Improving the cost-effectiveness of obesity programs: three basic strategies for reducing the cost per pound.

Empirical support is provided for three basic strategies of improving the cost-effectiveness of treatments for obesity. The importance of analyzing both the effectiveness and cost of different program components when attempting to improve cost-effectiveness is illustrated in the first two studies. First, the strength of relationships between changes in different eating behaviors and changes in obesity was assessed for a small sample of obese individuals. Change in only one of eight behaviors investigated was significantly and strongly correlated with change in obesity. Data also were collected on the subjective costs and benefits of changing 36 eating behaviors that are commonly included in treatments for obesity. Some eating behaviors were found to differ greatly in subjective cost and perceived benefit, as measured by clients' ratings of component difficulty and component usefulness. A final, quasi-experimental study demonstrated the importance of developing cost-effective systems for translating principles of treatment for obesity into actual treatment. The impact on cost-effectiveness in mind is illustrated in a comparison of dollars paid by clients in relation to percent reduction in obesity for two weight reduction programs. The studies are discussed as highlighting the importance of measuring the cost and effectiveness of alternative delivery systems for, and different components of, treatments for obesity.