

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Overview

We developed a modeled analysis with a base case consisting of a hypothetical cohort of morbidly obese white women, followed from a societal perspective over their entire lifetime. White women were selected because the majority of patients in GBP studies are white women [2]. These women were assigned to undergo GBP at age 40 if their body mass index (BMI) was ≥ 40 kg/m2, a common cutoff in studies for offering GBP. At age 40, this BMI cutoff corresponds to the upper 4.4% of the population of

Results

The base case scenario indicated that GBP was cost-effective at $7126 per QALY. Total costs for women undergoing GBP were $4600 higher, but these women had 0.61 years of additional life expectancy, the remainder of QALY gain due to improved quality of life. Which group had better quality of life depended on the age at which observation occurred; patients in the diet/exercise arm had better quality of life earlier in life, and those in the GBP arm had better quality of life later in life. The

Discussion

This cost-utility analysis indicates that GBP at age 40 is cost-effective compared with diet- and exercise-based intervention at age 18 among a cohort of obese white women. This finding is robust over a range of sensitivity analyses, including variation of the assumed outcome after the end of the period for which follow-up data are known. Whether women with BMI ≥ 33 kg/m2 at age 18 and those with BMI ≥ 40 kg/m2 at age 40 are the same individuals can be debated, because it is a major assumption

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