Some interventions that can reduce BMI may save more for society than they cost to implement. Other interventions may be relatively low-cost options for reducing BMI compared to more expensive interventions, like bariatric surgery.

The goal of the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Project’s cost-effectiveness analysis is to identify the best value for societal investment to reverse the obesity epidemic. The CHOICES project uses cost-effectiveness analysis to forecast the population-level costs and health effects of obesity prevention interventions in youth.

How cost-effectiveness analysis works

Cost-effectiveness analysis provides a structured, transparent process that integrates information from a range of sources on the economic cost and health effects of interventions. The primary outcome of cost-effectiveness analysis is the ratio of the net increase in costs from an intervention divided by the net gain in health effects.


  New strategy is less effective New strategy is more effective
New strategy costs more No deal or bad deal Good deal (depends on ratio/threshold)
New strategy costs less Good deal (depends on ratio/threshold) Great deal


One of the ways in which CHOICES measures cost-effectiveness is cost per BMI reduction. Each childhood obesity intervention is compared to the expected change in BMI levels and health outcomes if no interventions were conducted. By using the same cost-effectiveness framework for all of the obesity prevention interventions evaluated, the CHOICES project can compare the cost and health outcomes equally for each intervention.

Other outcomes identified by CHOICES include cost per Quality Adjusted Life Year (QALY) and cost per specified change in obesity prevalence. Read the CHOICES glossary for definitions of our modeled outputs.

Read the CHOICES Modeled Outputs Glossary