Evaluating the Cost-Effectiveness of Nutrition Policies to Reduce the Obesogenic Effects of Restaurant and Fast Food Intake

Background:  Reducing obesogenic effects of restaurant and fast food intake is a national nutrition policy priority.  This study estimated the potential cost-effectiveness of national restaurant menu calorie labeling and a proposed 20 percent fast food sales tax.

Methods:  The Childhood Obesity Intervention Cost Effectiveness Study (CHOICES) microsimulation model and systematic review process was used to estimate the cost-effectiveness of nutrition policies targeting restaurant and fast food intake.  Healthcare costs averted and cost-effectiveness of ten-year reductions in body mass index (BMI), childhood obesity and gains in quality-adjusted life years (QALYs) were estimated for the 2015 U.S. population.

Results: Implementing menu labeling and the fast food tax would cost $278 million and $141 million in the first year, respectively, and would reach approximately 90 million youth.  Based on a meta-analysis of menu labeling studies, menu labeling was estimated to reduce per capita BMI among youth by -0.014 units (95% Uncertainty Interval (UI): -0.039; 0.011).  Based on published estimates of fast food demand and relationship between fast food intake and BMI, the fast food tax was estimated to reduce BMI among youth by -0.002 units (95%UI: -0.005, 0). Results on healthcare costs and cost-effectiveness to reduce childhood and adult obesity and increase QALYs will be presented. 

Conclusions: The proposed policies would likely have limited impact on reducing childhood obesity.  However, due to higher fast food and restaurant intake as well as a stronger relationship between intake and BMI among adults, these policies are expected to have a greater impact on reducing adult obesity.