The Return on Investment for the Prevention and Treatment of Childhood and Adolescent Overweight and Obesity in Beijing: A Modeling Study

Author:

Li Zhenhui12ORCID,Meyer Christina L.3ORCID,Xu Haiquan4ORCID,Jackson-Morris Angie3,Zhang Man25ORCID,Wu Daphne3,He Hairong6,Chang Suying7,Ma Guansheng12ORCID

Affiliation:

1. Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China

2. Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing 100191, China

3. Center for Global Noncommunicable Diseases, RTI International, Durham, NC 12106, USA

4. Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing 100081, China

5. School of Nursing, Peking University, Beijing 100191, China

6. Beijing Center for Disease Control and Prevention, Beijing 100191, China

7. Child Health Development Section, United Nations International Children’s Emergency Fund (UNICEF) Office for China, Beijing 100600, China

Abstract

Background: The increasing prevalence of child and adolescent overweight and obesity (CAOAO) in Beijing poses significant health and economic challenges. This study assesses the potential health and economic outcomes of implementing specific interventions to address CAOAO in Beijing. Methods: A deterministic Markov cohort model was used to estimate the impact of five interventions from 2025 to 2115: restrictions on unhealthy food marketing to children, mandatory front of package labeling (FOPL), family-based nutrition and exercise education, school-based nutritional health education, and nutritional counseling in primary healthcare. The model evaluated societal costs, healthcare savings, wages, and economic productivity in adulthood, calculating the return on investment (ROI) for each intervention and their combined effect. Result: Without intervention, Beijing is projected to experience a loss of 13.4 million disability-adjusted life years (DALYs) due to CAOAO. The health and economic impact of childhood obesity in Beijing is projected to be CNY 14.6 trillion (USD 2.1 trillion), or a lifetime loss of CNY 6.8 million (USD 0.96 million) per affected child, exceeding the sum of Beijing’s GDP from 2021 to 2023. Restrictions on unhealthy food marketing to children and nutrition counseling in primary healthcare are projected to yield the highest returns, with benefits accruing within one year of implementation. Owing to the substantial upfront costs, including personnel, materials, and training, school-based and family-based interventions require a longer time horizon to realize significant health and economic benefits. Conclusions: Effective management of CAOAO in Beijing demands a multifaceted approach. The combination of restrictions on unhealthy food marketing to children, mandatory front of package labeling, nutrition counseling in primary healthcare, school-based intervention, and family-based intervention presents the most substantial health and economic returns. This comprehensive strategy aligns with global best practices and addresses the unique challenges faced by Beijing in combating childhood obesity.

Funder

UNICEF China

Publisher

MDPI AG

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