A systematic review of the economic value proposition for commercially available nonsurgical weight‐loss interventions

Abstract Objective The study aim was to review the economic evaluation literature of commercially available and effective nonsurgical weight‐loss interventions to investigate whether there is evidence to support claims of cost‐effectiveness (i.e., good value for money) or cost savings (i.e., a positive return on investment). Methods Relevant databases were systematically reviewed to identify economic evaluations of commercially available weight‐loss products and services shown to result in clinically significant weight loss. Five weight‐loss medications (orlistat, liraglutide, naltrexone‐bupropion, semaglutide, and phentermine‐topiramate), two meal replacement programs (Jenny Craig, Optifast), and one behavioral intervention (Weight Watchers [WW]) that met inclusion criteria were identified. After screening, 32 relevant comparisons of cost‐effectiveness or cost savings across 20 studies were identified. Results Ten of twenty pharmaceutical comparisons showed evidence of cost‐effectiveness based on established thresholds. Four of twelve nonpharmaceutical comparisons provided evidence of cost‐effectiveness, and five made claims of cost savings. However, methodological concerns cast doubt on the robustness of these claims. Conclusions Evidence of cost‐effectiveness for commercially available, evidence‐based, nonsurgical weight‐loss interventions is mixed. There is no evidence for cost‐saving weight‐loss medications and only weak evidence for behavioral and weight‐loss interventions. Results provide a call to action to generate more robust evidence of the economic value proposition for these interventions.