Inexpensive weight management program could improve health and reduce medical costs

A weight management program for inactive and retired military members and their families could improve health and reduce medical costs, according to a new study by researchers at RTI International, Virginia Commonwealth University, University of South Carolina, Cooper Institute, and TRICARE Management Activity.

The study, published online in Preventive Medicine, found that patients lost weight, increased physical activity and decreased blood pressure when participating in the Healthy Eating and Active Living in TRICARE Households (HEALTH) weight management program.

TRICARE is the health care program serving active duty service members, National Guard and Reserve members, retirees, families and survivors worldwide.

HEALTH weight management sought to help participants implement goal setting, problem solving and self-monitoring skills, and build social support for lifestyle changes.

"We found that a relatively inexpensive cognitive-behavioral weight management intervention improved patient outcomes," said Jim Hersey, Ph.D., a senior research psychologist at RTI and the study's lead author. "TRICARE tends to cover beneficiaries from the time of enrollment until they reach Medicare eligibility. Thus, a modest weight loss intervention that leads to savings for the entire TRICARE population would significantly reduce direct medical costs."

Almost 1,800 non-active duty TRICARE beneficiaries living in four Midwestern states participated in the study. The participants were divided into three groups: the first group received written materials and basic web access; the second group received the same materials as the first plus access to an interactive website that provided computerized feedback; and the third group received the same access as the second group as well as telephone and email coaching support every two weeks.

The study assessed changes in weight, blood pressure and physical activity at baseline, six months, one-year, and 15 to 18 months.

The findings showed that all three methods led participants to lose about 4.6 percent of their body weight after six months and one year, and 3.7 percent after 15 or 18 months. Almost one-third of participants lost 7 percent or more of their body weight. However, there were no significant differences in weight loss among the three groups.

The study also found that the proportion of participants engaging in regular physical activity increased significantly from 29.1 percent to 40.2 percent after one year and up to 44.2 percent after 15 to 18 months.

The researchers also found the weight management program to be cost-effective. The study found that for the first two groups $30 to $40 per person was required to produce a 1 percent weight loss. For the third group approach, which included coaching support, $70 per person was required to produce a 1 percent weight loss.

For the first two groups, the researchers estimated the savings in medical costs would equal $500 per participant and the costs of providing the program would be recouped in three years.

For the third group, the researchers found the medical costs savings would be $750 per participant and would take six years to recoup the cost of providing the program.

"The cost-effectiveness of the HEALTH weight management program compares favorably with other preventive health programs, such as smoking cessation counseling and cholesterol education," Hersey said. "It is more cost-effective than bariatric procedures."