Utility values for childhood obesity interventions: a systematic review and meta‐analysis of the evidence for use in economic evaluation

Rigorous estimates of preference‐based utilities are important inputs into economic evaluations of childhood obesity interventions, yet no published review currently exists examining utility by weight status in paediatric populations. A comprehensive systematic literature review and meta‐analysis was therefore undertaken, pooling data on preference‐based health state utilities by weight status in children using a random‐effects model. Tests for heterogeneity were performed, and publication bias was assessed. Of 3,434 potentially relevant studies identified, 11 met our eligibility criteria. Estimates of Cohen's d statistic suggested a small effect of weight status on preference‐based utilities. Mean utility values were estimated as 0.85 (95% uncertainty interval [UI] 0.84–0.87), 0.83 (95% UI 0.81–0.85), 0.82 (95% UI 0.79–0.84) and 0.83 (95% UI 0.80–0.86) for healthy weight, overweight, obese and overweight/obese states, respectively. Meta‐analysis of studies reporting utility values for both healthy weight and overweight/obese participants found a statistically significant weighted mean difference (0.015, 95% UI 0.003–0.026). A small but statistically significant difference was also estimated between healthy weight and overweight participants (0.011, 95% UI 0.004–0.018). Study findings suggest that paediatric‐specific benefits of obesity interventions may not be well reflected by available utility measures, potentially underestimating cost‐effectiveness if weight loss in childhood/adolescence improves health or well‐being.