Gortmaker et al. Am J Prev Med. 2015;49(1):102–111.

Advocates need data and evidence to choose among several strategies for reducing childhood obesity. Gortmaker and colleagues review the cost effectiveness of seven childhood obesity prevention interventions when applied to the US population.
They find that a sugary drink tax is one of three cost-effective interventions.

The authors conducted an evidence review and microsimulation (a computer model that The authors conducted an evidence review and microsimulation (a computer model that uses the best available data to estimate intervention effects) to calculate the costs and effectiveness of seven interventions based on their impact on body mass index (BMI) changes, obesity prevalence, and obesity-related health care costs over 10 years (2015–2025). Three policy actions reduced health care costs by more than the cost of the intervention: (1) placing a national excise tax on sugary drinks, (2) eliminating the tax subsidy for advertising unhealthy food to children, and (3) implementing nutrition standards for foods and beverages sold in schools outside of the National School Lunch Program. These interventions were found to reduce childhood obesity by 576,000, 129,000, and 345,000 cases respectively. Improving nutrition standards for school meals would have the largest impact on reducing the prevalence of childhood obesity, a reduction of 2.6% (1,186,000 cases), but is not cost saving because of the cost of the intervention.

A national sugary drink tax would reduce the prevalence of childhood obesity by 0.8%, a significant population-level impact for a single intervention. It would also save $14.2 billion in net costs, and raise $12.5 billion in tax revenue.

Limitations: Simulation models are sensitive to the assumptions and quality of included data. There is limited evidence linking the included interventions to population-level obesity prevalence. The authors did not account for the cumulative effects of all seven interventions or incorporate health improvements outside of reductions in obesity.

Implications: The findings provide advocates with useful information on how to choose among competing policy options based on relative impact. Policies like a sugary drink tax that reach adults and children have the dual benefit of reducing nearterm health care costs from adult obesity and laying the ground work for long-term savings through reductions in childhood obesity.