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| Modeled Output | Definition |
| Reach | |
| First Year Population Reach* | The number of people reached by the strategy in the first year of strategy implementation. |
| 10-Year Population Reach* | The number of people reached by the strategy over the model period. |
| Cost | |
| Average Annual Implementation Cost | The average annualized cost to implement the strategy over the model period. This includes cost by all payers (government, private sector, non-profit, individual/family). |
| Cost per Person | The average annualized cost to implement the strategy over the model period (e.g., 10 years) per person reached over the model period. This includes cost by all payers (government, private sector, non-profit, individual/family). |
| 10-Year Impact on Health and Health Care Costs | |
| Cases of Obesity Prevented* (In the final year of the model) |
In the final year of the model, the difference in the projected number of people with obesity if the strategy were not put in place and the projected number of people with obesity if the strategy were put in place. |
| Cases of Child Obesity Prevented* (In the final year of the model) |
In the final year of the model, the difference in the projected number of children with obesity if the strategy were not put in place and the projected number of children with obesity if the strategy were put in place. |
| Health Care Costs Saved | The amount avoided in health care cost related to excess weight over the model period. See the CHOICES Microsimulation Model Technical Documentation for more information about health care costs included in the CHOICES model. |
| Net Costs Difference | This is a cumulative measure of total cost impact. It includes costs to implement a strategy, cost savings due to efficiencies when implementing a strategy, and health care cost savings related to reductions in excess weight after a strategy is implemented. When net costs difference is negative, it means cost savings. |
| Quality-Adjusted Life Year (QALYs) Gained | The difference in total number of quality-adjusted life years (QALYs) in the population over the model period if the strategy were not put in place compared with if the strategy were put in place. A QALY is a measure of both the quantity and quality of life. CHOICES estimates the QALYs gained as a measure of how much implementing a strategy to prevent future excess weight gain could improve the quantity and quality of life for a population. See our CHOICES National Action Kit 2.0 User Guide and the CHOICES Microsimulation Model Technical Documentation for more information about health-related quality of life and QALYs. |
| Years with Obesity Prevented | The difference in total number of person-years lived without obesity if the strategy were not put in place compared with if the strategy were put in place. This measure sums up portions of years lived without obesity across all the persons in the model, comparing the result if the strategy were put in place or not. |
| Life Years Gained | The difference in total number of years of life in the population over the model period if the strategy were not put in place compared with if the strategy were put in place. |
| Deaths Averted* | The difference in total number of deaths related to excess weight in the population over the model period if the strategy were not put in place compared with if the strategy were put in place. See the CHOICES Microsimulation Model Technical Documentation for more information about how CHOICES measures BMI-related mortality reduction due to intervention. |
| Health Care Costs Saved per $1 Invested | The amount avoided in health care cost related to excess weight for every dollar spent to implement the strategy over the model period. A value greater than $1 means the strategy is “cost-saving”, meaning the health care costs saved are greater than the costs to implement the strategy. See the CHOICES Microsimulation Model Technical Documentation for more information about health care costs included in the CHOICES model. |
| Cost per Year with Obesity Prevented | The total cost impact to prevent someone living with obesity for a year. This is a measure of cost-effectiveness. It includes costs to implement a strategy, cost savings due to efficiencies when implementing a strategy, and health care cost savings related to reductions in excess weight after a strategy is implemented. If a strategy costs less to implement than the health care costs saved, it is considered a “cost-saving” intervention. |
| Cost per Quality-Adjusted Life Year (QALY) Gained | The total cost impact to improve population health in terms of quality-adjusted life years gained. Cost per QALY gained is a measure of cost-effectiveness. It includes costs to implement a strategy, cost savings due to efficiencies when implementing a strategy, and health care cost savings related to reductions in excess weight after a strategy is implemented. If a strategy costs less to implement than the health care costs saved, it is considered a “cost-saving” intervention. See our User Guide for more information about QALYs and cost per QALY gained and the CHOICES Microsimulation Model Technical Documentation for more information about health-related quality of life. |
| Cost per Life Year Gained | The total cost impact to improve population health in terms of years of life gained. This is a measure of cost-effectiveness. It includes costs to implement a strategy, cost savings due to efficiencies when implementing a strategy, and health care cost savings related to reductions in excess weight after a strategy is implemented. If a strategy costs less to implement than the health care costs saved, it is considered a “cost-saving” intervention. |
| Cost per Death Averted | The total cost impact to improve population health in terms of deaths averted. This is a measure of cost-effectiveness. It includes costs to implement a strategy, cost savings due to efficiencies when implementing a strategy, and health care cost savings related to reductions in excess weight after a strategy is implemented. If a strategy costs less to implement than the health care costs saved, it is considered a “cost-saving” intervention. See the CHOICES Microsimulation Model Technical Documentation for more information about how CHOICES measures BMI-related mortality reduction due to intervention. |
All metrics reported for the population over the model period and discounted at 3% per year, unless otherwise noted. Discounting converts future costs and benefits to their present value.1,2 Definitions for these modeled outputs are all written assuming that an intervention is implemented. Metrics are reported for the population ages 2-100 years except where noted. Children are defined as ages 2-19 years.
* Not discounted.
1 Sanders GD, Neumann PJ, Basu A, et al. Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses Second Panel on Cost-Effectiveness in Health and Medicine. JAMA. 2016;316(10):1093-1103. doi:10.1001/jama.2016.12195
2 Neumann PJ, Ganiats TG, Russell LB, Sanders GD, Siegel JE, eds. Cost-Effectiveness in Health and Medicine. 2nd ed. Oxford University Press; 2016.
Last updated: September 17, 2025