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Utility Decrements Associated with Adult Overweight and Obesity in Australia: A Systematic Review and Meta-Analysis


  • Joseph Carrello

    (University of Sydney)

  • Alison Hayes

    (University of Sydney)

  • Anagha Killedar

    (University of Sydney)

  • Amy Huben

    (University of Sydney)

  • Louise A. Baur

    (University of Sydney
    University of Sydney)

  • Stavros Petrou

    (University of Oxford, Radcliffe Observatory Quarter)

  • Thomas Lung

    (University of Sydney
    The George Institute for Global Health, University of New South Wales)


Objective The aim was to conduct a systematic review and meta-analysis of health state utility decrements associated with overweight and obesity in adults 18 years and over, for use in modelled economic evaluations in Australia. Methods A systematic review was conducted in nine databases to identify studies that reported health state utility values by weight status. Random-effects meta-analysis was used to synthesise average utility decrements (from healthy weight) associated with overweight, all obesity and obesity classes 1, 2 and 3. Heterogeneity surrounding utility decrements was assessed via sub-group analysis, random-effects meta-regression and sensitivity analyses. Results Twelve studies were found for which data were used to synthesise utility decrements, estimated as overweight = 0.020 (95% confidence interval 0.010–0.030), all obesity = 0.055 (0.034–0.076), obesity class 1 = 0.047 (0.017–0.077), class 2 = 0.072 (0.028–0.116) and class 3 = 0.084 (0.039–0.130). There was considerable heterogeneity in our results, which could be accounted for by the different ages and utility instruments used in the contributing studies. Conclusions Our results demonstrate that elevated weight status is associated with small but statistically significant reductions in utility compared with healthy weight, which will result in reduced quality-adjusted life years when extrapolated across time and used in economic evaluations.

Suggested Citation

  • Joseph Carrello & Alison Hayes & Anagha Killedar & Amy Huben & Louise A. Baur & Stavros Petrou & Thomas Lung, 2021. "Utility Decrements Associated with Adult Overweight and Obesity in Australia: A Systematic Review and Meta-Analysis," PharmacoEconomics, Springer, vol. 39(5), pages 503-519, May.
  • Handle: RePEc:spr:pharme:v:39:y:2021:i:5:d:10.1007_s40273-021-01004-x
    DOI: 10.1007/s40273-021-01004-x

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    References listed on IDEAS

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    4. Ejis, 2017. "Table of Contents," European Journal of Interdisciplinary Studies, Bucharest Economic Academy, issue 01, March.
    5. Pickles, Kristen & Lancsar, Emily & Seymour, Janelle & Parkin, David & Donaldson, Cam & Carter, Stacy M., 2019. "Accounts from developers of generic health state utility instruments explain why they produce different QALYs: A qualitative study," Social Science & Medicine, Elsevier, vol. 240(C).
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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Journal round-up: PharmacoEconomics 39(5)
      by Don Husereau in The Academic Health Economists' Blog on 2021-07-16 06:00:06

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